Dataset Information

Human Immunodeficiency Virus Partner Notification Services Among a Representative Sample of Young Black Men Who Have Sex With Men Demonstrates Limited Service Offering and Potential Benefits of Clinic Involvement.

ABSTRACT: BACKGROUND:Partner notification (PN) is commonly offered to persons recently diagnosed with human immunodeficiency virus (HIV) to improve linkage to care and prevent onward transmission. Yet, much remains unknown about the factors associated with successful PN participation in populations at highest risk. METHODS:Data were collected during the first 2 waves (2013-2015) of "uConnect," a population-based cohort study of young black men who have sex with men in Chicago (N = 618). Participants completed a biobehavioral survey and were tested for HIV. Among HIV-infected participants (N = 187), weighted logistic regression models examined the relationship between participant characteristics and being offered PN and providing partner names. RESULTS:30.3% (n = 187) of the sample was HIV-positive, of which 71.7% (n = 134) were offered PN, including: 8.2% (n = 11) by the city health department; 51.5% (n = 69) by health care providers; and 40.3% (n = 54) by both. Being offered PN was significantly associated with criminal justice involvement history (adjusted odds ratio [aOR], 2.49; 95% confidence interval [CI], 1.38-4.49), volatile nitrates usage (aOR, 2.88; 95% CI, 1.20-6.94), and recent conversations with HIV outreach workers (aOR, 2.68; 95% CI, 1.25-5.77). Providing partner names was significantly associated with intermittent (aOR, 7.26; 95% CI, 1.75-30.07) and heavy (aOR, 11.47; 95% CI, 2.57-51.22) marijuana use, and being offered PN by both the city health department and health care provider (aOR, 8.36; 95% CI, 2.73-25.62). CONCLUSIONS:A substantial proportion of HIV-diagnosed individuals were never offered PN. Being offered PN by multiple sources is associated with participation, and improved collaboration within health systems may improve participation rates.

SUBMITTER: Gore D

PROVIDER: S-EPMC6089660 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Human Immunodeficiency Virus Partner Notification Services Among a Representative Sample of Young Black Men Who Have Sex With Men Demonstrates Limited Service Offering and Potential Benefits of Clinic Involvement.

Gore Daniel D Ferreira Matthew M Khanna Aditya S AS Schneider John J

Sexually transmitted diseases 20180901 9

<h4>Background</h4>Partner notification (PN) is commonly offered to persons recently diagnosed with human immunodeficiency virus (HIV) to improve linkage to care and prevent onward transmission. Yet, much remains unknown about the factors associated with successful PN participation in populations at highest risk.<h4>Methods</h4>Data were collected during the first 2 waves (2013-2015) of "uConnect," a population-based cohort study of young black men who have sex with men in Chicago (N = 618). Par ...[more]

PMID: 29465643

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Project description:IntroductionIn 2007, the Cameroon Baptist Convention Health Services (CBCHS) initiated an assisted partner notification services (aPNS) public health programme to increase HIV case identification and reduce HIV incidence in the most affected regions of Cameroon. We describe large-scale implementation of aPNS and overall programmatic achievements in a resource-limited setting through 2015.MethodsCBCHS trained health advisors (HAs) from 16 CBCHS facilities and 22 non-CBCHS facilities to integrate aPNS into their existing jobs in five of the ten Cameroon regions. HAs recorded basic demographic, clinical and risk factor information from consenting index persons (IPs) and similar information about their sexual partners'/contact persons (CPs) on interview records and aPNS registers. These data were entered into an Epi-Info database. HAs provided pre-test counselling to CPs and offered them HIV testing in their home or other location. HAs educated IPs and CPs on HIV prevention and risk reduction, and referred IPs and HIV positive CPs to HIV care and treatment centres. Starting in 2014, HAs re-interviewed IPs 30 days after their initial aPNS interview to ascertain instances of social harms following partner notification. Continuous predictor and outcome variables were summarized using median and interquartile range, while categorical variables were summarized using percentages from 2007 to 2015.ResultsA total of 18,730 IPs (71% women) received aPNS over nine years. IPs identified 21,057 CPs (67% men) (mean CP/IP 1.12), of whom 12,867 (61.1%) were notified of their exposure to HIV. A total of 9202 (71.5% of notified CPs) tested for HIV, 4764 (51.8%) of whom tested HIV positive (number of IPs needed to interview = 3.9); 3112 (65.3%) HIV-positive partners were referred to HIV care and treatment centres. Of the 976 IPs receiving aPNS in 2014 to 2015, for whom follow-up data were available, 11 (1.1%) reported physical intimate partner violence from CPs. Thus, 44.3% of 1224 CPs were notified through provider referral. Of the 784 CPs who tested for HIV, 157 were newly diagnosed and the overall HIV prevalence was 41.6% (326/784).ConclusionsaPNS is feasible, can be brought to scale, yields a high level of case identification, and is infrequently associated with social harms and intimate partner violence.

