Acceptance of Index Case HIV Testing and Its Associated Factors Among HIV/AIDS Clients on ART Follow-Up in West Ethiopia: A Multi-Centered Facility-Based Cross-Sectional Study

Abstract

Background Index case HIV/AIDS testing (ICHT) is a good approach for addressing and improving the efficiency and yield of testing among high-risk populations. Partners and families of people living with HIV/AIDS are among the high-risk populations for contracting HIV/AIDS. However, there is limited study on index case HIV testing among HIV patients attending Anti-Retroviral Therapy (ART). Hence, this study was aimed at assessing the magnitude and factors associated with ICHT among HIV patients attending ART in Nekemte town public health facilities. Methods An institution-based cross-sectional study was conducted at Nekemte town public health facilities from May 20 to July 21, 2020. A systematic random sampling method was used to select the study participants. Multivariable logistic regression analysis was used to determine the predictors of acceptance of ICHT among HIV patients. Results The ICHT acceptance was 85.2% (95% CI=84.9–91.1%). Disclosure of their HIV status (AOR=9.74, 95% CI=4.11–23.06), having good knowledge of ICHT (AOR=4.70, 95% CI=1.92–11.61), believing HIV index case testing has benefits (AOR=3.43, 95% CI=1.27–9.29), and being on ART for more than 1 year (AOR=4.78, 95% CI=2.13–10.76) were significantly associated with index case HIV test acceptance. Conclusion and Recommendation This study revealed a significant proportion of index case HIV testing acceptance. HIV status disclosure of index cases, knowledge of ICHT, the perceived benefit of ICHT, and long duration on ART were found to be significantly associated with acceptance of ICHT. Hence, it is essential to give attention to counseling on the importance of ICHT, enhance people living with HIV (PLWHIV) to have positive belief on the advantage of ICHT, strengthen disclosure counseling, and assist HIV status disclosure in health facilities.

Sociodemographic factors associated with acceptance of index case testing among newly diagnosed human immunodeficiency virus-positive clients in southern borno, Nigeria

“…In both the unadjusted and adjusted models of the logistic regression analysis, age and marital status emerged as statistically significant factors associated with ICT acceptance. The finding that age is associated with ICT acceptance does not corroborate with previous studies conducted in Tanzania 10 and Ethiopia, 12 which found no association between age and ICT acceptance. The variation observed in these studies could be attributed to cultural differences, sample characteristics, and contextual factors such as environmental or social factors.…”

“…This rate is higher than that of previous studies conducted in Tanzania which reported an acceptance rate of 55.5% 10 but lower than that of a study conducted in Nigeria and Ethiopia that reported an acceptance rate of 84.9% and 85.2% respectively. 11,12 The differences in the acceptance rate among these studies might be due to factors such as effective partner elicitation strategies, the level of awareness about HIV testing and its benefits, stigma and discrimination, fear of being identified as living with HIV and the availability of convenient and confidential HIV testing services. 10 However, it's essential to recognize that further research is warranted to confirm these claims.…”

Examining the feasibility of assisted index case testing for HIV case-finding: a qualitative analysis of barriers and facilitators to implementation in Malawi

“…Assisted ICT has been widely recognized as an intervention with high potential to increase PLHIV status awareness [6, 13,14,17,19,20,21,22,23,24,25,26,28,29], which is important as countries in eastern and southern Africa strive to reach global UNAIDS targets. This study examines the implementation of assisted ICT from the perspective of very people doing the "assisting."…”

“…Traditional approaches to ICT rely on passive referral, in which index clients invite their contacts for testing [6]. However, the World Health Organization (WHO) and the President's Emergency Plan for HIV/AIDS Relief (PEPFAR) have both recommended assisted approaches to ICT [7,8,9], in which health care workers (HCWs) take an active role in referral of at-risk contacts for testing, due to improved effectiveness compared to passive approaches [10,11,12,13,14,15,16,17]. As a result, there have been attempts to scale assisted ICT throughout southern and eastern Africa over the past several years.…”

“…As a result, there have been attempts to scale assisted ICT throughout southern and eastern Africa over the past several years. Implementation evidence [18] from the region suggests that assisted ICT can be an acceptable [6,17,19,20,21,22,23], cost-effective [24], and low-risk [25] strategy to promote PLHIV status awareness [26,27,28,29]. However, despite effective implementation being at the heart of any assisted ICT strategy, there is limited implementation science research from the perspectives of the HCWs who are doing the "assisting".…”