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

Overview

Journal AIDS Behav

Specialty Infectious Diseases

Date 2021 Apr 22

PMID 33884511

Citations 8

Authors

Robin E Klabbers

Timothy R Muwonge

Emmanuel Ayikobua

Diego Izizinga

Ingrid V Bassett

Andrew Kambugu

Alexander C Tsai

Miranda Ravicz

Gonnie Klabbers

Kelli N OLaughlin

Affiliations

Soon will be listed here.

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.

Citing Articles

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References

Weinstein N . The precaution adoption process. Health Psychol. 1988; 7(4):355-86. DOI: 10.1037//0278-6133.7.4.355. View

Siedner M, Ng C, Bassett I, Katz I, Bangsberg D, Tsai A . Trends in CD4 count at presentation to care and treatment initiation in sub-Saharan Africa, 2002-2013: a meta-analysis. Clin Infect Dis. 2014; 60(7):1120-7. PMC: 4366582. DOI: 10.1093/cid/ciu1137. View

Sharma M, Smith J, Farquhar C, Ying R, Cherutich P, Golden M . Assisted partner notification services are cost-effective for decreasing HIV burden in western Kenya. AIDS. 2017; 32(2):233-241. PMC: 5736414. DOI: 10.1097/QAD.0000000000001697. View

OLaughlin K, Wyatt M, Kaaya S, Bangsberg D, Ware N . How treatment partners help: social analysis of an African adherence support intervention. AIDS Behav. 2011; 16(5):1308-15. PMC: 3354325. DOI: 10.1007/s10461-011-0038-4. View

Thin R . The legal framework covering the practice of genitourinary medicine in the UK: the Venereal Diseases Regulations. Int J STD AIDS. 2001; 12(11):701-4. DOI: 10.1258/0956462011924119. View

Myers R, Feldacker C, Cesar F, Paredes Z, Augusto G, Muluana C . Acceptability and Effectiveness of Assisted Human Immunodeficiency Virus Partner Services in Mozambique: Results From a Pilot Program in a Public, Urban Clinic. Sex Transm Dis. 2016; 43(11):690-695. DOI: 10.1097/OLQ.0000000000000529. View

Kegeles S, Catania J, Coates T, Pollack L, Lo B . Many people who seek anonymous HIV-antibody testing would avoid it under other circumstances. AIDS. 1990; 4(6):585-8. DOI: 10.1097/00002030-199006000-00016. View

Rutstein S, Brown L, Biddle A, Wheeler S, Kamanga G, Mmodzi P . Cost-effectiveness of provider-based HIV partner notification in urban Malawi. Health Policy Plan. 2013; 29(1):115-26. PMC: 3872371. DOI: 10.1093/heapol/czs140. View

Levy J, FOX S . The outreach-assisted model of partner notification with IDUs. Public Health Rep. 1998; 113 Suppl 1:160-9. PMC: 1307738. View

10.

Kigozi I, Dobkin L, Martin J, Geng E, Muyindike W, Emenyonu N . Late-disease stage at presentation to an HIV clinic in the era of free antiretroviral therapy in Sub-Saharan Africa. J Acquir Immune Defic Syndr. 2009; 52(2):280-9. PMC: 2815238. DOI: 10.1097/QAI.0b013e3181ab6eab. View

11.

Rosenberg N, Mtande T, Saidi F, Stanley C, Jere E, Paile L . Recruiting male partners for couple HIV testing and counselling in Malawi's option B+ programme: an unblinded randomised controlled trial. Lancet HIV. 2015; 2(11):e483-91. PMC: 4656790. DOI: 10.1016/S2352-3018(15)00182-4. View

12.

Landis S, Schoenbach V, Weber D, Mittal M, KRISHAN B, Lewis K . Results of a randomized trial of partner notification in cases of HIV infection in North Carolina. N Engl J Med. 1992; 326(2):101-6. DOI: 10.1056/NEJM199201093260205. View

13.

OLaughlin K, Rouhani S, Faustin Z, Ware N . Testing experiences of HIV positive refugees in Nakivale Refugee Settlement in Uganda: informing interventions to encourage priority shifting. Confl Health. 2013; 7(1):2. PMC: 3645965. DOI: 10.1186/1752-1505-7-2. View

14.

. Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies. Lancet HIV. 2017; 4(8):e349-e356. PMC: 5555438. DOI: 10.1016/S2352-3018(17)30066-8. View

15.

OLaughlin K, Kasozi J, Walensky R, Parker R, Faustin Z, Doraiswamy S . Clinic-based routine voluntary HIV testing in a refugee settlement in Uganda. J Acquir Immune Defic Syndr. 2014; 67(4):409-13. PMC: 4213244. DOI: 10.1097/QAI.0000000000000317. View

16.

Maman S, Groves A, McNaughton Reyes H, Moodley D . Diagnosis and Disclosure of HIV Status: Implications for Women's Risk of Physical Partner Violence in the Postpartum Period. J Acquir Immune Defic Syndr. 2016; 72(5):546-51. PMC: 4942348. DOI: 10.1097/QAI.0000000000001012. View

17.

Spiegel P . HIV/AIDS among conflict-affected and displaced populations: dispelling myths and taking action. Disasters. 2004; 28(3):322-39. DOI: 10.1111/j.0361-3666.2004.00261.x. View

18.

Perry S, Card C, Moffatt Jr M, Ashman T, Fishman B, Jacobsberg L . Self-disclosure of HIV infection to sexual partners after repeated counseling. AIDS Educ Prev. 1994; 6(5):403-11. View

19.

Brown L, Miller W, Kamanga G, Nyirenda N, Mmodzi P, Pettifor A . HIV partner notification is effective and feasible in sub-Saharan Africa: opportunities for HIV treatment and prevention. J Acquir Immune Defic Syndr. 2011; 56(5):437-42. PMC: 3207356. DOI: 10.1097/qai.0b013e318202bf7d. View

20.

Branson B, Viall A, Marum E . Expanding HIV testing: back to the future. J Acquir Immune Defic Syndr. 2013; 63 Suppl 2:S117-21. DOI: 10.1097/QAI.0b013e3182986f25. View