The role of recency testing and linkage to care in enhancing viral suppression among key populations in Guyana

Recency testing, a cutting-edge surveillance tool, identifies individuals recently infected with human immunodeficiency virus (HIV) to enable targeted interventions. This pilot study evaluates the effectiveness of recency testing in Guyana from February to May 2022, its integration with linkage-to-care strategies, and subsequent treatment outcomes in 2023. To assess the role of recency testing in identifying recent infections, linking newly diagnosed individuals to care, and achieving long-term viral suppression. This observational study included 120 individuals newly diagnosed with HIV across regions 4 and 5. Recency testing was conducted using samples processed at the National Public Health Reference Laboratory. Of the confirmed cases, 23 were identified as recent infections after verification. All participants were linked to care and initiated on dolutegravir-based antiretroviral therapy. Viral load measurements were recorded at baseline, 6 months, and 1 year. Quantitative data were analyzed using chi-square and logistic regression to assess associations between recency status, care linkage, and treatment outcomes. Ethical approval was obtained, ensuring participant confidentiality and informed consent. Baseline viral loads ranged from 704 to 1,820,000 copies/ml. Following treatment, viral loads demonstrated reductions of 80-95% at 6 months. By the 1-year mark, 95% of participants achieved viral suppression below 1000 copies/ml. Statistical analyses revealed significant associations between recency status and treatment outcomes, emphasizing the importance of prompt linkage to care in achieving viral suppression. Recency testing proved instrumental in identifying individuals at high risk, facilitating rapid linkage to care, and optimizing treatment outcomes.