Abstract

Facilitators and Barriers Affecting Participation in Partner Notification Services Among Newly Diagnosed Men Who Have Sex with Men in Coastal Kenya

Haley Adrian, MSPH¹, Maartje Dijkstra, MD, PhD², Don Operario, PhD¹, Eduard Sanders , PhD³, Elise van der Elst, PhD³ (1)Brown University , (2)The Public Health Service of Amsterdam (GGD Amsterdam), (3)Kenya Medical Research Institute (KEMRI) – Wellcome Trust Research Programme (KWTRP)

APHA 2022 Annual Meeting and Expo

Background: Partner notification services (PNS) have been proven safe and effective in finding undiagnosed HIV infections among the general population in various high HIV-incidence countries in Sub-Saharan Africa (SSA). However, data are limited on the effectiveness and safety of this testing and linkage strategy among high-incidence key populations, such as men who have sex with men (MSM) in SSA. This qualitative study aimed to describe index clients’ experiences with PNS and assess facilitators and barriers to participating in PNS among a sample of MSM newly diagnosed with HIV in coastal Kenya. The study also aimed to identify which PNS strategies were preferred for different types of sexual partners and most successful at enrolling sexual partners.
Methods: This study used data from a mixed-methods explorative study conducted between January – June 2019, which involved n=27 MSM participants newly diagnosed with HIV, of which 18 accepted to participate in a semi-structured in-depth interview, which captured their perceptions, experiences, and views on PNS and whether they experienced intimate partner violence (IPV) or other (social) harms. The study used inductive thematic analysis to analyze qualitative data and descriptive quantitative analyses on sociodemographic data collected for all index participants and male sexual partners enrolled in the study.
Results: The median age of index participants was 28 years old. We found that facilitators to PNS participation among MSM participants included a sense of duty/responsibility, reassurance of personal safety and certain characteristics of peer-mobilizers. Barriers to PNS participation included fear for stigma and discrimination and missing or incorrect partner contact information. Provider assisted partner notification was the preferred strategy selected by participants across all types of sexual partners. Leveraging existing trusting relationships/networks, and employing peer-led mobilization approaches were identified as potential strategies to further engaging MSM in PNS. No participant reported experiencing any IPV or other social harms.
Conclusions: These findings suggest that PNS, particularly assisted PNS, is a safe, feasible and acceptable HIV testing and linkage strategy for use among MSM in this context and should be brought to scale.