Partner Notification and Confidentiality of the Index Patient

Cates, Willard; Ke, Toomey; Gr, Havlak; Gs, Bowen; Ar, Hinman

doi:10.1097/00007435-199004000-00015

Cited by 16 publications

(5 citation statements)

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“…1–3 These services typically involve having a trained professional interview people with HIV to identify their sex partners and then having the professional contact the partners who have been identified with the goal of ensuring that they test for HIV and, if infected, link to medical care. Such services have not been widely implemented in Africa, and few data exist for the effectiveness and feasibility of their provision in primary health-care settings.…”

Section: Introductionmentioning

confidence: 99%

Assisted partner services for HIV in Kenya: a cluster randomised controlled trial

et al. 2017

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Summary Background Assisted partner services for index patients with HIV infections involves elicitation of information about sex partners and contacting them to ensure that they test for HIV and link to care. Assisted partner services are not widely available in Africa. We aimed to establish whether or not assisted partner services increase HIV testing, diagnoses, and linkage to care among sex partners of people with HIV infections in Kenya. Methods In this cluster randomised controlled trial, we recruited non-pregnant adults aged at least 18 years with newly or recently diagnosed HIV without a recent history of intimate partner violence who had not yet or had only recently linked to HIV care from 18 HIV testing services clinics in Kenya. Consenting sites in Kenya were randomly assigned (1:1) by the study statistician (restricted randomisation; balanced distribution in terms of county and proximity to a city) to immediate versus delayed assisted partner services. Primary outcomes were the number of partners tested for HIV, the number who tested HIV positive, and the number enrolled in HIV care, in those who were interviewed at 6 week follow-up. Participants within each cluster were masked to treatment allocation because participants within each cluster received the same intervention. This trial is registered with ClinicalTrials.gov, number NCT01616420. Findings Between Aug 12, 2013, and Aug 31, 2015, we randomly allocated 18 clusters to immediate and delayed HIV assisted partner services (nine in each group), enrolling 1305 participants: 625 (48%) in the immediate group and 680 (52%) in the delayed group. 6 weeks after enrolment of index patients, 392 (67%) of 586 partners had tested for HIV in the immediate group and 85 (13%) of 680 had tested in the delayed group (incidence rate ratio 4·8, 95% CI 3·7–6·4). 136 (23%) partners had new HIV diagnoses in the immediate group compared with 28 (4%) in the delayed group (5·0, 3·2–7·9) and 88 (15%) versus 19 (3%) were newly enrolled in care (4·4, 2·6–7·4). Assisted partner services did not increase intimate partner violence (one intimate partner violence event related to partner notification or study procedures occurred in each group). Interpretation Assisted partner services are safe and increase HIV testing and case-finding; implementation at the population level could enhance linkage to care and antiretroviral therapy initiation and substantially decrease HIV transmission. Funding National Institutes of Health.

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Section: Introductionmentioning

confidence: 99%

Assisted partner services for HIV in Kenya: a cluster randomised controlled trial

et al. 2017

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“…Assisted Partner Services (aPS) for HIV, the elicitation of sexual history of HIV-infected persons and testing of their sexual partners, is widely accepted as routine public health practice in the United States and Europe [ 1 , 2 ]. In Africa, aPS has been demonstrated to be feasible, effective and cost-effective, and more studies are ongoing in Kenya to corroborate this evidence [ 3 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Surveillance of HIV assisted partner services using routine health information systems in Kenya

