Outcomes of and factors associated with partner notification and HIV testing in Northeastern Tanzania.
Background:
There is growing evidence of high effectiveness of partner notification (PN) in reachingpreviously undiagnosed sexual partners. As a result, there is increasing implementation of PN in sub-Saharan Africa. Tanzania, like other countries in the region, has recently expanded PN in HIV testingservices. However, this approach is unlikely to yield the expected results if not well implemented. Thisstudy aimed to identify gaps and provide recommendations to improve routine implementation of PNin Tanzania.
Methods: A cross-sectional study was conducted across seven care and treatment centers (CTCs) inthe Kilimanjaro region from November 2018 to April 2019. A total of 297 newly diagnosed HIV infectedclients with sexual partner(s) in the past 24 months were recruited at 2 months of their CTCenrollment. Interviews using structured questionnaires were conducted. Descriptive statistics,bivariate and multivariate regression analyses were done.
Results: Two-thirds (195) were females. The majority 165 (85%) of those counseled and hadpartner(s) not previously tested for HIV consented to PN. They all chose passive PN with 102 (62%)reporting successful HIV status disclosure to their partner(s). Reporting disclosure was associatedwith; being married adjusted odds ratio (aOR 5.1, 95%CI: 2.4–10.9, p < 0.001), in a relationship for >10 years (aOR 4.9, 95%CI: 1.3–17.6, p = 0.02) and living with the partner(s) (aOR 3.4, 95%CI: 1.3–9.1,p = 0.02). Fifty-three clients (27%) of those with partners not previously tested for HIV reportedpartner HIV testing following PN, associated with being married (aOR 3.4, 95%CI: 1.3-9, p < 0.02) andliving with the partner (aOR 4.5, 95%CI: 1.3–15, p < 0.02). Male partner(s) had lower odds ofsuccessful HIV testing (aOR 0.4, 95%CI: 0.2–0.9, p = 0.02). Thirty-seven (67%) of those tested wereHIV infected.
Conclusions: Detection rate of previously undiagnosed HIV infection among clients referred for HIVtestingthrough PN was high. However, a significant number of partners did not report for HIV testingafter 2 months of index clients CTC enrollment. Initiatives to improve PN are needed with specialattention towards those who are single, not living with their partners, in a relationship for < 10 yearsas well as male sexual partners.