BASHH 2018 UK national audit of HIV partner notification

Bull, Lauren; Apea, Vanessa; Wiggins, H. V.; Davies, Sophia; Saxon, Cara; Hughes, Amelia; Curtis, Hilary; Sullivan, Ann

doi:10.1177/0956462421990281

Cited by 7 publications

(11 citation statements)

References 11 publications

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“…15,33 We found that programs in which HIV positivity among tested partners is high can still have low case-finding and that HIV positivity in tested partners explains a minority of the variance in case-finding between programs. These observations support the use of the indices used to monitor syphilis APS for decades in the United States and the United Kingdom 18,27 and should prompt Presidents Emergency Plan for AIDS Relief, CDC, and ministries of health around the world to adopt a more comprehensive approach to APS program assessment that includes traditional APS STD indices-not just HIV positivity in tested partners -in program monitoring and evaluation.…”

Section: Discussionmentioning

confidence: 64%

“…The erosion of APS effectiveness in high-income nations does not seem to be confined to the United States and stands in contrast to most recent findings from lowincome and middle-income nations. A 2016 national audit of APS conducted in the United Kingdom reported an interview case-finding index=0.065, 27 only slightly higher than that seen in the United States and substantially lower than the index of 0.12 reported from a similar UK audit performed in 2011. 28 By contrast, recent program evaluations conducted in low-income and middle-income countries have reported interview case-finding indices from 0.12 to 0.45, 5,[29][30][31][32] highlighting that the value of APS varies dramatically based on epidemiologic context.…”

Section: Discussionmentioning

confidence: 72%

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The Organization, Content, and Case-Finding Effectiveness of HIV Assisted Partner Services in High HIV Morbidity Areas of the United States

Golden

AugsJoost²,

Bender

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background:The contemporary effectiveness of assisted partner notification services (APS) in the United States is uncertain.Setting:State and local jurisdictions in the United States that reported ≥300 new HIV diagnoses in 2018 and were participating in the Ending the Epidemic Initiative.Methods:The study surveyed health departments to collect data on the content and organization of APS and aggregate data on APS outcomes for 2019. Analyses defined contact and case-finding indices (i.e., sex partners named and newly diagnosed per index case receiving APS) and estimated staff case-finding productivity.Results:Sixteen (84%) of 19 jurisdictions responded to the survey, providing APS outcome data for 14 areas (74%). Most health departments routinely integrated APS with linkage of cases and partners to HIV care (88%) and pre-exposure prophylaxis (88%). A total of 19,164 persons were newly diagnosed with HIV in the 14 areas. Staff initiated APS investigations on 14,203 cases (74%) and provided APS to 9937 cases (52%). Cases named 6799 partners (contact index = 0.68), of whom 1841 (27%) had previously diagnosed HIV, 2202 (32%) tested HIV negative, 541 (8% of named and 20% of tested partners) were newly diagnosed with HIV, and 2215 (33%) were not known to have tested. Across jurisdictions, the case-finding index was 0.054 (median = 0.05, range 0.015–0.12). Health departments employed 292 full-time equivalent staff to provide APS. These staff identified a median of 2.0 new HIV infections per staff per year. APS accounted for 2.8% of new diagnoses in 2019.Conclusions:HIV case-finding resulting from APS in the United States is low.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 72%

The Organization, Content, and Case-Finding Effectiveness of HIV Assisted Partner Services in High HIV Morbidity Areas of the United States

Golden

AugsJoost²,

Bender

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…The program’s productivity was particularly strong among recently diagnosed ICs (case finding index = 0.29) compared with ICs who had been enrolled in care for more than 6 months (case finding index = 0.07). Ukraine’s overall HIV case finding index was comparable of superior to rates observed in the US in 2019 (0.054) [ 17 ], the UK in 2018 (0.066) [ 16 ], Botswana in 2018–2020 (0.14) [ 12 ], and Namibia in 2019–2021 (0.14) [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Profile of partners who completed HIV testing and received a new HIV diagnosis in Ukraine’s HIV index testing program: a retrospective cohort study to inform program improvement

