A pilot project in which people with HIV encouraged their friends and neighbours to be tested for HIV succeeded in recruiting people with a very high rate of undiagnosed HIV, Elizabeth Reddy of Duke University told the Sixth International AIDS Society conference in Rome yesterday. People who themselves had just tested for HIV also recruited people for testing, but with a lower proportion of their contacts being found positive.
The project is a modification of a partner notification scheme. Partner notification involves people with a sexually transmitted infection (often when newly diagnosed) identifying their sexual partners, who will be informed of their possible exposure to infection and encouraged to be tested themselves.
Recently, pilot projects in seven American cities found that asking people with HIV to contact friends and other people in their social network who may be at risk of HIV infection (rather than sexual partners) also succeeded in bringing a large number of people with undiagnosed infection forward for testing.
The project presented at the Rome conference was established in the rural Kilimanjaro region of northern Tanzania, where the estimated prevalence of HIV is 1.9%. The project asked individuals to offer vouchers with details of testing services to their sexual partners, family, friends and neighbours.
At three villages, mobile voluntary counselling and testing services were being offered, and all eleven people who tested positive at these sites during the study period were asked to recruit others and were given vouchers. Moreover, a random sample of 312 people testing negative were provided with vouchers.
At the HIV care and treatment centre (up to 20km away), a random sample of 75 patients with HIV were also given vouchers in order to recruit others to be tested.
When recruiters passed the vouchers on to their contacts, the recipients could either test at one of the mobile sites or at the treatment centre, with travel costs reimbursed.
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