Barriers to assisted partner notification services among HIV infected adults on HIV care in Seme and Kisumu West Sub Counties

Abstract

BACKGROUND
Despite achievements in scaling up of antiretroviral therapy access worldwide, a substantial testing gap still remains. In Kenya, slightly more than half (53.1%) of HIV-positive individuals were not aware of their status in 2014. Currently, assisted partner notification services (aPNS) is now part of the World Health Organizations’ guidelines for standard practices for persons living with HIV (PLHIV), however, there are a number of barriers to aPNs uptake. Therefore, we investigated factors that obstruct assisted partner notification services in this setting.
MATERIALS AND METHOD
A descriptive cross-sectional quantitative study was conducted in 2020 in Seme and Kisumu West sub counties among HIV positive participants age ≥ 18 years attending Kombewa, Manyuada and Chulaimbo health facilities. Generalized linear modelling framework and log-binomial regression was used to model the occurrence of APNS and compared it among categories of explanatory variables using crude and multivariable-adjusted prevalence ratio.
RESULTS
More than half, (55%) of the 423 participants were females. Majority (34%) were aged between 26-35 years. Age, highest level of education attained, occupation and residence were significantly associated with assisted partner notification services. Participants who cited embarrassment as a barrier were 55% more likely not to participate in aPNS compared to those who did not cite embarrassment as a barrier (APRS=1.55; 95% CI, 1.12-2.15, p=0.009). At the same time, participants who cited stigma as a barrier were 44% more likely not to participate in aPNS compared to those who not mentioning stigma as a barrier (aPR=1.44; 95% CI, 1.06-1.95, p=0.018). Those mentioning unfriendly services had nearly 4-fold risk of not participating in APNS (APR=3.74; 95% CI, 2.72-5.14, p=<0.001).
CONCLUSION

Embarrassment and fears of stigma in the community came out strongly as a big hindrance to participating in aPNS. Highest education level attained emerged as a stronger demographic risk of not participating in aPNS as a client's decision to provide partner information may depend on the level of education.