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Index testing, is a strategy implemented in the fight against HIV in Burundi since 2018, with the aim of improving the quality and efficiency of testing services through the use of innovative and targeted approaches, including screening from a positive case commonly called index case and partners of patients with a detectable viral load, self-testing and index testing (the use of the HIV screening tool).

According to the World Health Organization (WHO), this strategy has already proven its effectiveness wherever it has been implemented. At Service Yezu Mwiza (SYM), a support structure for people living with HIV (PLHIV), the situation is the same. Out of 332 cases tested, 46 cases were positive for HIV and 39 of them are attributed to index testing, a rate of 85%.

Despite its effectiveness, this strategy also has its difficulties, as Eustache NDAYIKEZA, a social worker at SYM, points out: “In our daily task of index testing, we are often confronted with different obstacles, such as the person who categorically refuses to meet us, the index case who is afraid to reveal his or her sexual partners to us because of their social status, and sometimes we walk several kilometers leaving the vehicle behind because the person we are looking for lives far away in mountainous areas”. “Like the case-index, we also sometimes fail to approach the targeted person because of the position he occupies. Also, it is a job that requires more precautions; it happens that one moves on foot, not because of lack of vehicle, but to avoid arousing the curiosity of the neighborhood”, adds Mrs. Solange NISABWE, field supervisor.

Despite all these obstacles, this strategy is to be encouraged because, in addition to giving a more yield for less testing, it saves the lives of people who are unaware that their lives are at risk, as well as the lives of the whole community. When a new HIV positive case is detected, it should be put on antiretroviral treatment as soon as possible and preferably on the same day. Counselling and therapeutic education are therefore necessary to help him/her accept and live positively with the disease.

It should be noted that at Service Yezu Mwiza, at the end of 2021, out of an active file of 1,060 PLHIV, more than 96% had an undetectable viral load and can therefore no longer transmit HIV.