Adapting Contact Tracing and Disease Intervention Services to the Ugandan Context

By Habtamu Girma October 23, 2015

Uganda has made significant progress in the fight against HIV and AIDS over the last two decades. A 2015 National Technical Review of the Response to the HIV/AIDS Epidemic found that of the estimated 1,500,000 people living with HIV (PLHIV) in Uganda, an estimated 71% of PLHIV know their HIV status, and 61% of PLHIV are receiving antiretroviral therapy (ART). Despite Uganda’s success in improving and scaling up HIV services throughout the country, the 2015 Technical Review revealed that nearly 30% of all PLHIV remain undiagnosed, and the country continues to struggle with high loss to follow-up.

The Uganda Ministry of Health plans to address this gap with more focused and targeted initiatives at the facility and district level to identify PLHIV and link them to care. As part of this effort, NASTAD has been asked to provide technical assistance to initiate the implementation of an innovative Contact Tracing and Disease Intervention Services pilot project in two districts of Uganda, the Rakai and Kiboga districts. The project aims to accelerate the diagnosis and treatment of HIV and other infections among partners, to prevent HIV transmission and to reduce the burden of HIV across the country.

In the United States, Disease Intervention Specialists (DIS) have successfully implemented Contact Tracing and Partner Services programs, which allow for the confidential identification of sexual and/or needle-sharing partners of PLHIV. The DIS then work with individuals who are at risk for HIV and sexually transmitted infection (STI) infection to both prevent the further spread of HIV and STIs and to ensure that infected partners are linked to care and treatment services.

NASTAD Global convened a team of technical assistance providers from U.S. state health departments with strong backgrounds in DIS and Contact Tracing, including Aimee Shipman, Manager of HIV, STD, and Hepatitis Programs at the Idaho Department of Health and Welfare, to explore and facilitate the adaptation of these programs to the Ugandan context.

In the Fall of 2015, this NASTAD Global TA team spent two weeks in Uganda, visiting the Rakai and Kiboga districts. During this time they convened targeted discussions with District Health Teams, a variety of implementing partners (IPs) and health facility staff, to determine the feasibility of effective follow-up and testing of sexual partners of PLHIV and subsequent linkage of those partners to HIV care and treatment services. The TA team determined that, with adequate financial support, sufficient facility level oversight, and empowerment of current district- and facility-level staff, a Partner Services program could be integrated into existing HIV programs in Uganda.

Following this trip and assessment, NASTAD began planning a study-tour to the United States for senior public health technical experts from the Uganda Ministry of Health, Districts, Implementing Partners, CDC to build the capacity of in-country institutions and staff to strengthen the implementation of Contact Tracing and DIS activities at the district and national level in Uganda. The planned study-tour will enable members of the Uganda delegation team to better understand the planning, management and monitoring and evaluation of innovative HIV Partner Services and DIS programs in the United States. The conversations and experiences made possible through this study-tour will inform the development of a strategy for a pilot of the Contact Tracing and Disease Intervention Services program in Rakai and Kiboga districts in the coming months.

To learn more about NASTAD Global Program’s work in Uganda, please contact Habtamu Girma, Associate Director, Global Program, at hgirma@NASTAD.org.

Visit NASTAD.org/global to learn more about the NASTAD Global Program.