83 representatives from eleven countries throughout the Asia region partook in a landmark and highly successful virtual summit in September on the topic of improving Index Testing for HIV/AIDS. The Regional Learning Summit on Index Testing 2020: Focus on Asia included live panel sessions, self-guided sessions, a mini knowledge quiz, and access to a digital resource library. The summit was organized by American International Health Alliance (AIHA) and supported by the Centers for Disease Control and Prevention (CDC) Thailand regional office and HQ in Atlanta.  

 Index Case Testing is a key component in stemming the transmission of HIV/AIDS, particularly among Key Populations (KPs). Without adequate index testing, it will not be possible to achieve the UNAIDS and U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) PEPFAR’s 95-95-95 goals.  In Asia, it is estimated that 78% of the new HIV infections occur among KPs. 

Commenting on the summit, CDC’s Deputy Director, Division of Global HIV and TB (DGHT) for Thailand and Laos, Laurie Fuller said “On behalf of the Thailand team, we thank AIHA for the tremendous support in hosting this valuable learning summit.  You proved it is possible to successfully host a virtual training of such magnitude by connecting many across multiple time zones.”

The Summit, which was comprised of countries from South-East Asia, Central Asia, and additional regions of Asia included representatives from the CDC, local government authorities and relevant stakeholders. In an interactive setting designed to generate knowledge sharing, the group discussed lessons learned, challenges, innovations, experiences, and practices of Index Case Testing (with a focus on index testing for KPs for HIV/AIDS). Shane Diekman from CDC Headquarters in Atlanta, Behavioral Scientist with the HIV Testing Services Team reflected on the Summit with the following: “CDC Headquarters’ HIV Prevention Branch was thrilled to support the CDC Thailand team and the CDC Asia Regional Program in this important endeavor. At the heart of the summit was information sharing about best practices and lessons learned on how to safely and ethically delivery index testing. We’d like to thank AIHA for making this regional capacity building effort possible through their coordination of the summit and their commitment to providing a virtual, user-friendly platform to facilitate learning.”  

Reflecting on the Summit, Ketmala Banchongphanith, MD, MPH, Management of HIV/AIDS/STI Unit, Center for HIV/AIDS/STI (CHAS), Ministry of Public Health, Vientiane capital, Lao PDR said “Congratulations for convoking a successful learning submit. We learned a lot from all those attending the summit…we are so proud that representatives from other countries are interested in adapting Laos Index Testing guidelines and posters”.

The objectives of the 3-day Regional Learning Summit on Index Testing 2020: Focus on Asia were: 1) increase awareness of Index Case Testing Practices and Implementation; 2) learn from Countries’ Challenges and Successes with Index Case Testing; and 3) Peer Network to exchange practices, knowledge, and information.  

AIHA’s Program Director, Inna Jurkevich said “all of our objectives and more were met. The Summit was the first of its kind for the Asia region and marked an unprecedented virtual gathering that strengthened regional collaboration and learning exchange, establish shared commonalities and problem-solving of Index Testing among KPs.” An important outcome was the development of preliminary, specific, country plans to integrate and adapt Index Case Testing. Additionally, a major summit highlight was a strong multiple country interest in strengthening people-centric and KP-friendly health service delivery and quality improvement in these regions. 

The Summit, which included representatives from Burma/Myanmar, Cambodia, India, Kyrgyz Republic, Kazakhstan, Laos, Tajikistan, Thailand, Vietnam, Philippines, and the United States of America, included 47 presentations and related discussions. Seventeen program hours focused on country-based innovations and index testing plans with translation or interpretation available for the majority of presentations. Program innovations focused on “how to” and were shared across borders in video, slides, and documentation formats. Country programs were further supplemented by online sharing of 27 digital resource modules documented in three languages, including CDC’s approaches to gender-based and intimate partner violence, and ethical approaches to index testing.  

Index Case Testing is an innovative, anonymous, and voluntary case finding process that seeks to mitigate the HIV/AIDS epidemic through specific interventions to potential and known HIV exposure transmission pathways. Index Case Testing is also part of couple’s testing, partner testing, or family/child testing; however, Index Case Testing is a more comprehensive approach that focuses on all people potentially exposed to HIV/AIDS. Currently, 10 Steps define the Index Testing process through a series of confidential questions to ensure effective interventions could be disseminated to potential partners, children, family members, and anyone else who might have become infected through proximation. The World Health Organization Consolidated Guidelines on HIV/AIDS Testing: 5 Cs (consensual, confidential, counseling, correct test results, connection to treatment/prevention services) are the principles that guide Index Testing. The Summit included sessions on learning ways to integrate and modify the LIVES approach to responding to incidences of gender-based violence, as well as sessions on community engagement, safe and ethical delivery of services, supportive supervision, monitoring adverse events, and linking Index Testing to PrEP interventions.