{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T19:23:35Z","timestamp":1740425015762,"version":"3.37.3"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec025\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Zimbabwe exclusively implemented targeted HIV testing until 2022 when Status-neutral testing was embraced. Whilst targeted testing aims to expand access and uptake of testing among high-risk individuals, status-neutral testing emphasizes post-test linkage to prevention and treatment services. To address how the two concepts relate in practice, we explored how status-neutral and targeted testing concepts correlate, in developing a double-edged strategy for effective case identification and linkage to prevention and treatment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec026\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a cross-sectional study on 36 multi-stage sampled sites across 4\/10 provinces of Zimbabwe. A national screening algorithm was used to determine patient risk profiling and eligibility for testing. Screened-out patients were offered HIVST. Both screened and non-screened patients were tested and analysed for positivity ratios and linkage to post-test services. Epicollect5 was used to collect data and analysed using EpiData software and Stata. Univariate, bivariate and multivariate analyses were conducted at a 5% significance level.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec027\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 23,058 HIV tests done, females constituted 55% (n\u2009=\u200912,698), whilst 63.5% (n\u2009=\u200914,650) were retested. Through screening, at-risk patients contributed 75.1% to the overall positivity (1,296\/1,727), from 66% (n\u2009=\u200915,289) of the total HIV tests conducted. All screened-out patients were non-reactive on HIVST: 1,182\/1,182. The 45\u201349-year category was 3.6 times more likely to test positive (a95%CI:2.67,4.90). Males were 3.09 times more likely to test positive in adjusted analysis (a95%CI: 2.74, 3.49). First tests were 65% more likely to test HIV positive (a95%CI: 1.43, 1.91) whilst screened patients were 3.89 times more likely to link to HIV prevention services (a95%CI: 3.05, 4.97), against 25.5% (n\u2009=\u20091,871) linkage among patients not screened.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec028\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The complementarity of the status-neutral and targeted testing approaches is evident from our results. By prioritizing high-risk individuals for testing and ensuring comprehensive linkage to both prevention and treatment services, these integrated strategies can effectively identify and manage people living with HIV. This combined approach optimizes resource use, particularly in low- and middle-income countries, and contributes to improved health outcomes and reduced HIV transmission rates.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0302803","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T18:31:37Z","timestamp":1740421897000},"page":"e0302803","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrating status-neutral and targeted HIV testing in Zimbabwe: A complementary strategy"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4874-6381","authenticated-orcid":true,"given":"Hamufare","family":"D.\u00a0Mugauri","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Owen","family":"Mugurungi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joconiah","family":"Chirenda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2980-7735","authenticated-orcid":true,"given":"Kudakwashe","family":"Takarinda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prosper","family":"Mangwiro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mufuta","family":"Tshimanga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"pone.0302803.ref001","unstructured":"Issue Brief: Status Neutral HIV Care and Service Delivery | Policy and Law | HIV\/AIDS | CDC. [cited 21 Aug 2023]. Available from: https:\/\/www.cdc.gov\/hiv\/policies\/data\/status-neutral-issue-brief.html"},{"key":"pone.0302803.ref002","volume-title":"A status neutral approach: achieving together to End HIV epidemic.","author":"Demetre Daskalaki"},{"key":"pone.0302803.ref003","unstructured":"New York City Health. The New York City HIV Status Neutral Prevention and Treatment Cycle. New York City. 2022. [cited 4 Oct 2023]. 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Scientific, Ethical, and Legal Issues","volume":"9","author":"J Howard","year":"2019","journal-title":"J Leg Med"},{"issue":"1","key":"pone.0302803.ref025","doi-asserted-by":"crossref","first-page":"51","DOI":"10.7326\/0003-4819-159-1-201307020-00645","article-title":"Screening for HIV: U.S. preventive services task force recommendation statement","volume":"159","author":"S. Preventive Services Task Force*","year":"2013","journal-title":"Ann Intern Med"},{"key":"pone.0302803.ref026","unstructured":"Know Your HIV Status: What it Means to be Status Neutral - PrEP Daily. (cited 21 Augt 2023]. 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Available from: https:\/\/bhekisisa.org\/article\/2017-08-08-why-does-hiv-kill-more-men-than-women\/."},{"issue":"2","key":"pone.0302803.ref032","doi-asserted-by":"crossref","first-page":"e0245461","DOI":"10.1371\/journal.pone.0245461","article-title":"Quantifying the gender gap in the HIV care cascade in southern Mozambique: we are missing the men","volume":"16","author":"E Lopez-Varela","year":"2021","journal-title":"PLoS One"},{"issue":"14","key":"pone.0302803.ref033","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1097\/QAD.0000000000000395","article-title":"A systematic review of strategies to increase men\u2019s HIV-testing in sub-Saharan Africa","volume":"28","author":"B Hensen","year":"2014","journal-title":"AIDS"},{"key":"pone.0302803.ref034","year":"2020"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0302803","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T18:31:52Z","timestamp":1740421912000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0302803"}},"subtitle":[],"editor":[{"given":"Zypher Jude G.","family":"Regencia","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,2,24]]},"references-count":34,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0302803","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,24]]}}}