Discover Recency Surveillance for HIV
What is Recency Surveillance?
HIV Recent Infection Surveillance involves the identification and reporting of newly diagnosed HIV-infected persons in areas with ongoing transmission. When a rapid test for recent infection (RTRI) assay is used and confirmed with a baseline viral load (RITA), results can distinguish a recent HIV infection from a long-term infection. A recent infection is one that was acquired within the past 12 months while more than 12 months for a long term, for persons not receiving ART. As per the Zambia consolidated guidelines (2022), Recency was integrated in routine HIV testing services for surveillance purposes. Recent infections signal ongoing transmission, which provides an opportunity for program strengthening to prevent further transmission and identify hotspots and launch a public health response.
Recency surveillance in Zambia is a Ministry of Health led program and has been integrated into routine HTS services. The Country has been implementing Recency surveillance since 2020 and currently, testing is being done in 726 sites and 6 provinces (Lusaka, Copperbelt, southern, central, western, and Eastern) out of 10 provinces to achieve a target of 90% of eligible clients. The surveillance is being implemented in collaboration with the Centre for Infectious Disease Research in Zambia (CIDRZ) and other implementing partners, the Office of the U.S. Global AIDS Coordinator (O/GAC), U.S. Centres for Disease Control and Prevention (CDC), and U.S. Agency of International Development (USAID) and funded through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). key implementation activities include Site orientations, facility sensitization and mentorship concerning HIV testing services (HTS), supporting prevention and treatment units, capacity building and training of clinical and support staff, and partner engagement meetings and continuous quality improvement program.
Objectives
- To implement recent HIV infection in the surveillance system in Zambia, including integration of recent infection testing into routine HIV testing services.
- To estimate the proportion of clients with a recent HIV infection by their demographic characteristics
- To identify geographies associated with high rates of recent infection.
Recency Implementation Coverage
HIV Recency Surveillance is currently implemented in 6 out of 10 provinces of Zambia and 27 districts. The aim is to roll out the program to the other 4 provinces of the country. Below are the 6 recency active Provinces.
- Copperbelt province (Chingola, Chililabombwe, Luanshya, Mpongwe, Masaiti, Ndola, Kitwe, Mufulira, Kalulushi)
- Central Province (Kabwe, Luano, Mkushi, Kapiri Mposhi, Mumbwa, Serenje)
- Eastern Province (Chipata)
- Lusaka province (Lusaka, Chilanga, Chongwe and Kafue)
- Southern Province (Choma, Mazabuka, Monze, Chirundu, Siavonga, Livingstone)
- Western Province (Mongu)
Access to the full Recency dashboard is available here.
Recency Processes
Recency Testing
Our recency testing services utilize advanced technology to identify and report newly diagnosed HIV-infected persons. This involves distinguishing recent HIV infections (<12 months) from long-term ones (>12 months), providing crucial insights for program strengthening and public health responses.
Surveillance Activities
Our surveillance activities involve integrating recent infection testing into routine HIV testing services, conducting regular hotspot analyses to identify areas of high HIV transmission, and conducting precision public health responses in identified hotspots.
Implementation Activities
Our implementation activities encompass site orientations, facility sensitization, data quality audits, mentorship, and capacity building. We also conduct training for clinical and support staff, engage in partner meetings, and continuously improve program quality.
Expansion Plan
Our expansion plan entails extending recency surveillance to additional provinces and districts in Zambia. This will broaden our reach and enhance our ability to identify hotspots and launch targeted public health responses.
Figure 1. National hotspot analysis October 2022 to March 2023
