Who should receive RTRI in this activity? Every newly diagnosed HIV-positive person at PEPFAR facilities?
First, only newly diagnosedHIV-positive persons should be tested for recent infection. If the person was diagnosed previously and/or on ART, they should not be tested for recent infection. To meet the objectives of a recent infection surveillance system, a census of newly diagnosed PLHIV is required to identify any and all recent transmission in area under surveillance. However, the test should be performed only on persons aged 15 years and older. Most HIV-positive cases <15 years of age are likely to have been acquired perinatally and not likely to be newly infected.
Since national coverage of the surveillance system may not be feasible in the first year of implementation, COP 2018 funding should prioritize saturation of PEPFAR focus districts. Since the objective of this surveillance system is to serve as a signal for trends in new infections, all new diagnoses should be captured to the extent possible.