SUAC0101 | Leveraging Social Networks to Bridge the Gap: Impact of Risk Network Referral on HIV Case Finding and Linkage in Arusha

Raphael Ruseke | Services Health and Development for People Living Positively in HIV (SHDEPHA+), Arusha, Tanzania

Arusha, Tanzania, faces challenges in reaching hard-to-reach and high-risk Recipients of Care (RoC) due to factors such as remote locations, lack of HIV testing services (HTS), limited awareness, cultural norms, gender dynamics, and self-stigma. These barriers significantly hinder access to HTS and impede efforts to control the epidemic. To address this, SHDEPHA+, through the EpiC Project, implemented the Risk Network Referral (RNR) strategy, a Social Network Strategy (SNS) aimed at identifying and engaging underserved populations. This abstract highlights the impact of RNR on increasing HTS uptake, identifying new HIV cases, and improving linkage to care. The RNR strategy was implemented from October 2021 to January 2025. Twenty healthcare providers were trained in SNS, equipping them to utilize clients’ risk networks to enhance HIV case finding and linkage. Areas with low HTS coverage among key populations were given the most attention. During routine HTS, providers identified high-risk RoC (both HIV-positive and high-risk HIV-negative) based on sexual behavior, drug use, and history of HIV/STI exposure. These ROCs were asked to refer people in their networks, even if they only knew their address and how they looked. Outreach teams followed up using these referrals to deliver targeted health education, IEC materials, and voluntary HIV testing in confidential settings. Those testing positive were linked to care, followed up regularly, and offered integrated screening and referrals for TB, STIs, GBV, and family planning. From October 2021 to January 2025, 12,436 RoC were referred through the RNR strategy. Of these, 12,312 (99%) were successfully contacted, and 12,219 (99%) received HTS. A total of 854 individuals (7%) tested HIV positive. Among them, 778 (91%) were successfully linked to care and treatment services. The high reach, testing uptake, and linkage rates demonstrate the effectiveness of RNR in identifying and engaging previously unreached individuals. The RNR strategy significantly enhanced HTS coverage and linkage to care among hard-toreach populations in Arusha. Its effectiveness in case identification and service integration makes it a promising model for national and international HIV response strategies. Further research is recommended to assess its impact on long-term retention and viral suppression.