SUAC0102 | Social Network Strategies enhance HIV Case Identification Among Adolescent Girls and Young Women in Uganda

Benjamin Watyaba¹, Bernard Kikaire^1|2, Hamza Kalutte², Rose Naluwuge², Maria Nanyonjo², Claire Mukwano², Flavia Nakanjako², Victor Musiime¹, Lydia Nakiyingi Harriet¹, Harriet Mayanja Kizza¹ | ¹Makerere University College of Health Sciences, Kampala, Uganda; ²Uganda Virus Research Institute, Entebbe, Uganda

Unidentified HIV infections are responsible for the continued transmission and sustenance of the HIV pandemic. Identifying populations at higher risk of HIV with low uptake of HIV testing services (HTS) is crucial for advancing progress toward the elimination of HIV. Adolescent girls and young women (AGYW) are a well-recognized group at high risk of HIV but have low HTS rates. Several approaches have been implemented to enhance HIV case identification, yet challenges remain in detecting new HIV infections. This study hypothesized that the Social Network Strategy (SNS) would improve the identification of new HIV infections among AGYW. This was a cross-sectional study conducted among AGYW aged 10 to 24 years at the Uganda Virus Research Institute (UVRI) clinic that used the snowball strategy to recruit participants. Eligible participants were identified and enrolled through community mobilization strategies and provider-initiated testing and counseling (PITC) was offered. After testing, each participant was trained on effective communication and given four coupons to refer individuals from her social network. The referred participants were requested to refer other members in their network until the sample size was attained. HIV testing was done following the Ugandan national HTS rapid testing algorithm. Summary statistics were presented using means, medians, and percentages. The HIV positivity rate was compared between index participants and those recruited through the social network strategy using a difference in proportions. A total of 828 participants were enrolled with a mean age of 21.4 years (SD = 2.5). Of these, 243 (29.3%) were recruited through PITC community mobilization strategies, and 172 of the 243 (70.8%) were willing to refer their networks. A total of 630 participants were referred, of which 585 (92.9%) were eligible for testing. The overall HIV positivity rate was 45/828 (5.4%), while the positivity rate among the PITC participants was 9/243 (3.7%), and the positivity rate among the social referral networks was 36/585 (6.2%) giving a 40% increase in positivity rate. HIV testing within social networks enhances detection of new HIV infections among adolescent girls and young women and has the potential to improve identification of undiagnosed infections in hard-to-reach populations.