Assisted Partner Notification Services (APS) in Namibia: Comparison of Case-Finding in Persons with New and Previously Diagnosed HIV, and Success as a Platform for PrEP Referral
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3 01 2024
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Source: Sex Transm Dis. 51(3):214-219
Details:
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Alternative Title:Sex Transm Dis
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Personal Author:
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Description:Background
Assisted partner notification services (APS) are widely implemented throughout sub-Saharan Africa. The effectiveness of APS among persons with previously diagnosed HIV infection is uncertain, and there are few published data on the success of integrating referrals for HIV pre-exposure prophylaxis (PrEP) into APS.
Methods
Staff in 22 Namibian Ministry of Health and Social Service clinics offered APS to patients newly and previously diagnosed with HIV (index cases [ICs]) between October 2019 and June 2021. Counselors used a structured interview guide to elicit ICs’ sex partners and biological children and assisted ICs to arrange testing of contacts. Contacts testing HIV-positive were linked to HIV services and those aged ≥14 years testing negative were offered PrEP. The primary outcome was the case-finding index (contacts testing HIV-positive ÷ ICs receiving APS).
Results
Staff provided APS to 1,222 (78%) of 1,557 newly diagnosed ICs eliciting 1,155 sex partners and 649 biological children. Among 280 previously diagnosed ICs, 279 sex partners and 158 biological children were elicited. The case-finding index was higher among ICs with newly diagnosed HIV compared to previously diagnosed HIV (0.14 vs. 0.09, p=0.46), though this difference was not statistically significant. Most sex partners testing HIV-negative were initiated on PrEP (67% in sex partners from newly diagnosed ICs; 74% in sex partners from previously diagnosed ICs).
Conclusions
APS successfully identified sex partners and biological children with undiagnosed HIV infection when provided to both newly and previously diagnosed ICs. Integration of referral to PrEP resulted in many HIV-negative partners initiating PrEP.
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Pubmed ID:38412468
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Pubmed Central ID:PMC10901442
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