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Integrating status-neutral and targeted HIV testing in Zimbabwe: A complementary strategy
Hamufare D Mugauri1, Owen Mugurungi2, Joconiah Chirenda1
1Faculty of Medicine and Health Sciences, The University of Zimbabwe, Global, Public Health and Family Medicine Department, Harare, Zimbabwe.
Plos One
|February 24, 2025
Summary
Zimbabwe
Area of Science:
- Public Health
- Epidemiology
- HIV/AIDS Research
Background:
- Zimbabwe transitioned from targeted HIV testing to status-neutral testing in 2022.
- Targeted testing focuses on high-risk groups, while status-neutral testing emphasizes post-test linkage to care.
- Understanding the practical correlation between these strategies is crucial for effective HIV case identification and management.
Purpose of the Study:
- To explore the correlation between status-neutral and targeted HIV testing approaches in Zimbabwe.
- To develop an integrated strategy for effective HIV case identification and linkage to prevention and treatment services.
- To assess the impact of screening on HIV positivity ratios and linkage to post-test services.
Main Methods:
- Cross-sectional study conducted across 36 sites in 4 Zimbabwean provinces.
- Utilized a national screening algorithm to identify at-risk individuals; screened-out individuals received HIV self-testing (HIVST).
- Analyzed HIV positivity ratios and linkage to services using univariate, bivariate, and multivariate analyses (significance level: 5%).
Main Results:
- Of 23,058 tests, 75.1% positivity was observed among at-risk screened patients.
- Individuals aged 45-49, males, and those undergoing first-time testing showed higher positivity rates.
- Screened patients had a significantly higher linkage rate (3.89 times) to HIV prevention services compared to non-screened patients.
Conclusions:
- The study demonstrates the complementarity of status-neutral and targeted HIV testing strategies.
- Integrating these approaches enhances the identification and management of individuals living with HIV.
- This combined strategy optimizes resource utilization and improves health outcomes in low- and middle-income countries.
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