Integrating syphilis screening in a large-scale HIV prevention program for key populations: the Avahan experience from India

  • Mugundu Ramien Parthasarathy FHI360, India Country Office, New Delhi, India
  • Prakash Narayanan FHI360, India Country Office, New Delhi, India
  • Anjana Das FHI360, India Country Office, New Delhi, India
  • Anup Gurung FHI360, Papua New Guinea Country, New Guinea
  • Parimi Prabhakar India HIV/AIDS Alliance, Hyderabad, India
  • Teodora Wi World Health Organization Headquarters, Geneva, Switzerland
Keywords: key population, syphilis screening, ICST, HIV prevention

Abstract

Introduction: Documented experiences from India on the implementation of syphilis screening in large-scale HIV prevention programs for “key populations at higher risk’ (KPs) are limited. Avahan is a large-scale HIV prevention program providing services to more than 300,000 KPs in six high HIV prevalence states of India since 2004. Avahan clinics provide a sexually transmitted infection service package which includes bi-annual syphilis screening. The trends in the coverage of syphilis screening among Avahan clinic attendees were studied retrospectively.

Methodology: Screening was performed using either the Rapid Plasma Reagin (RPR) test or point-of-care immunochromatographic strip test (ICST). Clinic records from 2005 to 2009 were collated in an individual tracking database and analyzed with STATA-10.

Results: Initially the coverage of syphilis screening (2.6% in 2005) was constrained by the availability and operational complexity of the RPR test. After its introduction in 2007, the use of ICST for screening increased from 7.4% to 77.0% and the proportion of clinic attendees screened increased from 9.0% to 21.6% during 2007-2009. The RPR reactivity rates declined from 6.6% (2006) to 4.4% (2009).

Conclusion: The data showed improved rates of screening of clinic attendees and declining trends in sero-reactivity over time. The introduction of point-of-care syphilis tests may have contributed to the improved coverage of syphilis screening. The ICST may be considered for initial syphilis screening at other resource-constrained primary care sites in India such as ante-natal clinics and other KP interventions.

Author Biographies

Mugundu Ramien Parthasarathy, FHI360, India Country Office, New Delhi, India

Technical Manager

STI Capacity Raising team

FHI360

H-5, Green Park Extension, New Delhi

India

Prakash Narayanan, FHI360, India Country Office, New Delhi, India

Senior Technical Officer

STI Capacity Raising team

FHI360

H-5, Green Park Extension, New Delhi

India

Anjana Das, FHI360, India Country Office, New Delhi, India

Director

STI Capacity Raising team

FHI360

H-5, Green Park Extension, New Delhi

India

Teodora Wi, World Health Organization Headquarters, Geneva, Switzerland
Medical Officer, HIV/AIDS & STIsWORLD HEALTH ORGANIZATIONWestern Pacific Regional OfficeUnited Nations Avenue1000 Manila, Philippines
Published
2013-06-15
How to Cite
1.
Parthasarathy MR, Narayanan P, Das A, Gurung A, Prabhakar P, Wi T (2013) Integrating syphilis screening in a large-scale HIV prevention program for key populations: the Avahan experience from India. J Infect Dev Ctries 7:484-488. doi: 10.3855/jidc.2810
Section
Brief Original Articles