| Popis: |
Partners of persons living with HIV (PLHIV) are at a high risk of HIV acquisition, particularly if PLHIV are newly diagnosed or not virally suppressed. A focused partner HIV testing strategy could stimulate efficient identification of persons for pre-exposure prophylaxis (PrEP) or antiretroviral therapy (ART) programs.We sequentially implemented 2 partner testing strategies at 2 Kenyan HIV clinics: (1) an invitation for clinic-based testing and (2) HIV self-testing (HIVST) kits distribution to index PLHIV. For each testing strategy, we enrolled approximately 150 consecutive index PLHIV with partners of unknown HIV status, not on ART,6 months on ART, or who had detectable viral load. We compared partner engagement, testing uptake, and linkage for ART or PrEP between the 2 testing strategies.Of 313 index PLHIV enrolled (160 in invitation, 153 in HIVST), the median age was 32 years (interquartile range 26-40) and 76% were women. Overall, 73% of participants (229) discussed HIV testing with their partners: 76% (121) in the invitation strategy vs 71% (108) in the HIVST strategy [adjusted odds ratio (adjOR): 0.54, 95% confidence interval (CI): 0.31 to 0.97]. Overall, 52% (79) partners in the HIVST strategy tested vs 38% (60) in the invitation strategy (adjOR: 1.78, 95% CI: 1.13 to 2.78). Among partners engaged, 73% in the HIVST strategy vs 50% in the invitation tested (adjOR: 2.68, 95% CI: 1.46 to 4.96); 25% (35/139) tested positive for HIV. Eighty-nine percentage (31/35) who tested positive initiated treatment, but only 21% (20/93) who tested negative initiated PrEP.HIVST kit distribution to PLHIV with partners of unknown HIV status effectively increased partner testing. Only one-fifth of partners who tested negative initiated PrEP-thus innovations to link to prevention services are urgently needed. |