Puttkammer

Ihnatiuk²,

Shapoval³

et al. 2023

BMC Infect Dis

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Background Approximately one-third of people living with HIV in Ukraine are unaware of their HIV status. Index testing (IT) is an evidence-based HIV testing strategy that supports voluntary notification of partners with HIV risk, so they can receive HIV testing, prevention, and treatment services. Methods Ukraine scaled up IT services in 2019. This observational study of Ukraine’s IT program covered 39 health facilities located in 11 regions with high HIV burden. The study used routine program data from January—December 2020 to describe the profile of named partners and explore index client (IC) and partner factors associated with two outcomes: 1) completing testing; and 2) HIV case finding. Analysis used descriptive statistics and multilevel linear mixed regression models. Results The study included 8,448 named partners, of whom 6,959 had unknown HIV status. Among them,72.2% completed HIV testing and 19.4% of those tested were newly diagnosed with HIV. Two-thirds of all new cases were among partners of ICs who were recently diagnosed and enrolled in care (< 6 months), while one third were among partners of established ICs. In adjusted analysis, partners of ICs with unsuppressed HIV viral load (VL) were less likely to complete HIV testing (adjusted odds ratio [aOR] = 0.11, p < 0.001), but more likely to receive a new HIV diagnosis (aOR = 1.92, p < 0.001). Partners of ICs who cited injection drug use or having a known HIV + partner as their own reason for testing were more likely to receive a new HIV diagnosis (aOR = 1.32, p = 0.04 and aOR = 1.71, p < 0.001 respectively). Involving providers in the partner notification process was associated with completed testing (aOR = 1.76, p = 0.001) and HIV case finding (aOR = 1.64, p < 0.01), compared with notification by ICs. Conclusion HIV case detection was highest among partners of recently diagnosed ICs, but IT participation among established ICs still yielded an important share of all newly-identified HIV cases. Areas for improvement in Ukraine’s IT program include completing testing for partners of ICs with unsuppressed HIV VL, with history of injection drug use or discordant partnerships. Using intensified follow-up for the sub-groups at risk of incomplete testing may be practical. Greater use of provider-assisted notification could also accelerate HIV case finding.

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“…To date, multiple studies have evaluated IT in the USA, Western Europe and sub-Saharan Africa, but few studies have done so in Eastern Europe 3 5 9–14. Ukraine has the second largest population of PLHIV, approximately 240 000 people, in Eastern Europe and Central Asia, a region leading the world in HIV epidemic growth in recent years 15–17.…”

Section: Introductionmentioning

confidence: 99%

“…Recent observational studies of scaled IT programmes describe variable success in HIV case-finding across low-income, middle-income and high-income settings 9 10 13 14. Reported case finding indices, representing the number of newly diagnosed partners identified per participating IC, have varied from 5.4 newly diagnosed partners per hundred participating ICs (0.054) in the USA in 2019 to 14 newly diagnosed partners per hundred participating ICs (0.14) in Botswana in 2018–2020 9 14.…”

Section: Introductionmentioning

confidence: 99%

Distinctive model for HIV index testing (IT) in Eastern Europe: results of Ukraine’s physician-led, integrated IT programme

Ihnatiuk,

Shapoval,

Kazanzhy

et al. 2023

BMJ Open

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ObjectivesThe effectiveness of HIV index testing (IT) in Eastern Europe has not been described. This study reports the performance of a scaled IT programme in Ukraine.DesignThis observational study included clients enrolled in IT services in 2020, and used routinely collected data from programme registers and the national electronic health record system.SettingThe study covered 39 public-sector health facilities where IT services were integrated into medical visits for persons living with HIV (PLHIV) already enrolled in HIV care.ParticipantsParticipants included PLHIV with both recent (<6 months) and previously established (≥6 months) HIV diagnoses.InterventionUkraine’s physician-led IT model involves a cascade of steps including voluntary informed consent, partner elicitation, selection of partner notification method and follow-up with clients to ensure partners are notified, tested for HIV and linked to HIV prevention and treatment services, as needed.Primary and secondary outcome measuresOutcomes included contact index, testing, index and HIV case-finding index disaggregated by index client (IC) subgroups, including people with current or past injection drug use (PWID) and men who have sex with men (MSM).ResultsOf 14 525 ICs offered index testing, 51.9% accepted, of whom 98.3% named at least one sexual, injection or biological child partner. In total, 14.9% of ICs were PWID and 3.5% were MSM. Clients named 8448 unique partners (contact index=1.14). HIV case finding averaged 0.14 cases per client, and was highest among clients with recent HIV diagnosis (0.29) and among PWID (0.23), and lower among clients with established HIV diagnosis (0.07). More than 90% of all partners with new HIV diagnoses were linked to care.ConclusionsThere was a high case-finding index among ICs with recent HIV and high linkage to care for all partners, demonstrating the effectiveness of this integrated, physician-led model implemented in 39 health facilities in Ukraine.

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BASHH 2018 UK national audit of HIV partner notification

Cited by 7 publications

References 11 publications

The Organization, Content, and Case-Finding Effectiveness of HIV Assisted Partner Services in High HIV Morbidity Areas of the United States

The Organization, Content, and Case-Finding Effectiveness of HIV Assisted Partner Services in High HIV Morbidity Areas of the United States

Profile of partners who completed HIV testing and received a new HIV diagnosis in Ukraine’s HIV index testing program: a retrospective cohort study to inform program improvement

Distinctive model for HIV index testing (IT) in Eastern Europe: results of Ukraine’s physician-led, integrated IT programme

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