TRACE INITIATIVE: Practical Scenarios

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PRACTICAL SCENARIOS

What if this happens? How should we handle it?

What do we do if a client declines participation? Thank the client for his/her time Declining to participate does not affect clinic services or care Record the following information in the Recent HIV Infection Surveillance Register for all clients who decline: Consent = No Sex Age Residence Last test result and time since last test This information helps to understand how well our results represent all new HIV diagnoses and who we are missing

What do we do if a participant reports previous diagnosis after recency testing or during routine HTS post-test counseling? Record the following information in the Recent HIV Infection Surveillance Register: Previous diagnosis Diagnosis date History of ART

Where do we record this in the surveillance register? Additional Client Information Did client reveal L+ or Self Test+ status (L+ /S+/ No) If yes, date of previous positive test (mm/yy) Has client ever been on ART? (Y/N)   Did client reveal a previous positive or self test positive? [During post-test counseling] L+ = Last HIV Test Positive S+= Self-test HIV positive No = No Has the client ever been on ART? [Revealed during post-test counseling] Y = Yes N = No Time of last HIV positive test in months or years

What do we do when providing HIV testing to a couple? Test both persons according to the national HIV Algorithm If they have discordant results, the one with reactive test should continue on R/S if consented If both are reactive and consent they may be tested together for POC recent infection As always, POC recent infection results will not be returned to either person

What do we do if Test 2 (UniGold) is Non-Reactive? Repeat HIV Test 1 (Determine) and HIV Test 2 (Unigold) in parallel with a new blood specimen (fingerprick). Read and record parallel HIV test results in HTS Register, following HIV testing algorithm. DO NOT COLLECT A DBS sample for recency! [Adapt information based on the national testing algorithm and protocol for your country]

What do we do if POC TRI is invalid? DO NOT REPEAT RECENCY TEST! Document results in the register Collect DBS as long as UniGold result is reactive [Adapt information based on the national testing algorithm and protocol for your country]

What do we do if participant asks to know their result for the POC test for recent infection? Remind the client that: We cannot return the current results because they need to be confirmed at the lab Treatment services do not differ based on recency status Results are used for surveillance purposes to: Count new infections among population groups To support prevention activities and reduce new infections

Questions? Comments?

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