{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:57:02Z","timestamp":1753869422736,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T00:00:00Z","timestamp":1732579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In the context of key population HIV testing programmes, identifying new HIV acquisitions, tracking incidence, and responding with prevention and treatment interventions will be critical for achieving HIV epidemic control. Laboratory tests for recently acquired HIV used as part of a \u201crecent infection testing algorithm\u201d (RITA), offer a potential tool to support this work. We implemented a RITA for female sex workers (FSWs) in Zimbabwe to explore opportunities and programmatic benefits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between October 2021 and January 2023, recency testing was offered to FSWs attending the Centre for Sexual Health and HIV\/AIDS Research (CeSHHAR) Zimbabwe's key populations programme. Dried blood spot (DBS) samples were taken at 86 clinic sites across 10 provinces and Laboratory LAg Avidity and viral load testing conducted. RITA results were analysed and linked to programme data to explore geographical differences and calculate HIV incidence. We describe concurrent efforts in HIV testing for social (social network testing [SNT]) and sexual (index case testing [ICT]) contacts of those testing HIV positive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 24,976 FSWs tested at programme sites, 9.5% (2363\/24,976) were confirmed HIV positive. We enrolled 55.5% (1311\/2363) of eligible HIV\u2010positive FSWs to our study, of whom 11.7% (153\/1311) were identified as having recently acquired HIV. It took a median of 37 days (IQR 20\u201367) for samples to be processed. Enrolment rates varied between provinces but the proportion of recently acquired HIV was similar (range: 18.4% to 4.0%). Overall HIV incidence was 3.4 (95% CI 2.7\u22124.0) per 100py. Where results could be linked to routinely collected data, we found no evidence of a difference in test\u2010positivity between the ICT and SNT contacts of those with recently acquired compared to those with long\u2010term HIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Implementation of a RITA was possible within a nationally scaled sex worker programme, and while challenging to implement, can provide an understanding of transmission dynamics and HIV incidence in this context. Sub\u2010optimal recruitment and data linkage limited the interpretation of our findings and opportunities for strategic gains though focusing on HIV prevention efforts.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.26391","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T08:25:25Z","timestamp":1732609525000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Recent infection testing to inform HIV prevention responses and surveillance in a programme context: lessons from implementation within a nationally scaled female sex worker programme in Zimbabwe"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4007-7144","authenticated-orcid":false,"given":"Harriet S.","family":"Jones","sequence":"first","affiliation":[{"name":"Faculty of Public Health and Policy, London School of Hygiene &amp; Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fortunate","family":"Machingura","sequence":"additional","affiliation":[{"name":"Centre for Sexual Health and HIV\/AIDS Research (CeSHHAR) Zimbabwe  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah","family":"Gaihai","sequence":"additional","affiliation":[{"name":"Centre for Sexual Health and HIV\/AIDS Research (CeSHHAR) Zimbabwe  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Memory","family":"Makamba","sequence":"additional","affiliation":[{"name":"Centre for Sexual Health and HIV\/AIDS Research (CeSHHAR) Zimbabwe  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Chanyowedza","sequence":"additional","affiliation":[{"name":"Centre for Sexual Health and HIV\/AIDS Research (CeSHHAR) Zimbabwe  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panganai","family":"Masvikeni","sequence":"additional","affiliation":[{"name":"Centre for Sexual Health and HIV\/AIDS Research (CeSHHAR) Zimbabwe  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Matsikire","sequence":"additional","affiliation":[{"name":"Centre for Sexual Health and HIV\/AIDS Research (CeSHHAR) Zimbabwe  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Primrose","family":"Matambanadzo","sequence":"additional","affiliation":[{"name":"Centre for Sexual Health and HIV\/AIDS Research (CeSHHAR) Zimbabwe  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sithembile","family":"Musemburi","sequence":"additional","affiliation":[{"name":"Centre for Sexual Health and HIV\/AIDS Research (CeSHHAR) Zimbabwe  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip N.","family":"Chida","sequence":"additional","affiliation":[{"name":"Centre for Sexual Health and HIV\/AIDS Research (CeSHHAR) Zimbabwe  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffery","family":"Dirawo","sequence":"additional","affiliation":[{"name":"Centre for Sexual Health and HIV\/AIDS Research (CeSHHAR) Zimbabwe  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Owen","family":"Mugurungi","sequence":"additional","affiliation":[{"name":"AIDS and TB Directorate, Ministry of Health and Child Care  Harare Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9151-1567","authenticated-orcid":false,"given":"Sarah","family":"Bourdin","sequence":"additional","affiliation":[{"name":"Faculty of Public Health and Policy, London School of Hygiene &amp; Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernadette","family":"Hensen","sequence":"additional","affiliation":[{"name":"Sexual and Reproductive Health Group, Department of Public Health, Institute of Tropical Medicine  Antwerp Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0943-0045","authenticated-orcid":false,"given":"Lucy","family":"Platt","sequence":"additional","affiliation":[{"name":"Faculty of Public Health and Policy, London School of Hygiene &amp; Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary","family":"Murphy","sequence":"additional","affiliation":[{"name":"Independent Consultant  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3509-3572","authenticated-orcid":false,"given":"James R.","family":"Hargreaves","sequence":"additional","affiliation":[{"name":"Faculty of Public Health and Policy, London School of Hygiene &amp; 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