Cherutich

Golden

Betz

et al. 2016

BMC Med Inform Decis Mak

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BackgroundThe utilization of routine health information systems (HIS) for surveillance of assisted partner services (aPS) for HIV in sub-Saharan is sub-optimal, in part due to poor data quality and limited use of information technology. Consequently, little is known about coverage, scope and quality of HIV aPS. Yet, affordable electronic data tools, software and data transmission infrastructure are now widely accessible in sub-Saharan Africa.MethodsWe designed and implemented a cased-based surveillance system using the HIV testing platform in 18 health facilities in Kenya. The components of this system included an electronic HIV Testing and Counseling (HTC) intake form, data transmission on the Global Systems for Mobile Communication (GSM), and data collection using the Open Data Kit (ODK) platform. We defined rates of new HIV diagnoses, and characterized HIV-infected cases. We also determined the proportion of clients who reported testing for HIV because a) they were notified by a sexual partner b) they were notified by a health provider, or c) they were informed of exposure by another other source. Data collection times were evaluated.ResultsAmong 4351 clients, HIV prevalence was 14.2 %, ranging from 4.4–25.4 % across facilities. Regardless of other reasons for testing, only 107 (2.5 %) of all participants reported testing after being notified by a health provider or sexual partner. A similar proportion, 1.8 % (79 of 4351), reported partner notification as the only reason for seeking an HIV test. Among 79 clients who reported HIV partner services as the reason for testing, the majority (78.5 %), were notified by their sexual partners. The majority (52.8 %) of HIV-infected patients initiated their HIV testing, and 57.2 % tested in a Voluntary Counseling and Testing (VCT) site co-located in a health facility. Median time for data capture was 4 min (IQR: 3–15), with a longer duration for HIV-infected participants, and there was no reported data loss.ConclusionaPS surveillance using new technologies is feasible, and could be readily expanded into HIV registries in Kenya and other sub-Saharan countries. Partner services are under-utilized in Kenya but further documentation of coverage and implementation gaps for HIV and aPS services is required.

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“…In public health terms, PN is regarded as standard best practice globally for the prevention and control of sexually acquired infections (Cates et al 1990, Oxman et al 1994, Cowan et al 1996, Fenton et al 1998, Macke and Maher 1999, WHO/Joint United Nations Programme on HIV/AIDS 1999, Mathews et al 2002, Tomnay et al 2004, Osterterlund et al 2005. However, internationally there has been a failure to investigate lay perspectives on partner notification with any patient group (for exceptions, but mainly relating to HIV, see Jones et al 1990, Gorbach 2000, Tyde´n and Ramstedt 2000, Maman et al 2001, Carballo-Dieguez et al 2002, Golden et al 2003, Lichtenstein and Schwebke 2005, Coleman and Lohan 2007.…”

Section: Introductionmentioning

confidence: 99%

Regulating sexual bodies or addressing health needs? Men who have sex with men and partner notification

Coleman

Begley

2009

Critical Public Health

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Partner notification is the process by which people who are thought to have been exposed to sexually transmitted infections (STIs) are traced, informed about their exposure and invited to attend clinical services. It is the cornerstone of genitourinary medicine for the prevention and treatment of STIs. The central question of the article is whether partner notification (PN) represents the medical regulation of sexual bodies or is an appropriate medical response to health care needs. The question is first of all addressed through contrasting theoretical lenses: a Functionalist Parsonian perspective, a Post-structuralist, Foucauldian perspective and a critical theory Habermasian perspective. The question is then explored empirically by drawing on the perspectives of men who have sex with men (MSM) as drawn from a study of MSM's lay perspectives on partner notification in the context of a syphilis outbreak in Dublin. The findings show that the views of MSM in this study suggest that PN is an appropriate response to health care needs and, thus, the lay views most clearly resonate with a functionalist understanding of trust in the expert and moral status of public health. However, the difficulties MSM experience in complying with PN also suggests that the medical logic of PN needs to be counter-balanced with the social logic as derived from lay experiences of its practice in their lives. A critical theory approach holds potential for mediating between medicine's regulation of sexual health and individual health care needs.

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Partner Notification and Confidentiality of the Index Patient

Cited by 16 publications

References 0 publications

Assisted partner services for HIV in Kenya: a cluster randomised controlled trial

Assisted partner services for HIV in Kenya: a cluster randomised controlled trial

Surveillance of HIV assisted partner services using routine health information systems in Kenya

Regulating sexual bodies or addressing health needs? Men who have sex with men and partner notification

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