news from the projects

TCE 1

For Harriet Muzembo, a DAPP Field Officer under the Total Control of the Epidemic (TCE) project at Kalingalinga Clinic in Lusaka, a typical day begins with a prayer asking that she be successful in bringing at least one client in for HIV testing and then for treatment, if needed. As the focal person for TCE index testing, Harriet knows how difficult it is to convince sexual partners of known HIV-positive clients of their need to be tested.

Index clients—individuals newly diagnosed as HIV-positive and/or an HIV-positive individual who is enrolled in HIV treatment services—are the key to DAPP’s index-testing approach. Index testing, also known as partner notification, is an effective case-finding strategy that targets the exposed contacts of HIV-positive persons for HIV-testing services.

It is a voluntary process where counsellors ask clients to list all of their sexual partners within the past year and their children. All index testing is consensual, confidential, and includes counseling, correct test results, and connection to treatment or prevention services.

If the index client agrees, Harriet contacts each listed partner and offers voluntary HIV testing services. “The goal of index testing is to break the chain of HIV transmission to persons who have been exposed to HIV and linking them to treatment, if positive, or prevention services, if negative.” She says.

“Hello, my name is Harriet from Kalingalinga Clinic,” Harriet says, beginning the sometimes difficult telephone conversation to the person on the other end of the phone. “I’m calling to interest you to come for HIV testing because you have not come in the past six months.” The barrage of questions from the other side of the line is intimidating: “Who are you and how did you get my number? How do you know me?” “Well,” she calmly responds, “you left your number at the registry the last time you visited the clinic, it is important that you come and get an HIV test to know your status. If you are HIV-positive, we immediately enroll you in free treatment and support for you to stay healthy and live longer. If you are HIV-negative, we can teach you and provide the support you need to stay uninfected.” After some pleading and explaining that her facility offers much-needed health services for those at risk of HIV infection, including screenings for sexually transmitted infections, and client agrees to come in.

Harriet 2

For the first two hours of her day, Harriet makes calls using different strategies, dependent on a profile derived from index clients identified the previous days. She may also call upon those that have not honored their promise to come in for testing.

She works by first conducting an HIV test with these clients and then seek their consent to document and track their sexual partners. They are usually invited for testing at the facility or if they cannot manage, they are followed to their places of residence. “We prioritize testing for sexual partners of all old and newly identified HIV-positive individuals, sexual partners of patients with a non-suppressed and suppressed HIV viral load, and document and track all sexual partner elicited in through the registry,” Harriet explains.

“It’s not a straight forward process to convince these partners to come forward and take the test,” Harriet notes. Some may invite her to their homes but later switch off their phones while some may say they are out of town or too busy to be tested. Nevertheless, Harriet does not give up. “I keep calling until they come or I follow them to their homes.”

Despite difficult calls, a good number of those contacted present themselves at the Clinic or invite her to go and conduct the testing at their homes.

Thanks to her dedication and tenacious efforts, Harriet managed to test and index 32 clients, where she also got 69 contacts. From the contacts, she tracked and tested 45, 31 were positive and immediately put on treatment while 14 tested negative and she put them on HIV prevention. 

“I really love my work. I get satisfaction in knowing that I’m helping people get better and live healthy lives. Sometimes clients tell me that they no longer feel sick and they are thriving since starting treatment.” She says proudly. 

 Harriet min 1

 

 

 

 

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