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

Area of Science:

• Public Health
• Epidemiology
• HIV/AIDS Research

Background:

• Assisted partner services (APS) are crucial for HIV prevention, but partner elicitation often occurs only at initial diagnosis.
• Index clients may be hesitant to disclose all partners initially, limiting the effectiveness of traditional APS.
• The benefits of sustained partner elicitation beyond the initial HIV diagnosis visit are not well understood.

Purpose of the Study:

• To evaluate the impact of ongoing partner elicitation in assisted partner services (APS) on identifying male partners at increased HIV risk.
• To compare the characteristics and HIV diagnosis rates of partners named during initial versus follow-up visits within an APS program.
• To assess the association between continued partner elicitation and the number of new HIV diagnoses.

Main Methods:

• A prospective study involving 872 female index clients in western Kenya who accepted APS.
• Partners were elicited at initial HIV diagnosis and during 12 months of follow-up clinic visits.
• Multivariable Poisson Generalized Estimated Equation models were used to analyze data on partner characteristics and HIV diagnoses.

Main Results:

• A total of 3461 male partners were named, with 2920 successfully contacted and HIV tested.
• Partners named at follow-up visits were significantly more likely to be newly diagnosed with HIV (17.5%) compared to those named at the initial visit (4.9%).
• Partners named at follow-up visits were 3.9 times more likely to be newly diagnosed with HIV and reported higher-risk behaviors.

Conclusions:

• Continuing partner elicitation for APS for 12 months after initial HIV diagnosis substantially increases the identification of male partners at increased HIV risk.
• Ongoing partner services are more effective in diagnosing new HIV infections than relying solely on initial partner disclosure.
• Sustained APS efforts are vital for comprehensive HIV case finding and prevention strategies.