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Exploring the acceptability of HIV partner notification in prisons: Findings from a survey of incarcerated people living with HIV in Indonesia.

ABSTRACT: Assisted HIV partner notification services provide a safe and effective way for people living with HIV (PLHIV) to inform their partners about the possibility of exposure and to offer them testing, treatment, and support. This study examined whether or not PLHIV in prison might be willing to participate in assisted HIV partner notification services and their reasons for and against disclosing their HIV-positive status to their partners. PLHIV (n = 150) recruited from Jakarta's two largest all-male prisons completed an interviewer-administered questionnaire collecting demographic and risk behavior data, and attitudes toward HIV disclosure and partner services. Among those who were sexually active and/or injecting drugs before incarceration, two-thirds (66.4%, 91/137) endorsed provider referral as an acceptable way to notify their sex partners, and nearly three quarters (72.4%, 89/123) endorsed provider referral to notify their drug-injecting partners. Only a quarter (25.1%) of participants reported that their main sex partner had ever received an HIV test. Participants with anticipated stigma were less likely to endorse provider referral for sex partners (adjusted odds ratio [aOR] = 0.58, 95% CI: 0.35, 0.96) and drug-injecting partners (aOR = 0.54, 95% CI: 0.29, 1.00). Relationship closeness was associated with higher odds of endorsing provider referral for drug-injecting partners (aOR = 2.08, 95% CI: 1.25, 3.45). Protecting partners from infection and a moral duty to inform were main reasons to disclose, while stigma and privacy concerns were main reasons not to disclose. Most incarcerated PLHIV have at-risk partners in the community who they would be willing to notify if provided with assistance. Assisted partner notification for prison populations offers a promising public health approach to accelerate diagnosis, treatment, and prevention of HIV infection in the community, particularly among women.

SUBMITTER: Culbert GJ

PROVIDER: S-EPMC7326233 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Exploring the acceptability of HIV partner notification in prisons: Findings from a survey of incarcerated people living with HIV in Indonesia.

Culbert Gabriel J GJ Waluyo Agung A Earnshaw Valerie A VA

PloS one 20200630 6

Assisted HIV partner notification services provide a safe and effective way for people living with HIV (PLHIV) to inform their partners about the possibility of exposure and to offer them testing, treatment, and support. This study examined whether or not PLHIV in prison might be willing to participate in assisted HIV partner notification services and their reasons for and against disclosing their HIV-positive status to their partners. PLHIV (n = 150) recruited from Jakarta's two largest all-mal ...[more]

PMID: 32603363

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Project description:IntroductionCanadian correctional institutions have been prioritized for COVID-19 vaccination given the multiple outbreaks that have occurred since the start of the pandemic. Given historically low vaccine uptake, we aimed to explore barriers and facilitators to COVID-19 vaccination acceptability among people incarcerated in federal prisons.MethodsThree federal prisons in Quebec, Ontario, and British Columbia (Canada) were chosen based on previously low influenza vaccine uptake among those incarcerated. Using a qualitative design, semi-structured interviews were conducted with a diverse sample (gender, age, and ethnicity) of incarcerated people. An inductive-deductive analysis of audio-recorded interview transcripts was conducted to identify and categorize barriers and facilitators within the Theoretical Domains Framework (TDF).ResultsFrom March 22-29, 2021, a total of 15 participants (n = 5 per site; n = 5 women; median age = 43 years) were interviewed, including five First Nations people and six people from other minority groups. Eleven (73%) expressed a desire to receive a COVID-19 vaccine, including two who previously refused influenza vaccination. We identified five thematic barriers across three TDF domains: social influences (receiving strict recommendations, believing in conspiracies to harm), beliefs about consequences (believing that infection control measures will not be fully lifted, concerns with vaccine-related side effects), and knowledge (lack of vaccine-specific information), and eight thematic facilitators across five TDF domains: environmental context and resources (perceiving correctional employees as sources of outbreaks, perceiving challenges to prevention measures), social influences (receiving recommendations from trusted individuals), beliefs about consequences (seeking individual and collective protection, believing in a collective "return to normal", believing in individual privileges), knowledge (reassurance about vaccine outcomes), and emotions (having experienced COVID-19-related stress).ConclusionsLack of information and misinformation were important barriers to COVID-19 vaccine acceptability among people incarcerated in Canadian federal prisons. This suggests that educational interventions, delivered by trusted health care providers, may improve COVID-19 vaccine uptake going forward.

Project description:BackgroundVoluntary assisted partner notification (aPN) services are effective in increasing access to and uptake of HIV testing among partners of people with HIV. Following recommendations by the World Health Organization in 2016, Indonesia evaluated various approaches to aPN. We present the lessons learned from formative operational research undertaken to understand provider and patient perspectives on aPN from three demonstration sites in cities with a high HIV burden.MethodsWe conducted a formative qualitative study in three cities: Jakarta, Semarang, and Denpasar between September and October 2019. We conducted six focus group discussions (FGDs) (n = 44 participants) among health-care providers, people living with HIV and the general population. We explored participant preferences and concerns about how aPN should be delivered, including the methods of and messaging for contacting partners. All FGDs were conducted in the Indonesian language. Qualitative data were analysed using thematic analysis.ResultsaPN was acceptable across different participant populations, although with caveats. Some differences were observed between the general population, providers and people living with HIV. People living with HIV were mainly concerned with confidentiality of the procedure and preferred the use of telecommunication and messages that avoid explicit mention of HIV exposure. Providers preferred similar approaches but for different reasons, being concerned mainly with self-efficacy and security. There was consensus regarding dual referral models. The use of phone calls and short messages were preferred as these are perceived to minimize negative reactions and stigma, protect client confidentiality and are suitable in the current legal situation. The general population was mainly concerned with effectiveness and prefer direct provider-led approaches, such as preferring in-person meeting with explicit notification of potential HIV exposure.ConclusionsWe found consensus among stakeholders on acceptance of aPN, especially dual referral methods. Development and implementation of aPN protocols should also consider clients' individual situations and concerns regarding safeguarding of confidentiality, and offer a range of options to accommodate all stakeholders involved.

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: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.

Dataset Information

Exploring the acceptability of HIV partner notification in prisons: Findings from a survey of incarcerated people living with HIV in Indonesia.

Publications

Exploring the acceptability of HIV partner notification in prisons: Findings from a survey of incarcerated people living with HIV in Indonesia.

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