BACKGROUND: HIV index testing, an intervention in which HIV-positive "indexes" (persons diagnosed with HIV) are supported to recruit their "contacts" (sexual partners and children) efficiently identifies HIV-infected persons in need of treatment and HIV-uninfected persons in need of prevention. However, index testing implementation in sub-Saharan African health care settings has been suboptimal. The objective of this study was to develop and pilot test a blended learning capacity-building package to improve index testing implementation in Malawi. METHODS: In 2019, a blended learning package combining digital and face-to-face training modalities was field tested at 6 health facilities in Mulanje, Malawi using a pre-/post- type II hybrid design with implementation and effectiveness outcomes. Health care worker (HCW) fidelity to the intervention was assessed via observed encounters before and after the training. Preliminary effectiveness was examined by comparing index testing program indicators in the 2 months before and 4 months after the training. Indicators included the mean number of indexes screened, contacts elicited, and contacts who received HIV testing per facility per month. RESULTS: On a 30-point scale, HCW fidelity to index testing protocols improved from 6.0 pre- to 25.5 post-package implementation (P = 0.002). Index testing effectiveness indicators also increased: indexes screened (pre = 63, post = 101, P < 0.001); contacts elicited (pre = 75, post = 131, P < 0.001); and contacts who received HIV testing (pre = 27, post = 41, P = 0.014). CONCLUSIONS: The blended learning package improved fidelity to index testing protocols and preliminary effectiveness outcomes. This package has the potential to enhance implementation of HIV index testing approaches, a necessary step for ending the HIV epidemic.
BACKGROUND: HIV index testing, an intervention in which HIV-positive "indexes" (persons diagnosed with HIV) are supported to recruit their "contacts" (sexual partners and children) efficiently identifies HIV-infected persons in need of treatment and HIV-uninfected persons in need of prevention. However, index testing implementation in sub-Saharan African health care settings has been suboptimal. The objective of this study was to develop and pilot test a blended learning capacity-building package to improve index testing implementation in Malawi. METHODS: In 2019, a blended learning package combining digital and face-to-face training modalities was field tested at 6 health facilities in Mulanje, Malawi using a pre-/post- type II hybrid design with implementation and effectiveness outcomes. Health care worker (HCW) fidelity to the intervention was assessed via observed encounters before and after the training. Preliminary effectiveness was examined by comparing index testing program indicators in the 2 months before and 4 months after the training. Indicators included the mean number of indexes screened, contacts elicited, and contacts who received HIV testing per facility per month. RESULTS: On a 30-point scale, HCW fidelity to index testing protocols improved from 6.0 pre- to 25.5 post-package implementation (P = 0.002). Index testing effectiveness indicators also increased: indexes screened (pre = 63, post = 101, P < 0.001); contacts elicited (pre = 75, post = 131, P < 0.001); and contacts who received HIV testing (pre = 27, post = 41, P = 0.014). CONCLUSIONS: The blended learning package improved fidelity to index testing protocols and preliminary effectiveness outcomes. This package has the potential to enhance implementation of HIV index testing approaches, a necessary step for ending the HIV epidemic.
Authors: Lillian B Brown; William C Miller; Gift Kamanga; Naomi Nyirenda; Pearson Mmodzi; Audrey Pettifor; Rosalie C Dominik; Jay S Kaufman; Clement Mapanje; Francis Martinson; Myron S Cohen; Irving F Hoffman Journal: J Acquir Immune Defic Syndr Date: 2011-04-15 Impact factor: 3.731
Authors: Catherine Kahabuka; Marya Plotkin; Alice Christensen; Charlene Brown; Mustafa Njozi; Renatus Kisendi; Werner Maokola; Erick Mlanga; Ruth Lemwayi; Kelly Curran; Vincent Wong Journal: AIDS Behav Date: 2017-08
Authors: Niall Winters; Laurenz Langer; Promise Nduku; James Robson; James O'Donovan; Pallab Maulik; Chris Paton; Anne Geniets; David Peiris; Shobhana Nagraj Journal: BMJ Glob Health Date: 2019-07-30
Authors: Alexander K Rowe; Samantha Y Rowe; David H Peters; Kathleen A Holloway; John Chalker; Dennis Ross-Degnan Journal: Lancet Glob Health Date: 2018-10-08 Impact factor: 26.763
Authors: Nora Ellen Rosenberg; Tapiwa A Tembo; Katherine R Simon; Katie Mollan; Sarah E Rutstein; Victor Mwapasa; Steven Masiano; Hanna E Huffstetler; Vivian Go; Maria H Kim Journal: JMIR Form Res Date: 2022-04-19