Factors associated with partners elicitation during HIV Index client´s testing in Dar es Salaam Region, Tanzania

Abstract

Introduction: Identifying people exposed to HIV is critical towards achieving the UNAIDS 90-90-90 goals for HIV epidemic control. The first 90 in Tanzania is at 53% and yet factors for partner's elicitation to HIV care providers are poorly understood. The objective of this study was to determine predictors of partner's elicitation among index HIV positive clients. Methods: We conducted a cross-sectional study from January to March 2019 among HIV positive clients diagnosed within the previous 12 months within HIV care and treatment centers in Dar-es Salaam. A structured questionnaire was used to collect the indexes' partner such as including name, type and status of relationship, and location. Participants were asked to choose the preferred approach to notify partners. Using modified Poisson regression estimate prevalence ratios predictors were determined for variables at p< to 0.05. Results: A total of 438 HIV index clients, mean age 37yrs ±11 SD were identified. Of these, 243 (55.5%) provided partners information to HIV Testing and Care (HTC) provider. Predictors for partner elicitation were awareness of notification methods aPR 3.80, 95%CI 2.11-7.01; having privacy at initial HTC visit aPR 3.20 95%CI 1.30-7.40; awareness of partner's HIV status aPR 1.16, 95%CI 1.03-1.30 and having no fear of rejection by partner aPR1.52, 95%CI 1.23-1.88. However, being a female HIV index client was significantly associated with decreased likelihood of partner's elicitation aPR 0.87, 95% CI 0.80-0.95. Conclusion: There is a low elicitation rate of exposed partners by index clients. Awareness of notification approaches, confidentiality, having no fear of rejection by partner, and privacy during HTC services contribute to high partner elicitation. Promotion of community awareness on partner's notification approaches and HIV transmission dynamics, and provision of additional support networks for women improve elicitation outcomes are recommended.