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Effectiveness of Human Immunodeficiency Virus Index Testing: A Global Scoping Review
Abhiruchi Galhotra1, Sanjana Agrawal2, Aditi Chandrakar1
1Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Background And Objective:
Over 2.5 million people are living with human immunodeficiency virus (HIV) in India. The World Health Organization recommends HIV self-screening and partner notification services. Index testing is a case-finding approach that focuses on eliciting the sexual or needle-sharing partners and biological children of HIV-positive individuals. This review aims to understand the effectiveness of index case testing in the uptake of HIV diagnosis and care.
Methods:
A scoping review was conducted to examine the effectiveness of HIV index case testing. Studies published between 2010 and 2024 in English were included. A total of 10 final studies were included in this scoping review. No such studies were found in the Indian context.
Results:
The studies were from Zimbabwe, Malawi, Nigeria, South Africa, Lesotho, Kenya, Zambia, Mozambique, and Ukraine. Sample sizes ranged from under 1,000 individuals to large-scale community-based programs enrolling over 38,000 participants. The studies demonstrated the effectiveness of index case testing in identifying previously undiagnosed HIV infections among sexual partners (up to 51%) and children (4.0-5.8%) of people living with HIV. The studies also indicated high acceptance rates and feasibility of the approach.
Conclusion And Global Health Implications:
HIV index case testing presents a valuable strategy for reaching diverse populations at risk for HIV infection and improving care linkages. Further research is needed to explore cost-effectiveness and optimize implementation strategies for various contexts.
