Improving HIV assisted partner services outcomes by eliciting additional partners after the initial encounter

Most assisted partner services (APS) programs elicit partners at the time of HIV diagnosis when index clients may be reluctant to name all partners. Little is known about the benefits of ongoing partner elicitation after the initial visit. We utilized data collected in an APS implementation study across 31 facilities in western Kenya from August 2019 to June 2022. HIV testing service providers offered APS to consenting female index clients and asked them to name their male partners both at initial diagnosis and during follow-up clinic visits for 12 months. Partners were traced and offered HIV testing. Using multivariable Poisson Generalized Estimated Equation models, we compared characteristics of index clients who did and did not name additional partners and assessed HIV diagnoses and characteristics of partners named during initial versus follow-up visits. The 872 female index clients who accepted APS named 3461 male partners, of whom 2920 (84%) were successfully contacted and HIV tested. Of 1819 male partners named at the initial visit, 430 (23.6%) were previously diagnosed and 90 (4.9%) were newly diagnosed with HIV. Of 1101 male partners named at follow-up visits, 335 (30.4%) were previously diagnosed and 193 (17.5%) were newly diagnosed with HIV. Among partners tested, those named at follow-up visits were 3.9 times more likely to be newly diagnosed with HIV than those named at the initial visit (Relative Risk = 3.88, 95%CI = 3.00-4.98) and were more likely to report behaviors associated with HIV transmission, including having sex with >1 partner (p < 0.001) and with a partner at risk of HIV or with unknown HIV status (p = 0.01). Continuing partner elicitation for APS for 12 months after the initial visit was associated with a higher likelihood of identifying male partners at increased HIV risk compared to those initially named and increased the number of new HIV diagnoses.