Addressing the First 90: A Highly Effective Partner Notification Approach Reaches Previously Undiagnosed Sexual Partners in Tanzania

Abstract

To meet UNAIDS’ 90–90–90 treatment goals, effective approaches to HIV testing services (HTSs) are urgently needed. In 2015, a cross-sectional study was conducted to evaluate effectiveness and feasibility of partner notification for HTS in Tanzania. Men and women newly diagnosed with HIV were enrolled as index clients, listed sexual partners, and given options to notify and link their partners to HTS. Of 653 newly diagnosed individuals, 390 index clients were enrolled, listed 438 sexual partners, of whom 249 (56.8%) were successfully referred. Of 249 partners reaching the facilities, 96% tested for HIV, 148 (61.9%) tested HIV+ (all newly diagnosed), and 104 (70.3%) of partners testing positive were enrolled into HIV care and treatment. Results showed good acceptability, feasibility and effectiveness, as evidenced by high uptake of partner notification among newly diagnosed individuals, over half of listed partners successfully referred, and a very high positivity rate among referred sexual partners.

Perspectives on HIV partner notification, partner HIV self‐testing and partner home‐based HIV testing by pregnant and postpartum women in antenatal settings: a qualitative analysis in Malawi and Zambia

“…Stakeholders identified potential implementation challenges for each HIV testing modality. Although evaluation trials have demonstrated the effectiveness of these male partner HIV testing approaches in antenatal settings , implementation research with cost‐effectiveness analysis would be helpful to guide countries when considering partner testing approaches. While cost‐effectiveness studies in the general adult population have been promising , evidence of cost‐effectiveness in antenatal settings is still needed.…”

Enhancing an HIV index case testing passive referral model through a behavioural skills‐building training for healthcare providers: a pre‐/post‐assessment in Mangochi District, Malawi

“…These index‐based approaches can be passive, in which the index is responsible for contact recruitment, or active, in which the healthcare system supports the index with contact recruitment . Such index‐based approaches are promoted due to their potential to improve HIV testing coverage and efficiently identify other undiagnosed HIV infections .…”

“…Malawi, in its national HIV guidelines, has adopted a passive referral model , in spite of local and international evidence demonstrating the enhanced effectiveness of active approaches, along with adequate safety , acceptability and cost‐effectiveness . Active approaches have not been pursued due to concerns of cost, complexity and social harms.…”

Assisted partner services for HIV

“…Programs evaluated in published studies have varied substantially, variously relying on medical professionals and religious pastors (Cameroon), trained study staff (Kenya and Malawi), HIV testing counselors (Tanzania)[10] and community health workers (Mozambique). Some APS models have emphasized resource-intensive field investigation (Kenya and Cameroon), others have relied almost entirely on cellphone contact (Mozambique), and some have focused primarily on disclosure counseling (Tanzania).…”