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ORIGINAL ARTICLE
Open Access

Test and Prevent: Evaluation of a Pilot Program Linking Clients With Negative HIV Test Results to Pre-exposure Prophylaxis in Zimbabwe

Kayla Stankevitz, Definate Nhamo, Joseph Murungu, Kathleen Ridgeway, Takudzwa Mamvuto, Rachel Lenzi, Megan Lydon, Naledi Katsande, Imelda Mahaka and Theresa Hoke
Global Health: Science and Practice March 2021, 9(1):40-54; https://doi.org/10.9745/GHSP-D-20-00444
Kayla Stankevitz
aFHI 360, Durham, NC, USA.
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  • For correspondence: kstankevitz{at}fhi360.org
Definate Nhamo
bPangaea Zimbabwe AIDS Trust, Harare, Zimbabwe.
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Joseph Murungu
bPangaea Zimbabwe AIDS Trust, Harare, Zimbabwe.
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Kathleen Ridgeway
aFHI 360, Durham, NC, USA.
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Takudzwa Mamvuto
bPangaea Zimbabwe AIDS Trust, Harare, Zimbabwe.
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Rachel Lenzi
aFHI 360, Durham, NC, USA.
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Megan Lydon
aFHI 360, Durham, NC, USA.
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Naledi Katsande
bPangaea Zimbabwe AIDS Trust, Harare, Zimbabwe.
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Imelda Mahaka
bPangaea Zimbabwe AIDS Trust, Harare, Zimbabwe.
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Theresa Hoke
aFHI 360, Durham, NC, USA.
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Figures & Tables

Figures

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  • FIGURE 1
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    FIGURE 1

    Number of Clients at Each Stage of the HIV Test and Prevent Intervention, Zimbabwe

    Abbreviations: PrEP, pre-exposure prophylaxis; RAST, Risk Assessment Screening Tool.

  • FIGURE 2
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    FIGURE 2

    Risk Assessment Screening Tool Used in Zimbabwe for HIV Risk Screening

    Abbreviations: PEP, postexposure prophylaxis; PrEP, pre-exposure prophylaxis.

  • FIGURE 3
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    FIGURE 3

    Adult Screening Tool Used in Zimbabwe for HIV Risk Screening

    Abbreviations: ART, antiretroviral therapy; OI, opportunistic infections unit; STI, sexually transmitted infection.

Tables

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    TABLE 1.

    Components of the Test and Prevent Pilot Intervention in Zimbabwe

    Intervention ComponentCurrent National Guidelines for PrEP24Test and Prevent Pilot Intervention
    Risk assessmentClients with negative HIV test results who are at substantial risk of HIV should be screened for PrEP eligibility using the RAST (see Box)Use the RAST to screen all clients with negative HIV test results immediately after delivering results
    Counseling and referralClients with negative HIV test results should be proactively linked to prevention servicesAll clients who are determined to be at risk based on the RAST receive
    • Detailed counseling about oral PrEP using the national PrEP fact sheet

    • Referral to oral PrEP services, including referral slip

    • A prevention services card, detailing the prevention services available at the facility

    Accompanied referrals with fast trackingNot part of national guidelines for PrEP
    • Women referred for PrEP are given the option of having a provider immediately accompany them to PrEP services at the time of referral.

    • When accompanying a client, the provider facilitates fast tracking, allowing the client to skip the queue.

    Follow-upNot part of national guidelines for PrEP
    • Clients not completing their PrEP referral in 2 weeks receive reminder messages via phone call, WhatsApp, or SMS (based on client preference at enrollment).

    • Abbreviation: PrEP, pre-exposure prophylaxis; RAST, Risk Assessment Screening Tool; SMS, short message service.

    • View popup
    TABLE 2.

    Age and Sex of Enrolled Participants in Test and Prevent Pilot Intervention in Zimbabwe (n=206)

    CharacteristicsNo. (%)
    Age, years
        15–1813 (6.3)
        19–2446 (22.3)
        25–2949 (23.8)
        30–3950 (24.3)
        40–4931 (15.0)
        ≥5017 (8.3)
    Sex
        Female158 (76.7)
        Male47 (22.8)
        Transgender1 (0.5)
    • View popup
    TABLE 3.

    Reported Time to Complete Different Components of Test and Prevent Intervention, Zimbabwe

    Study ComponentAverage Time (Range), Min
    RAST10 (3–30)
    Counseling and referral following HIV testing17 (5–30)
    Accompanied referral and fast tracking13 (5–45)
    • Abbreviation: RAST, Risk Assessment Screening Tool.

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Global Health: Science and Practice: 9 (1)
Global Health: Science and Practice
Vol. 9, No. 1
March 31, 2021
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Test and Prevent: Evaluation of a Pilot Program Linking Clients With Negative HIV Test Results to Pre-exposure Prophylaxis in Zimbabwe
Kayla Stankevitz, Definate Nhamo, Joseph Murungu, Kathleen Ridgeway, Takudzwa Mamvuto, Rachel Lenzi, Megan Lydon, Naledi Katsande, Imelda Mahaka, Theresa Hoke
Global Health: Science and Practice Mar 2021, 9 (1) 40-54; DOI: 10.9745/GHSP-D-20-00444

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Test and Prevent: Evaluation of a Pilot Program Linking Clients With Negative HIV Test Results to Pre-exposure Prophylaxis in Zimbabwe
Kayla Stankevitz, Definate Nhamo, Joseph Murungu, Kathleen Ridgeway, Takudzwa Mamvuto, Rachel Lenzi, Megan Lydon, Naledi Katsande, Imelda Mahaka, Theresa Hoke
Global Health: Science and Practice Mar 2021, 9 (1) 40-54; DOI: 10.9745/GHSP-D-20-00444
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