Outcomes of and factors associated with partner notification and HIV testing in Northeastern Tanzania.

Abstract

Background: There is growing evidence of high effectiveness of partner notification (PN) in reaching previously undiagnosed sexual partners. As a result, there is increasing implementation of PN in sub-Saharan Africa. Tanzania, like other countries in the region, has recently expanded PN in HIV testing services. However, this approach is unlikely to yield the expected results if not well implemented. This study aimed to identify gaps and provide recommendations to improve routine implementation of PN in Tanzania.Methods: A cross-sectional study was conducted across seven care and treatment centers (CTCs) in the Kilimanjaro region from November 2018 to April 2019. A total of 297 newly diagnosed HIV infected clients with sexual partner(s) in the past 24 months were recruited at 2 months of their CTC enrollment. Interviews using structured questionnaires were conducted. Descriptive statistics, bivariate and multivariate regression analyses were done.Results: Two-thirds (195) were females. The majority 165 (85%) of those counseled and had partner(s) not previously tested for HIV consented to PN. They all chose passive PN with 102 (62%) reporting successful HIV status disclosure to their partner(s). Reporting disclosure was associated with; being married adjusted odds ratio (aOR 5.1, 95%CI: 2.4–10.9, p < 0.001), in a relationship for > 10 years (aOR 4.9, 95%CI: 1.3–17.6, p = 0.02) and living with the partner(s) (aOR 3.4, 95%CI: 1.3–9.1, p = 0.02). Fifty-three clients (27%) of those with partners not previously tested for HIV reported partner HIV testing following PN, associated with being married (aOR 3.4, 95%CI: 1.3-9, p < 0.02) and living with the partner (aOR 4.5, 95%CI: 1.3–15, p < 0.02). Male partner(s) had lower odds of successful HIV testing (aOR 0.4, 95%CI: 0.2–0.9, p = 0.02). Thirty-seven (67%) of those tested were HIV infected.Conclusions: Detection rate of previously undiagnosed HIV infection among clients referred for HIV-testing through PN was high. However, a significant number of partners did not report for HIV testing after 2 months of index clients CTC enrollment. Initiatives to improve PN are needed with special attention towards those who are single, not living with their partners, in a relationship for < 10 years as well as male sexual partners.

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

“…Other studies have reported low uptake of HIV counseling and testing services among married couples (28, 29). This nding was contrary to what Lyamuya and colleagues found that married participants in their study were 410 times more likely to take up APN than those who were not (30). Relatedly, widowhood had no signi cant association with uptake of APN, which is similar to ndings by Lyamulya and colleagues (30).…”

“…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.…”

Factors associated with Assisted Partner Notification Services in Seme and Kisumu west sub counties, Kenya.

“…The proportion was that a similar to a study carried out in the Tanzania (Plotkin et al, 2018) on the study on the outcomes of men and women on partner notification indicated that 63.4% of the male partners were successfully referred and 49.8% of the female partners were referred. However, the participation rates were low compared to a study in Mozambique where uptake of assisted partner notification was 85% where the index patients gave community health workers permission to contact their partners (Myers et al, 2016).Similarly, according a study in Tanzania on outcomes and factors associated with partner notification, 85% of the HIV care clients consented to participate in partner notification (Lyamuya et al, 2020). Assisted partner notification was established to be safe, acceptable and effective (Myers et al, 2016).…”

Facilitators and Barriers of HIV Partner Notification Services Among Men Who Have Sex With Men in China: A Qualitative Analysis Using a Socioecological Framework

“…22 Partner notification also needs to be delivered in a differentiated way, just as the delivery of HIV testing and ART. 23 The most commonly known differentiated PN methods include passive referral, contract referral, and provider referral, and some studies incorporated other interventions such as providing HIV self-testing or MSM-serving community-based organizations outreach. 3,24 Our results extend the idea of differentiated HIV PS by providing different combinations of interventions to index clients based on the evaluation of notification risks, relationship status, and other conditions.…”

“…Different models of differentiated care have been developed for PLHIV based on clinical characteristics, subpopulation, and client context 22 . Partner notification also needs to be delivered in a differentiated way, just as the delivery of HIV testing and ART 23 . The most commonly known differentiated PN methods include passive referral, contract referral, and provider referral, and some studies incorporated other interventions such as providing HIV self-testing or MSM-serving community-based organizations outreach 3,24 .…”