Advertisement

AIDS and Behavior

, Volume 22, Issue 8, pp 2458–2467 | Cite as

Reaching the First 90 in Uganda: Predictors of Success in Contacting and Testing the Named Sexual Partners of HIV+ Index Clients in Kiboga District

  • Katherine BuhikireEmail author
  • Joachim Voss
  • Joanita Kigozi
  • Patience Nyakato
  • Nickson Ankunda
  • Brenda Kalebbo
  • Michael Musiitwa
  • Alex Muganzi
  • Nelson K. Sewankambo
  • Damalie Nakanjako
Original Paper

Abstract

Assisted partner notification programs represent one strategy for targeted HIV testing and treatment of exposed individuals in high-risk populations. This study of a pilot Partner Services program in rural Uganda describes predictors of successful contact tracings and testing of partners of HIV+ individuals and possible barriers to contact. Partner contact tracing data was extracted from registers at seven Ministry of Health facilities between May and October 2016, to inform program implementation and scale up. A total of 464 HIV+ index clients named 660 sexual partners; 334/660 (51%) were contacted, 193/334 (58%) tested for HIV, and 61/193 (32%) tested HIV+. Current relationship status predicted contact [AOR = 0.23; (95% CI 0.15, 0.37), p < 0.0001] and testing [AOR = 0.19; (95% CI 0.09, 0.36), p < 0.0001]. Partner contact information type was associated with contact (p < 0.0001), and assisted disclosure with testing (p < 0.0001). Partner contact tracing is an effective means of identifying undiagnosed HIV infections.

Keywords

Partner services Assisted partner notification Disclosure Contact tracing Linkage to HIV care Uganda 

Notes

Acknowledgements

This work was supported by the Office of the Global AIDS Coordinator (OGAC); President’s Emergency Plan for AIDS Relief (PEPFAR); the United States National Institutes of Health (NIH) Office of AIDS Research (OAR); and a supplement to Grant #D43TW000007-22S3 from the Fogarty International Center (FIC) of the NIH. This project was made possible by the Afya Bora Consortium Fellowship, which is supported by PEPFAR and the OAR of the U.S. NIH through funding to the University of Washington under Cooperative Agreement U91 HA06801 from the US Department of Health and Human Services, Health Resources and Services Administration (HRSA) Global HIV/AIDS Bureau. Ugandan co-authors are employed at the Infectious Diseases Institute (IDI), and Makerere University College of Health Sciences, the site that hosted Katherine for the Afya Bora Consortium Global Health Leadership fellowship. The authors acknowledge the staff and participants of the Kiboga District Partner Services program that provided the platform for analysis of these data to inform the scale up of partner services. The authors acknowledge Damalie Nakanjako’s group leader award from MUII-plus with funding from Wellcome Trust grant 107742/Z/15/z, that support capacity building activities at Makerere University College of Health Sciences. The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust and the UK government. The views expressed in this publication are those of the author(s) and not necessarily those of AAS, NEPAD Agency, Wellcome Trust or the UK.

Compliance with Ethical Standards

Conflicts of interest

The authors have no conflicts of interest to declare.

Ethical Approval

Permission to analyze the program data was given by Kiboga District Health Authorities employed by the Uganda Ministry of Health. Ethical approval to analyze and disseminate Partner Services program data, and waiver of written informed consent were obtained from the Makerere University School of Medicine Research and Ethics Committee.

Informed Consent

Informed verbal consent was obtained from all participants and/or their parent/guardian prior to participation in the Partner Services program.

Supplementary material

10461_2018_2137_MOESM1_ESM.docx (71 kb)
Supplementary material 1 (DOCX 71 kb)

