K Selvaraj1, A M V Kumar2,3, S Chawla4, K S Shringarpure5, P Thekkur6, C Palanivel7, P B Verma8, A N Shah9, K N Pandya10, G Roy7, Z Singh1, B B Rewari11, A R Dongre12. 1. Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India. 2. International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India. 3. The Union, Paris, France. 4. Gujarat State AIDS Control Society, Ministry of Health and Family Welfare, Government of Gujarat, Ahmedabad, India. 5. Department of Preventive and Social Medicine, Government Medical College, Baroda, Vadodara, India. 6. Department of Community Medicine, Mahathma Gandhi Medical College and Research Institute, Puducherry, India. 7. Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. 8. Department of Community Medicine, Gujarat Medical Education and Research Society Medical College, Gandhinagar, Gujarat, India. 9. Department of Medicine, BJ Medical College, Civil Hospital, Ahmedabad, Gujarat, India. 10. Department of Medicine, MP Shah Government Medical College and GG Government Hospital, Jamnagar, Gujarat, India. 11. World Health Organization Country Office India, New Delhi, India. 12. Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India.
Abstract
Setting: Four selected antiretroviral therapy (ART) centres of Gujarat State, India, which accounts for 8% of the human immunodeficiency virus (HIV) burden in India. Objectives: 1) To assess the proportion of people living with HIV (PLHIV) whose partners were not tested for HIV; 2) to assess sociodemographic and clinical characteristics of index cases associated with partner testing; and 3) to understand perceived facilitators and barriers to partner testing and make suggestions on how to improve testing from the perspective of the health-care provider. Design: A mixed-method design with a quantitative phase that involved reviewing the programme records of married PLHIV enrolled during 2011-2015, followed by a qualitative phase of key informant interviews. Results: Of 3884 married PLHIV, 1279 (33%) did not have their partners tested for HIV. Factors including index cases being male, illiterate, aged >25 years, belonging to key populations, substance use and being in advanced clinical stages were more likely to be associated with partner non-testing. Non-disclosure of HIV status (due to fear of marital discord) and lack of awareness and risk perception were the key barriers to testing. Conclusion: One third of PLHIV did not have their partners tested for HIV. Several factors were identified as being associated with the non-testing of partners, and solutions were explored that need to be implemented urgently if we are to achieve the 90-90-90 targets and end HIV.
Setting: Four selected antiretroviral therapy (ART) centres of Gujarat State, India, which accounts for 8% of the human immunodeficiency virus (HIV) burden in India. Objectives: 1) To assess the proportion of people living with HIV (PLHIV) whose partners were not tested for HIV; 2) to assess sociodemographic and clinical characteristics of index cases associated with partner testing; and 3) to understand perceived facilitators and barriers to partner testing and make suggestions on how to improve testing from the perspective of the health-care provider. Design: A mixed-method design with a quantitative phase that involved reviewing the programme records of married PLHIV enrolled during 2011-2015, followed by a qualitative phase of key informant interviews. Results: Of 3884 married PLHIV, 1279 (33%) did not have their partners tested for HIV. Factors including index cases being male, illiterate, aged >25 years, belonging to key populations, substance use and being in advanced clinical stages were more likely to be associated with partner non-testing. Non-disclosure of HIV status (due to fear of marital discord) and lack of awareness and risk perception were the key barriers to testing. Conclusion: One third of PLHIV did not have their partners tested for HIV. Several factors were identified as being associated with the non-testing of partners, and solutions were explored that need to be implemented urgently if we are to achieve the 90-90-90 targets and end HIV.
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