NAPNEUNG: optimizing HIV testing, 2015-2019 (first phase) and 2019-2024 (second phase)

The number of people using appropriate prevention methods among those living with HIV who know their status and of those at high risk of HIV acquisition is still far too low to defeat the epidemic. Effective interventions do exist and are affordable. Insufficient use of testing and prevention services is, therefore, a major problem. Napneung is an interventional research program developed by the Thailand-France research collaboration at the Faculty of Associated Medical Sciences, Chiang Mai University and aimed at evaluating strategies to optimize the use of these services.

During Napneung's first phase, awareness-raising methods targeting people at risk were developed (social media, field interventions). More than 7,000 screening sessions were carried out. In addition, retention strategies in screening and prevention services for people at high risk of HIV acquisition were evaluated using clinical research methods such as randomized controlled trials. These showed that computer-assisted counselling is well received and reduces the time spent on counselling without reducing the proportion of users who subsequently come for re-testing, the educational value of the counselling, or the likelihood of risky sexual behavior. Furthermore, interventions as simple, easy to implement and affordable as booking an appointment and sending a reminder one week in advance were found to significantly increase follow-up for people at high risk of HIV acquisition.

The second phase aims at studying the requirements for implementing and integrating widespread access to quality HIV prevention and testing services into the existing health system in medium-sized cities in Thailand. The project is evaluating the use of supervised self-tests, a computer-based counselling program and an online appointment system. All users are also tested for syphilis and viral hepatitis B and C, and those at risk for other STIs as well. Sub-studies are dedicated to these three infections.

The project is sponsored by L’Initiative (Expertise France).

ClinicalTrials.gov: NCT02752152, NCT04585165