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). This study aimed to explore the awareness of and need for HIV partner notification, as well as to outline potential strategies for APNS based on identified barriers and facilitators. Methods We conducted semi-structured interviews to explore partner notification with MSM, TW, and counselors. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS. Results Most participants reported experiences with informal partner notification and serostatus disclosure, but not with APNS. Only one counselor indicated assisting notification systematically. The main barriers for notifying or disclosing mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier to inform 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 counselors 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 could potentially 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.

A qualitative study of healthcare providers’ attitudes toward assisted partner notification for people with HIV in Indonesia

“…Education in best notification practices, including information about the country’s laws and policies governing health information disclosure, was seen as mandatory. Realistic job descriptions and written guidelines for APN providers should accompany this training but be sufficiently flexible to address the needs and safety of even the most vulnerable client [ 42 ].…”

Do No Harm: A Review of Social Harms Associated with HIV Partner Notification

“…7 Integrating a flexible approach within PNS programs so that the index client can choose the safest option and so health care workers can adjust their monitoring approaches based upon each client's risk level may help to reduce risk. 31 Rigorous monitoring of index clients who are at risk for IPV may further mitigate risk. 5 , 20 , 32 However, even quality IPV screening can enable false negatives when clients are not comfortable disclosing incidents of violence with their provider.…”