Awareness of HIV status is critical in addressing the HIV epidemic among the population at risk of HIV infection. Social Network Strategy (SNS) has proved to be an incredibly successful strategy for locating individuals at the highest risk for HIV and bringing them in for testing, counselling and referral services, and this is one of the strategies that LVCT Health continues to use in its efforts to end HIV in Kenya.
Through the CDC-funded Dhibiti project, LVCT Health hosted 75 HTS counsellors drawn from Muranga County to promote the strategy and identify HIV follow-up gaps identified.
Besides general testing and partner notification services (PNS), the strategy is more effective in identifying positives. The primary target person is the index client, and the secondary target is a sexual partner. The central assumption is that HIV is transmitted through sexual intercourse. As a result, the HTS counsellor is interested to know whether the primary and index sexual partners are sexually active.
“SNS is a recruitment strategy targeting high-risk populations by using social network connections to locate individuals at the highest risk for HIV. One assumption in SNS of identifying a high-risk population is a client having unprotected sex and recurring STI infections. The idea is people of the same social network share the same risks,” noted Onesmus Musau, Senior Technical Advisor, LVCT Health.
Musau called on the HTS counsellors to identify and enrol HIV-positive clients as a step towards ending HIV infections in the County.
“Let us implement SNS with fidelity,” said Musau.
SNS is effectively implemented in four phases, and in the first phase, called initial recruiter identification (referred to as seed), a newly diagnosed client who is HIV positive or high-risk negative is recruited by the HTS counsellor and is willing to refer network members to the counsellor. In the second phase, recruiter instruction, the seed is given instructions by providing a brief overview of the program, explaining their role as a recruiter, and coaching on the best practices for recruitment. The third stage involves the recruitment of network members, where clients are given coupons to recruit their members, whereby they are given incentives to drive the recruitment process. If a member network is found to be HIV positive, they are linked to HIV care and treatment; if negative, they are offered HIV counselling and prevention services, including condoms, lube, and PrEP. The fourth and final phase involves testing network members and offering them the opportunity to recruit members of their network for HIV testing.
By the end of the training, the HTS counsellors gained several strategies for dealing with demanding clients and implementing better actions toward curbing HIV infections in Murang’a County.
LVCT Health is implementing the Dhibiti Project, a five-year transitional program funded by PEPFAR through the CDC in Kenya that supports the implementation of sustainable, comprehensive, high-quality HIV/TB prevention and treatment programs in six counties in Kenya’s central region.