Factors that influence uptake of assisted partner notification for HIV index testing services among new diagnosed HIV positive adults at Ndirande Health Centre, Blantyre

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Date
2020-12-01
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Kamuzu University of Health Sciences
Abstract
To achieve first 95 where 95% of PLHIV need to know their status, the Ministry of Health introduced the 2019 Active index testing policy, in which assisted partner notification services (APNS) were chosen as the key innovative and effective strategy to increase HIV case identification. We conducted descriptive qualitative research to assess barriers and facilitators to uptake of APNS among newly diagnosed HIV positive clients at Ndirande Health Centre. The study used mixed variational sampling. The study sought in-depth opinions and perceptions from index clients who accepted APNS, partners who either accepted or refused APNS and health care workers who provide index testing services. Data collection was done through in-depth interviews and key informant interview guides. Data analysis was done manually using thematic inductive and deductive analysis. The study results were thematically analysed and presented in the context of the theoretical framework, the Socio-Ecological Model. The study showed that lack of knowledge among partners of index clients, wrong physical addresses, non disclosure of results for fear of intimate partner violence (IPV), lack of provider knowledge, the proximity of the contact house to the neighbour’s, and the COVID 19 pandemic were the key barriers to uptake of APNS. Knowledge of APNS, stability of marriage, gender, health care worker training, health care worker notification, home tracing, and testing were the key facilitating factors to the uptake of APNS. Sensitisation and demand creation, screening for intimate partner violence, provision of funds to support home tracing and testing, provider skills training and health care worker notification approach were the strategies used to increase uptake of APNS.Non-disclosure of HIV testing results for fear of IPV was the major prohibitive factor to the uptake of APNS. Health care workers should actively screen and look for IPV, particularly in clients with unstable relationships and optimize health care worker notification approach which reduces IPV occurrence, support disclosure, and increase APNS uptake.
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