High Acceptability of Assisted Partner Notification Services Among HIV-Positive Females in Kenya: Results From an Ongoing Implementation Study.
High Acceptability of Assisted Partner Notification Services Among HIV-Positive Females in Kenya: Results From an Ongoing Implementation Study.
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DOI：
10.1097/qai.0000000000002527
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发表时间：
2021-01-01
期刊：
影响因子：
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通讯作者：
Farquhar C
中科院分区：
文献类型：
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作者：
Sharma M;Kariithi E;Kemunto E;Otieno G;Lagat H;Wamuti B;Obongo C;Macharia P;Masyuko S;Bosire R;Mugambi M;Weiner B;Farquhar C
协助伙伴服务(APS)涉及为被诊断为艾滋病毒阳性的人(索引客户)的性伴侣提供通知和艾滋病毒检测。由于APS的影响取决于高接受度，我们在一个正在进行的扩大项目中评估了女性指数客户不参加的特征和原因。我们分析了2018年5月至2019年8月在31个机构提供AP的艾滋病毒阳性女性的数据。我们通过APS注册(接受、拒绝、不合格)来比较社会人口学特征，并使用多变量二项回归来评估人口统计和拒绝之间的关联。24418名女性接受了艾滋病毒检测，1050名(4.3%)艾滋病毒检测呈阳性；839名女性参加了APS(80%)，59名女性(6%)被拒绝，152名不合格(14%)。APS的摄取率没有年龄、测试历史或测试类型的差异(提供者与客户发起的比较)。与已婚/同居相比，拒绝接受APS的女性更有可能完成中学学业(调整后的相对危险度[ARR]2.03，95%CI：1.13-2.82)、离婚/分居(ARR：3.09，95%CI：1.39-6.86)或单身(2.66 95%CI：1.31-5.42)。拒绝APS的原因包括感觉情绪上没有准备好(31%)和报告在过去3年中没有性伴侣(22%)。不符合资格的原因包括对亲密伴侣暴力的恐惧或风险(9%)、既往艾滋病毒诊断(9%)或提供APS服务的时间不足(3%)。APS在HIV阳性女性中有很高的接受度，无论年龄或检测史。可能需要更多的咨询，以增加受过高等教育的女性和分居/单身女性的接受程度。对情绪上没有准备好的女性或在诊所就诊时没有足够时间进行APS的女性进行随访可以提高覆盖率。
Assisted partner services (aPS) involves notification and HIV testing for sexual partners of persons diagnosed HIV-positive (index clients). Since the impact of aPS is contingent on high acceptance, we assessed characteristics and reasons for non-enrollment among female index clients in an ongoing scale-up project. We analyzed data from HIV-positive females offered aPS in 31 facilities from 5/2018–8/2019. We compared socio-demographic characteristics by aPS enrollment (accepted, refused, ineligible) and used multivariate binomial regression to assess associations between demographics and refusal. 24,418 females received HIV testing and 1,050 (4.3%) tested HIV-positive; 839 females enrolled in aPS (80%), 59 refused (6%) and 152 were ineligible (14%). APS uptake did not differ by age, testing history or testing type (provider vs. client-initiated). Females refusing aPS were more likely to have completed secondary school (adjusted relative risk [aRR] 2.03, 95% CI: 1.13–2.82) and be divorced/separated (aRR: 3.09, 95% CI 1.39–6.86) or single (2.66 95% CI: 1.31–5.42) compared to married/cohabitating. Reasons for refusing aPS included not feeling emotionally ready (31%) and reporting no sexual partners in past 3 years (22%). Reasons for ineligibility included fear or risk of intimate partner violence (9%), previous HIV diagnosis (9%) or insufficient time for aPS provision (3%). APS has high acceptability among HIV-positive females regardless of age or testing history. More counseling may be needed to increase uptake among females with higher education and those who are separated/single. Follow-up for females not emotionally ready or who had insufficient time for aPS in their clinic visit can improve coverage.