Developing HIV Assisted Partner Notification Services Tailored to Mexican Key Populations: A Qualitative Approach

Abstract

Background. Assisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW). We conducted semi-structured interviews to explore partner notification with MSM, TW and health care providers to identify the essential elements to include in the design and implementation of APNS directed to MSM and TW in Mexico City. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS. Results. Most participants reported experiences with informal partner notification, but not with APNS. Only one health care provider indicated assisting notification systematically. The main barriers for notifying mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier notifying a formal partner, conditional of being well informed about HIV. Given current stigma and lack of awareness, it was suggested that APNS should be preceded by HIV awareness efforts, and be provided by counsellors or peers to mitigate potential rejection or violent reactions. Conclusions. While APNS are not formally implemented in Mexico, all participants supported the service, indicating that APNS can enhance early HIV diagnosis in Mexico. Strategies to implement such services need to be flexible addressing the individual needs of participants, guaranteeing the safety of more vulnerable participants.

Uptake of assisted partner notification among HIV-positive adults with severe mental illness at a national referral hospital in Uganda: A cross-sectional study

“…Furthermore, the total number of patients who were reported as declining APNs included those who were not told about APN, which could have overestimated the number that did not take up APN. Last, factors such as the type of partner (formal or informal), method of APN use (passive or active), and quali cations of health workers who offered APN were not included in the study; however, these factors have been considered important confounders in other studies (32,33). The cross-sectional design of the study does not allow conclusions on a causal relationship.…”

“…Of the 125 study participants, 41 (32.8%) took up APN. The majority (69%) were females, and the median (IQR) age was 29.5 (25)(26)(27)(28)(29)(30)(31)(32)(33)(34) years. Only 48.6% were married, 78% had good adherence to ART, and 80% had received at least three adherence counseling sessions before they were introduced to the APN.…”