Project description:BACKGROUND:Traditional partner notification methods have been implemented for HIV-infected patients, as well as HIV treatment, in order to identify people at risk of HIV infection, especially men who have sex with men (MSM), since they are more likely to have casual sex partners. These traditional methods have some limitations. OBJECTIVE:Our study focused on developing an mHealth app to improve partner notification in practice for MSM; the study then focused on evaluating the effects of the app. METHODS:We developed an mHealth app with different modules using Java and HTML5 and tested it in an MSM community to prevent HIV transmission. The HIV incidence stratified by different follow-up periods were calculated. Poisson regression and social networks were used to estimate the risk ratios and to identify the connection among MSM, respectively. RESULTS:In addition to the partner notification module, which is the kernel of the app, we developed a test result self-query module to enable MSM to get their approved test results in a timely manner, a prompt and warning module to alert users to protect themselves from high-risk conditions, and a health education module to teach users more skills regarding HIV/AIDS prevention. Over a 1-year duration, a total of 3186 MSM used the app, of which 678 had at least two HIV test results since becoming app users; they were included in the final analysis. Among 678 users, a total of 6473 self-queries and 623 partner notifications were recorded, which identified 180 social networks of MSM app users. Those who used the partner notification function were more likely to have self-queries (P<.001). The 678 MSM app users covered 296.47 person-years and contributed to 20 HIV seroconversions; the cumulative HIV infection incidence was estimated as 6.75 per 100 person-years (95% CI 4.38-10.01). We found that the longer the app was used, the lower the HIV incidence (>5 months vs ?5 months: 2.22 per 100 person-years vs 6.99 per 100 person-years; risk ratio 0.32, 95% CI 0.12- 0.87). CONCLUSIONS:The app developed in this study is consistent with the World Health Organization's sensitivity and confidentiality recommendations; it has the potential to reduce the risk of HIV infection among MSM.

Project description:BackgroundAssisted partner notification (PN) is an effective approach for increasing HIV testing among heterosexual partners. There is sparse evidence on its effect among sexual partners of men who have sex with men (MSM).MethodsA randomized controlled trial was conducted to compare the effect of assisted PN and passive PN interventions on uptake of HIV testing among male and female sexual partners of newly HIV-diagnosed MSM. In the passive PN group, participants were encouraged to disclose their HIV status and refer and persuade sexual partners to access HIV testing services (HTS). In the assisted PN group, participants were further provided with HIV self-testing kits for sexual partners to take a test at home or allow a community health worker from MSM-serving community-based organization (CBO) to anonymously refer and persuade their sexual partners to access HTS. The primary outcome was the proportion of index cases who had any sexual partner accessing HTS within four months after randomization. This trial is registered with chictr.org.cn, ChiCTR1800017813.FindingsBetween August 2017 and January 2019, 187 MSM newly diagnosed with HIV in a large city Shenyang in northern China were enrolled in the study and randomly assigned to either passive PN (n=90) or assisted PN (n=97) study groups. The proportion of index cases who disclosed their HIV status to any sexual partners within three months of randomization was similar between passive PN (57%, 95% confidence interval [CI]: 46-67%) and assisted PN groups (58%, 95% CI: 48-68%). During four months of follow-up, the number of sexual partners named, referred to HTS, tested and testing positive per index case was 3•2, 0•7, 0•2 and 0•03 in the passive PN group, and 4•0, 1•0, 0•5 and 0•10 in the assisted PN group. Thirty-five percent of index cases in the assisted PN group had any sexual partners accessing HIV testing compared to 17% in the passive PN group (P = 0•004); 49% sexual partners who were disclosed by index cases in the assisted PN group had access HTS compared to 28% in the passive PN group (P = 0•007).InterpretationThe assisted PN strategy incorporating HIV self-testing and CBO outreach can increase uptake of HIV testing among sexual partners of MSM who were recently diagnosed with HIV.FundingNational Science and Technology Major Project of China, National Natural Science Foundation of China, and Project for Overseas Visiting Research of Liaoning Province.