References

  1. 1.
    European Partner Notification Study Group. Recently diagnosed sexually HIV-infected patients seroconversion interval, partner notification period and a high yield of HIV diagnoses among partners. QJM. 2001;94(7):379–90.CrossRefGoogle Scholar
  2. 2.
    Kissinger P, Malebranche D. Partner notification: a promising approach to addressing the HIV/AIDS racial disparity in the United States. Am J Prev Med. 2007;33(2 Suppl):S86–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Brown LB, Miller WC, Kamanga G, et al. HIV partner notification is effective and feasible in sub-Saharan Africa: opportunities for HIV treatment and prevention. J Acquir Immune Defic Syndr. 2011;56(5):437–42.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Henley C, Forgwei G, Welty T, et al. Scale-up and case-finding effectiveness of an HIV partner services program in Cameroon: an innovative HIV prevention intervention for developing countries. Sex Transm Dis. 2013;40(12):909–14.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    UNAIDS. Global HIV/AIDS response: epidemic update and health sector progress towards universal access, 2011. http://files.unaids.org/en/media/unaids/contentassets/documents/unaidspublication/2011/20111130_UA_Report_summary_en.pdf Accessed 27 Apr 2018.
  6. 6.
    Uganda Ministry of Health. AIDS Indicator Survey, 2011. https://dhsprogram.com/pubs/pdf/AIS10/AIS10.pdf Accessed 27 Apr 2018.
  7. 7.
    Uganda Ministry of Health. Preliminary results of the 2016 Uganda population HIV impact assessment, 2017. http://ugandajournalistsresourcecentre.com/preliminary-results-2016-uganda-population-hiv-impact-assessment/Accessed 27 Apr 2018.
  8. 8.
    Uganda Ministry of Health. HIV and AIDS Uganda Country Progress Report 2014. http://library.health.go.ug/download/file/fid/580856 Accessed 27 Apr 2018.
  9. 9.
    UNAIDS. Prevention Gap Report. 2016. http://www.unaids.org/sites/default/files/media_asset/2016-prevention-gap-report_en.pdf Accessed 27 Apr 2018.
  10. 10.
    Cherutich P, Golden MR, Wamuti B, et al. Assisted partner services for HIV in Kenya: a cluster randomised controlled trial. Lancet HIV. 2017;4(2):e74–82.CrossRefPubMedGoogle Scholar
  11. 11.
    Kamanga G, Brown L, Jawati P, Chiwanda D, Nyirenda N. Maximizing HIV partner notification opportunities for index patients and their sexual partners in Malawi. Malawi Med J. 2015;27(4):140–4.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Rosenberg NE, Mtande TK, Saidi F, et al. Recruiting male partners for couple HIV testing and counselling in Malawi’s option B+ programme: an unblinded randomised controlled trial. Lancet HIV. 2015;2(11):e483–91.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Rutstein SE, Brown LB, Biddle AK, et al. Cost-effectiveness of provider-based HIV partner notification in urban Malawi. Health Policy Plan. 2014;29(1):115–26.CrossRefPubMedGoogle Scholar
  14. 14.
    Kahabuka C, Plotkin M, Christensen A, et al. Addressing the first 90: a highly effective partner notification approach reaches previously undiagnosed sexual partners in Tanzania. AIDS Behav. 2017;21(8):2551–60.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Tafuma TA, Ntwayagae BC, Moalafhi CK, Bolebantswe JM. Patient initiated sexual partner notification in Botswana and time taken for sexual contacts to report for treatment. S Afr Med J. 2014;104(1):42–4.CrossRefGoogle Scholar
  16. 16.
    Kyabayinze DJ, Achan J, Nakanjako D, et al. Parasite-based malaria diagnosis: are health systems in Uganda equipped enough to implement the policy? BMC Public Health. 2012;12:695.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Uganda Ministry of Health. Uganda partner services implementation guide. 2017. (Unpublished).Google Scholar
  18. 18.
    Simbayi LC, Kalichman SC, Strebel A, Cloete A, Henda N, Mqeketo A. Disclosure of HIV status to sex partners and sexual risk behaviours among HIV-positive men and women, Cape Town, South Africa. Sex Transm Infect. 2007;83(1):29–34.CrossRefPubMedGoogle Scholar
  19. 19.
    Winchester MS, McGrath JW, Kaawa-Mafigiri D, et al. Early HIV disclosure and nondisclosure among men and women on antiretroviral treatment in Uganda. AIDS Care. 2013;25(10):1253–8.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Maman S, van Rooyen H, Groves AK. HIV status disclosure to families for social support in South Africa (NIMH Project Accept/HPTN 043). AIDS Care. 2014;26(2):226–32.CrossRefPubMedGoogle Scholar
  21. 21.
    Mugasha C, Kigozi J, Kiragga A, et al. Intra-facility linkage of HIV-positive mothers and HIV-exposed babies into HIV chronic care: rural and urban experience in a resource limited setting. PLoS ONE. 2014;9(12):e115171.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Kranzer K, Zeinecker J, Ginsberg P, et al. Linkage to HIV care and antiretroviral therapy in Cape Town, South Africa. PLoS ONE. 2010;5(11):e13801.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Gardner EM, McLees MP, Steiner JF, Del Rio C, Burman WJ. The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. Clin Infect Dis. 2011;52(6):793–800.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Maman S, Mbwambo JK, Hogan NM, Weiss E, Kilonzo GP, Sweat MD. High rates and positive outcomes of HIV-serostatus disclosure to sexual partners: reasons for cautious optimism from a voluntary counseling and testing clinic in Dar es Salaam, Tanzania. AIDS Behav. 2003;7(4):373–82.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Katherine Buhikire
    • 1
    Email author
  • Joachim Voss
    • 1
  • Joanita Kigozi
    • 2
  • Patience Nyakato
    • 3
  • Nickson Ankunda
    • 2
  • Brenda Kalebbo
    • 2
  • Michael Musiitwa
    • 4
  • Alex Muganzi
    • 2
  • Nelson K. Sewankambo
    • 5
  • Damalie Nakanjako
    • 5
  1. 1.Sarah Cole Hirsh Institute for Best Nursing Practices Based on Evidence, Frances Payne Bolton School of NursingCase Western Reserve UniversityClevelandUSA
  2. 2.Outreach Department, Infectious Diseases InstituteMakerere University College of Health SciencesKampalaUganda
  3. 3.Research Department, Infectious Diseases InstituteMakerere University College of Health SciencesKampalaUganda
  4. 4.Kiboga Hospital, Ministry of HealthKibogaUganda
  5. 5.Department of Medicine, School of MedicineMakerere University College of Health SciencesKampalaUganda

Personalised recommendations