Can network-based testing services have an impact beyond testing for HIV?

Abstract

New strategies and innovations are needed to achieve ambitious global goals for the control of HIV, hepatitis B, hepatitis C and STIs. Network-based testing (NBT) services, including partner services, social network testing, and family and household testing, are a heterogeneous group of practices in which healthcare providers support clients with STIs or bloodborne infections to offer testing and/or other services to sexual or injecting partners, biological children, or household members or contacts. Although significant evidence supports the efficacy of NBT services to identify, diagnose and link to care partners and other contacts of people with HIV, there has been less direct research about NBT for viral hepatitis or STIs, or for providing prevention services to partners. Research is needed to better understand how NBT can best be utilised for multiple infections, specific populations and to achieve maximal impact. Integrating NBT service delivery to achieve testing, treatment and/or prevention for multiple infections may be efficient, and this might include dual or multiplex testing for different populations. Self-testing or self-sampling for partners may overcome barriers to testing. Providing partners who test negative with prevention options, including PrEP or hepatitis B vaccination where appropriate, might be a powerful way to expand prevention efforts for multiple pathogens. NBT is an important tool for identifying those in need of interventions; a better understanding of how to expand and integrate this tool may help achieve cross-cutting health outcomes globally.