Research & Publications

Experiences and lessons learned from the real-world implementation of an HIV recent infection testing algorithm in three routine service-delivery settings in Kenya and Zimbabwe (2021).

Testing for recent HIV infection can distinguish recently acquired infection from long-standing infections. Given current interest in the implementation of recent infection testing algorithms (RITA), we report our experiences in implementing a RITA in three pilot studies and highlight important issues to consider when conducting recency testing in routine settings.

Can HIV recent infection surveillance help us better understand where primary prevention efforts should be targeted? Results of three pilots integrating a recent infection testing algorithm into routine programme activities in Kenya and Zimbabwe (April 2020)

The MESH consortium conducted three pilot studies to assess the feasibility and utility of recent infection testing in Kenya and Zimbabwe. The results of those pilots suggest that recent infection surveillance, when rolled-out nationally, may help in further targeting primary prevention efforts.

Recent HIV Infection Surveillance in Routine HIV Testing in Nairobi, Kenya: A Feasibility Study (May 2020)

The MESH consortium with UCSF and the Eastern Deanery AIDS Relief Program (EDARP) conducted a feasibility assessment of integration recent infection testing into routine HIV counseling and testing at selected sites in Nairobi Kenya. The results found that integrating recent infection testing into routine HTS services in Kenya is feasible and largely acceptable to clients and providers. More studies should be done on possible physical and social harms related to returning results, and the best uses of the recent infection data at an individual and population level.

HIV recency testing: should results be disclosed to individuals tested? (June 2020)

An expert panel was assembled by the PEPFAR scientific advisory board to assess the ethical and safety considerations related to returning recent infection test results to individuals.

MeSH Consortium Report on the feasibility and utility of HIV recent infection testing in a range of routine service provision contexts (July 2019)

Distinguishing recently acquired infection from “long-standing” infection among persons newly diagnosed with HIV can help identify populations and geographic areas where current transmission is occurring; crucial information to inform programme planning. Given this, we set out to assess the feasibility and utility of various approaches to conducting HIV recent infection testing in a range of routine service-provision contexts; namely, in antenatal clinics providing PMTCT services (Siaya County, Kenya), routine HIV testing and counselling clinics (Nairobi, Kenya), and a programme for female sex workers (Zimbabwe).

Tracking with recency assays to control the epidemic: real-time HIV surveillance and public health response (July 2019)

With new developments in laboratory technology, rapid detection of recent HIV infection (i.e. HIV-antibody seroconversion occurring on average in the past 6 months) is now possible using a validated rapid test for recent infection (RTRI) that diagnoses HIV and detects recent infection within minutes [4–6]. The RTRI allows person, place, and time to be described for all new HIV diagnoses at the point of HIV testing services (HTS), forming the basis of a real-time surveillance and public health response system that accelerates the surveillance to care continuum. As the system generates routine information on trends in new diagnoses, it can simultaneously provide signals at the most granular level to inform programs where to focus interventions to reach those that need them the most.

Estimating HIV Incidence and Detecting Recent Infection among Pregnant Adolescent Girls and Young Women in Malawi – Working Together for an AIDS-free Future for Girls and Women (October 2019)

The Malawi Ministry of Health (MOH) and its partners implemented a novel surveillance system to detect and characterize recent HIV infections and estimate HIV incidence among adolescent girls and young women (AGYW) receiving antenatal care (ANC) in four high-prevalence districts of Malawi. A description of the methods and key findings from the pilot implementation of this surveillance system – which was called the Malawi Recency Study.

Performance of a novel point-of-care test for recent HIV infection among newly diagnosed pregnant adolescent girls and young women in 4 high HIV prevalence districts – Malawi (2017-2018)

The MESH consortium conducted three pilot studies to assess the feasibility and utility of recent infection testing in Kenya and Zimbabwe. The results of those pilots suggest that recent infection surveillance, when rolled-out nationally, may help in further targeting primary prevention efforts.

Performance Evaluation of Asante™ Rapid Recency Assay for HIV Diagnosis and Detection of Recent Infection: Potential for Surveillance and Prevention (2017).

Detection of recent infection is critical for incidence estimates from surveys and can also help in targeted prevention. We previously described development of a rapid test that can diagnose HIV infection and detect recency of infection in one device. This technology was successfully transferred to a commercial partner as AsanteTM Rapid Recency Assay developed by Sedia BioSciences (Portland, OR). We evaluated performance of this assay in laboratory using a well-characterized panel of specimens.

Development of a Novel Rapid HIV Test for Simultaneous Detection of Recent or Long-Term HIV Type 1 Infection Using a Single Testing Device (2013)

Laboratory assays for the detection of recent HIV infection for HIV incidence surveillance are essential to HIV prevention efforts worldwide because they can identify populations with a high incidence and allow targeting of resources and monitoring of incidence trends over time. This study describes the development of a novel rapid HIV-1 incidence-prevalence (I-P) test that can be used for the simultaneous detection and discrimination of prevalent (long-term) or incident (recent) HIV infections using a single device.