Health Worker Perspectives on Barriers and Facilitators of Assisted Partner Notification for HIV for Refugees and Ugandan Nationals: A Mixed Methods Study in West Nile Uganda

Abstract

Assisted partner notification (APN) is recommended by the World Health Organization to notify sexual partners of HIV exposure. Since 2018, APN has been offered in Uganda to Ugandan nationals and refugees. Distinct challenges faced by individuals in refugee settlements may influence APN utilization and effectiveness. To explore APN barriers and facilitators, we extracted index client and sexual partner data from APN registers at 11 health centers providing care to refugees and Ugandan nationals in West Nile Uganda and conducted qualitative interviews with health workers (N = 32). Since APN started, 882 index clients participated in APN identifying 1126 sexual partners. Following notification, 95% (1025/1126) of partners tested for HIV; 22% (230/1025) were diagnosed with HIV with 14% (139/1025) of tested partners newly diagnosed. Fear of stigma and disclosure-related violence limit APN utilization and effectiveness. Prospective research involving index clients and sexual partners is needed to facilitate safe APN optimization in refugee settlements.

Screening, Diagnostic and Prognostic Tests for COVID-19: A Comprehensive Review

“…Their diagnostic accuracy is greatest in symptomatic patients, when the viral load in the nasopharynx is higher, enabling early diagnosis, triage and treatment [28]. The optimum timing of testing can vary (within 5, 7 and 12 days from symptom onset) [29]. Therefore, the advantages of point of care tests, with rapid identification and isolation of cases, at a lower cost to RT-PCR tests, may perhaps be limited to some extent by the poor sensitivity they offer, especially in asymptomatic or pre-symptomatic individuals.…”

A randomized trial of index HIV self-testing for sexual partners of ART clients in Malawi

“…Voluntary assisted partner disclosure and testing, whereby health care workers (HCWs) visit index partners in the community to provide HIV testing services, promises to increase testing uptake 12 , but is costly 13 and has increased risk for coercion and unwanted disclosure for the ART client, especially among women living with HIV. [14][15][16][17] New strategies are needed to effectively reach partners with index testing, particularly men.…”

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

“…2,5 Barriers include perceived stigma and discrimination, 6 concerns about negative consequences and social harm, 7,8 and lacking contact information. 9 However, there is still a gap in comprehensively understanding the facilitators and barriers of HIV PS for Chinese MSM living with HIV. First, few empirical studies have focused on HIV PS in LMICs.…”

“…First, few empirical studies have focused on HIV PS in LMICs. 7,[9][10][11] The social context surrounding sex and sexuality in LMICs, including institutional legislations and religious or cultural norms, differs from that in high-income countries; thus, facilitators and barriers of HIV partner notification services for MSM may also differ. 12 Moreover, fewer resources are available in LMICs, such as peer and community support, and medical facilities and services.…”

“…Commonly reported facilitators include perceived social responsibility to prevent further HIV transmission and related health benefits to partners and the public 2,5 . Barriers include perceived stigma and discrimination, 6 concerns about negative consequences and social harm, 7,8 and lacking contact information 9 …”