Standard Operating Procedure for Identifying and Responding to Intimate Partner Violence in the Context of Index Testing

The SOP is adapted for use by programs offering index testing. The evidence suggests that gender-based violence (GBV) is a barrier to HIV services, and it is possible that violence can result from index testing. To link survivors of violence to violence-response services and avoid adverse events related to index testing, all PEPFAR-funded index testing sites are required to conduct routine inquiry for IPV with all clients engaged in index testing. Routine enquiry is an approach to identifying cases of IPV among all clients who present for specific services, without resorting to the public health criteria of a screening program. For populations that may be at higher risk of experiencing violence, routine enquiry is recommended in services such as antenatal care, HIV care and treatment, and pre-exposure prophylaxis (PrEP) services. The SOP outlines the responsibilities of staff in preparing their clinics to ask about and respond to IPV, identifying clients who are experiencing IPV, and providing appropriate violence response services. The SOP also includes procedures for providing first-line support to clients who disclose violence, adapting procedures due to COVID-19, and establishing and maintaining a referral network. The SOP defines key terms, including IPV, GBV, and routine enquiry, and provides guidance on how to identify and respond to IPV in the context of index testing. The SOP also includes job aids and templates to support staff in implementing the procedures outlined in the SOP. The SOP is intended to be used in conjunction with other resources, including the World Health Organization's guidelines for responding to IPV. The SOP is adapted from the Standard Operating Procedure for Addressing Partner Relationships and IPV in PrEP Services, and input and comments from EpiC staff are acknowledged. The SOP was made possible by the generous support of the American people through the United States Agency for International Development (USAID) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). The contents of the SOP are the responsibility of the LINKAGES and EpiC projects and do not necessarily reflect the views of USAID, PEPFAR, or the United States Government. The SOP is organized into several sections, including background, purpose, responsibilities, procedures, and appendices. The procedures outlined in the SOP include preparation, routine enquiry in index testing, provision of first-line support to clients who disclose violence, staff experiences of trauma, and referral network establishment. The SOP provides guidance on how to identify and respond to IPV in the context of index testing, and it is intended to be used by clinics and programs offering index testing. The SOP is adapted for use by programs offering index testing and is intended to be used in conjunction with other resources, including the World Health Organization's guidelines for responding to IPV.