Project description:BACKGROUND:Partner notification is an essential component of sexually transmitted infection (STI) management. The process involves identifying exposed sex partner(s), notifying these partner(s) about their exposure to a curable STI, and offering counselling and treatment for the STI as a part of syndromic management or after results from an STI test. When implemented effectively, partner notification services can prevent the index patient from being reinfected with a curable STI from an untreated partner, reduce the community burden of curable STIs, and prevent adverse health outcomes in both the index patient and his or her sex partner(s). However, partner notification and treatment rates are often low. This study seeks to explore experiences and preferences related to partner notification and treatment for curable STIs among pregnant women receiving care in an antenatal clinic with integrated HIV and curable STI testing. Results are intended to inform efforts to improve partner notification and treatment rates in Southern Africa. METHODS:We conducted qualitative interviews among women diagnosed with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and/or Trichomonas vaginalis (TV) infection while seeking antenatal care in Gaborone, Botswana. Semi-structured interviews were used to obtain women's knowledge about STIs and their experiences and preferences regarding partner notification. RESULTS:Fifteen women agreed to participate in the study. The majority of women had never heard of CT, NG, or TV infections prior to testing. Thirteen out of 15 participants had notified partners about the STI diagnosis. The majority of notified partners received some treatment; however, partner treatment was often delayed. Most women expressed a preference for accompanying partners to the clinic for treatment. Experiences and preferences did not differ by HIV infection status. CONCLUSIONS:The integration of STI, HIV, and antenatal care services may have contributed to most women's willingness to notify partners. However, logistical barriers to partner treatment remained. More research is needed to identify effective and appropriate strategies for scaling-up partner notification services in order to improve rates of partners successfully contacted and treated, reduce rates of STI reinfection during pregnancy, and ultimately reduce adverse maternal and infant outcomes attributable to antenatal STIs.

Project description:BACKGROUND:Patient-initiated partner notification (PN) following the diagnosis of a sexually transmitted infection is a critical component of disease control in men who have sex with men (MSM) sexual networks. Both printed and internet-based technologies offer potential tools to enhance traditional partner notification approaches among MSM in resource-limited settings. OBJECTIVE:This randomized controlled trial aimed to evaluate the effect of 2 different PN technologies on notification outcomes following syphilis diagnosis among MSM in Peru: a Web-based notification system and patient-delivered partner referral cards. METHODS:During 2012-2014, we screened 1625 MSM from Lima, Peru, for syphilis infection and enrolled 370 MSM with symptomatic primary or secondary syphilis (n=58) or asymptomatic latent syphilis diagnosed by serology (rapid plasma reagin, RPR, and Microhemagglutination assay for Treponema pallidum antibody; n=312). Prior to enrollment, potential participants used a computer-based self-interviewing system to enumerate their recent sexual partnerships and provide details of their 3 most recent partners. Eligible participants were randomly assigned to one of 4 intervention arms: (1) counseling and patient-initiated Web-based PN (n=95), (2) counseling with Web-based partner notification and partner referral cards (n=84), (3) counseling and partner referral cards (n=97), and (4) simple partner notification counseling (control; n=94). Self-reported partner notification was assessed after 14 days among 354 participants who returned for the follow-up assessment. RESULTS:The median age of enrolled participants was 27 (interquartile range, IQR 23-34) years, with a median of 2 partners (IQR 1-5) reported in the past month. Compared with those who received only counseling (arm 4), MSM provided with access to Web-based partner notification (arms 1 and 2) or printed partner referral cards (arms 2 and 3) were more likely to have notified one or more of their sexual partners (odds ratio, OR, 2.18, 95% CI 1.30-3.66; P=.003 and OR 1.68, 95% CI 1.01-2.79; P=.045, respectively). The proportion of partners notified was also higher in both Web-based partner notification (241/421, 57.2%; P<.001) and referral card (240/467, 51.4%; P=.006) arms than in the control arm (82/232, 35.3%). CONCLUSIONS:Both new Web-based technologies and traditional printed materials support patient-directed notification and improve self-reported outcomes among MSM with syphilis. Additional research is needed to refine the use of these partner notification tools in specific partnership contexts. TRIAL REGISTRATION:ClinicalTrials.gov NCT01720641; https://clinicaltrials.gov/ct2/show/NCT01720641 (Archived by WebCite at http://www.webcitation.org/70A89rJL4).

Dataset Information

Human Immunodeficiency Virus Partner Notification Services Among a Representative Sample of Young Black Men Who Have Sex With Men Demonstrates Limited Service Offering and Potential Benefits of Clinic Involvement.

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Human Immunodeficiency Virus Partner Notification Services Among a Representative Sample of Young Black Men Who Have Sex With Men Demonstrates Limited Service Offering and Potential Benefits of Clinic Involvement.

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