Testing

The AGYW Programming & Implementation Repository contains resources relevant to AGYW programming that have been collated to support enhanced implementation and programming of Global Fund Catalytic Funding for HIV prevention among AGYW in Eastern and Southern Africa. Developed in collaboration with Global Fund in response to an identified need from the SEA sub-region, we are confident that you will all find the repository useful in your support of national AGYW programmes.

The repository is housed on Google Drive and is accessible without a Gmail account. The resources are organized in folders by key programming area and are easily searchable through a google sheet. Powerpoint slides have also been developed to help you navigate through the repository.

The spreadsheet and slideshow are available for download above.

Community and primary health facility platforms have been recognized as important, but under-utilized entry points to address the large prevention, case detection and treatment gaps faced by young children with TB and/or HIV. In 2014, WHO and UNICEF revised community health worker packages for integrated community case management (iCCM) targeting children under five years of age, to include screening and referral for TB and HIV (TB/HIV iCCM). As part of an integrated, child-centered approach, TB/HIV iCCM is recommended for use in high TB and HIV burden settings.

Developed by UNICEF and Save the Children, Lessons from the Field (Uganda, Nigeria, Malawi) and Guidance (under development) are available for download.

This brief summarizes lessons learned from Zimbabwe’s pilot implementation of integrated or multi-disease testing. Partnerships in the country focused on leveraging existing GeneXpert platforms for both TB and HIV testing to improve access to early infant HIV diagnosis and viral load testing. These findings describe the benefits of integrated testing for clients, health providers and the health system and are a resource for other countries scaling up point-of-care integrated testing.

This brief highlights the current scenario of policies and programmes related to point-of-care viral load testing among pregnant and breastfeeding women living with HIV. In many countries, viral load policies are not differentiated for pregnant and breastfeeding women despite evidence that point-of-care viral load testing is helpful for this population. Same-day results for pregnant and breastfeeding women can help ensure timely initiation of ART, improved rates of viral suppression and retention in care to support efforts of preventing vertical transmission of HIV.

Susceptible de changer la donne en matière de traitement pédiatrique du VIH, le dépistage précoce du nourrisson (DPN) sur le lieu de soins est une approche innovante visant à renforcer les programmes de DPN et il améliore les résultats en matière de santé pour les enfants les plus jeunes et les plus vulnérables.

A game changer for paediatric HIV, point-of-care early infant diagnosis (POC EID) is an innovative approach to strengthen EID programs, and improve health outcomes for the youngest and most vulnerable children.

Paediatric HIV treatment coverage is stagnating. The most recent estimates suggest that only 46% of children living with HIV are on treatment, well below the AIDS Free target of 1.6 million by the end of 2018. A key challenge is to identify children who are living with HIV that have been missed through routine testing services.

For children in the 0-14 year age group, over 95% of HIV infections are acquired as a result of vertical transmission. As a result, historical approaches to pediatric diagnosis have tended to focus on early infant diagnosis (EID) within the context of prevention of mother-to-child-transmission (PMTCT) programs.

Testing the family of adult or child ‘index’ cases can serve as an entry point for identification of children living with HIV not identified through PMTCT program
testing. This type of family-based approach to HIV testing and service delivery enables parents and their children to access care as a unit. Such approaches may improve retention and offer a convenient service for families affected by HIV.

This is part of a series of 12 policy briefs by the Child Survival Working Group on scaling up key interventions for children and adolescents living with HIV. Learn more. 

Despite remarkable progress in prevention of mother-to-child transmission of HIV (PMTCT), 160,000 children were newly infected with HIV in 2016. Less than half of HIV-exposed infants (HEI) received early infant diagnosis (EID) within 6 weeks of life, a major challenge for early antiretroviral therapy for HIV-positive infants. Although introduction of dried blood spot (DBS) has increased EID access, conventional laboratory networks have relatively long (22-60 days) turnaround time, resulting in low proportions of results returned and missed opportunities for ART initiation. The WHO conditionally recommends introduction of point-of-care (POC)/ near-POC nucleic acid testing (NAT) for EID.

Recent encouraging evidence for POC/ near-POC EID warrants consideration of rapid adoption and strategic scale-up of this solution complementing the existing laboratory network.

This is part of a series of 12 policy briefs by the Child Survival Working Group on scaling up key interventions for children and adolescents living with HIV. Learn more.