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Fingerprints protect privacy for AIDS testing in South Africa

Fingerprints protect privacy for AIDS testing in South Africa
The fingerprint scanner itself is Integrated Biometrics’ Watson Mini, a two-finger device that delivers FBI certified results in a thin and durable package that integrates smoothly with the rest of the system and requires little if any maintenance.
Fingerprints have been the gold standard for identity for more than 125 years. Instant, accurate identification can, however, work against the goals of public health initiatives for diseases such as AIDS or tuberculosis. Individuals concerned they may be at risk for these conditions often avoid testing due to fear of the social the stigma that comes with a positive diagnosis. As a result, they refuse examination if required to provide identification before testing, putting both themselves and their communities at risk.

Shout It Now, a non-governmental organization based in South Africa, dramatically improved both testing and treatment rates for AIDS by turning this conventional paradigm upside down. Rather than using fingerprints to identify individuals, Shout It Now’s mobile testing vans use biometric fingerprint scanners to create a unique and private identifier for each tested individual. No one must reveal who they are until they know their HIV status and have made decisions regarding treatment.

In short, Shout It Now turned biometric fingerprint scanning into a tool that protects confidentiality. The practical results represent a potential revolution in public health.

The process begins with Shout It Now placing its vans in areas frequented by young adults. An individual concerned about HIV status enters the first van, where a technician takes a fingerprint using an application developed by IDversol, a leading South African identity management provider. The fingerprint scanner itself is Integrated Biometrics’ Watson Mini, a two-finger device that delivers FBI certified results in a thin and durable package that integrates smoothly with the rest of the system and requires little if any maintenance.

The fingerprint becomes the patient’s unique and private identifier. No information passes to government databases or law enforcement organizations. The technician performs the bloodwork and initiates the tests. The patient receives the results via SMS text within 24 hours.

Those individuals who test positive then have the option to visit Shout It Now’s companion van to receive confirmation of results, counseling, and, when warranted, an initial course of anti-retroviral therapy (ART). The fingerprint serves as the link between test results and recommended treatment. These patients may choose to reveal their identity at that time, or to wait until they visit their regular health care provider.

Shout it Now enrollment with integrated biometricsThis community-based approach serves up to 250 clients per day per location for 24/7 operation. Each mobile clinic sets up in less than 15 minutes. The testing process itself takes as little as 10 minutes. Each van provides instructional materials in English, Zulu, and Sepedi.

The cost of the program, as well as the cost of treatment, receives support from the United States President’s Emergency Plan for AIDS Relief (PEPFAR). PEPFAR combines resources from eight US governmental agencies, six at the cabinet level, to provide public-private whole-government support to transform the global response to AIDS.

Shout It Now designed its mobile testing system to help South Africa meet the United Nation’s “90-90-90” goals. The 90-90-90 initiative encourages nations to diagnose 90% of their HIV-infected populations, treat 90% of those diagnosed with antiretroviral medications, and achieve 90% viral suppression for those receiving treatment.

The need is urgent. Currently, only 53% of the world’s HIV-positive population receive testing. 12.9 million people globally remain untreated, and almost 1/3 of HIV-infected individuals on treatment are not virally suppressed. Taken collectively, these results significantly impact public health agencies’ ability to control and prevent the transmission of AIDS.

Shout It Now’s education efforts deliver impressive results that directly counter these trends, with 97% of participants agreeing to same-day testing compared to 34% willing to undergo HIV testing before the program. The organization’s mobile testing and treatment vans extend those efforts by making it exceptionally convenient for individuals to receive testing, counseling, and treatment in a safe, confidential environment. The organization has been so pleased with the mobile clinics’ initial success that they hope to extend testing from HIV to tuberculosis soon.

"HIV and AIDS remain the biggest social issue facing South Africa. As a stakeholder, we take our role in ensuring the national 90-90-90 targets are met seriously. We have found that first and foremost, our clients want convenience — fast, free and friendly service at a time and location that suits them,” says Bruce Forgrieve, chairman, Shout-It-Now.

"We are very pleased to have worked with Shout It Now to bring this program to fruition,” said Cher Appunn, founder and CEO of IDversol. “It’s a fascinating twist on our usual identity management customer — protecting identity rather than verifying it and doing so in a way that advances public health. We also thank Integrated Biometrics for their participation. We needed a foundational technology that was fast, thin, didn’t need cleaning between scans, and could take a beating out in the field. IB’s Watson Mini has been an ideal hardware solution for us.”

"Identity is a basic human right, and accurate, convenient identification is critical in health care,” added Stephen Thies, Chief Executive Officer of Integrated Biometrics. “The ability to encourage testing by using fingerprints to protect patient confidentiality is just another fantastic example of how this technology protects and saves lives. Shout It Now’s approach and IDversol’s solution for this public health challenge illustrate how critical identity is for building a better, safer world.”

While HIV and AIDS remain the biggest social issue facing the youth of South Africa, the challenge continues to evolve and affect adults. In 2011 we shifted our focus from education to providing what is most needed and asked for by our clients – free, fast, and friendly HIV testing and links to care for both youth and adults through a network of mobile testing locations operational in the Ekurhuleni metropole.

Today, a client-centric approach is at the heart of what we do. We are piloting an innovative new approach to testing and extending our service to also include immediate, convenient on-site initiation onto Antiretroviral Treatment for eligible clients.
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