Can Tho, a centre of Mekong River Delta in Viet Nam, is one of the first cities in the country to implement community-led, multiple disease testing for human immunodeficiency virus (HIV), hepatitis C virus (HCV) and syphilis, including through lay-provider, self-testing and partner notification services. Between 15 and 17 May 2019, the Can Tho Provincial AIDS Centre in Viet Nam hosted a delegation from Indonesia. The visit was supported by the collaboration of the World Health Organization (WHO) regional offices in the South-East Asia and Western Pacific, as well as country offices in Indonesia and Viet Nam.
Joining the Indonesia delegation were Dr Hellen Dewi Prameswari-Ministry of Health, Dr Rasmah Doleng Syarifuddin-Provincial HIV&STI programme, Mr Rachman Rahim-peer support group for people living with HIV, Mr Andi Muhammad Yusif Ridwan-Indonesia Health care Partnership Foundation and Dr Tiara Nisa from the WHO Indonesia. The delegation visited Viet Nam to learn on introducing community-led testing, including HIV self-testing and partner notification to improve access to HIV and syphilis testing, as well as linkage to care and treatment. In 2017, the testing coverage in Indonesia was 42% and the coverage of antiretroviral therapy (ART) was only 14%.
The community-led testing project in Can Tho was designed to assess the feasibility and effectiveness of lay and self-testing approaches to improve testing coverage of the said diseases among key populations and informed policy development. The pilot project was supported by WHO Viet Nam which started in January 2017, and targeted men who have sex with men (MSM) and female sex workers (FSWs) in Can Tho City. Lay-provider, self-testing, and partner notification services were offered by trained MSM and FSW peer educators. The project results demonstrated that community-led testing reached young and “undiagnosed” key populations with successful linkages to diagnosis and treatment services. Between February 2017 and December 2018, of the 2,392 clients from key populations that received HIV testing, 160 were diagnosed with HIV (7%) and 154 (96%) received ART. In addition, of the 901 clients that received syphilis testing, 71 (8%) were diagnosed with active syphilis and 64 (90%) received treatment.
During the visit, the Viet Nam team shared with the Indonesian delegation how the project was implemented and how the results informed national guidelines development. There were in-depth discussions on selection of peer educators and community mobilization to reach key populations and quality assurance. The Indonesia team also visited a community-led testing session in a coffee shop on 15 May. Observing peer educators providing testing services for HIV, Syphilis and HCV, including HIV self-testing, the delegation team was impressed on the professional services provided by confident and dedicated peer educators.
“We are very impressed on the achievements that Viet Nam and Can Tho have made. We learned a lot on community-led testing, which would be extremely useful for us in advocating for this innovative testing approach and would help us in the development of our pilot plan in our country. Although we may face different challenges, this visit gave us strong evidence on the feasibility and effectiveness of community-led testing in successfully reaching key populations, testing and linkage to care. We are now convinced that if we empower our communities, they can be a champion,” Dr Hellen Dewi Prameswari, National HIV&STI Programme Officer, Indonesian Ministry of Health said.
“Can Tho is very happy to receive the Indonesia delegation and share our experiences in community-led testing approach. We are very proud of our peer educators who are very committed, dedicated and skilled in providing testing and linkage services to their communities. The community-led testing approach has significant contribution to achieve the first and second 90 targets in Can Tho. We hope that our experiences will be useful for Indonesia in increasing testing and treatment coverage,” Dr Nguyen Danh Lam, Deputy Director, Can Tho Provincial AIDS Centre, said at the closing session of the meeting.
