부산대학교 도서관

BACKGROUND:: Assisted partner services (aPS) involves notification and HIV testing for sexual partners of persons diagnosed HIV-positive (index clients). Since the impact of aPS is contingent on high acceptance, we assessed characteristics and reasons for non-enrollment among female index clients in an ongoing scale-up project. METHODS:: We analyzed data from HIV-positive females offered aPS in 31 facilities from 5/2018-8/2019. We compared socio-demographic characteristics by aPS enrollment (accepted, refused, ineligible) and used multivariate binomial regression to assess associations between demographics and refusal. RESULTS:: 24,418 females received HIV testing and 1,050 (4.3%) tested HIV-positive; 839 females enrolled in aPS (80%), 59 refused (6%) and 152 were ineligible (14%). APS uptake did not differ by age, testing history or testing type (provider vs. client-initiated). Females refusing aPS were more likely to have completed secondary school (adjusted relative risk [aRR] 2.03, 95% CI: 1.13-2.82) and be divorced/separated (aRR: 3.09, 95% CI 1.39-6.86) or single (2.66 95% CI: 1.31-5.42) compared to married/cohabitating. Reasons for refusing aPS included not feeling emotionally ready (31%) and reporting no sexual partners in past 3 years (22%). Reasons for ineligibility included fear or risk of intimate partner violence (9%), previous HIV diagnosis (9%) or insufficient time for aPS provision (3%). CONCLUSION:: APS has high acceptability among HIV-positive females regardless of age or testing history. More counseling may be needed to increase uptake among females with higher education and those who are separated/single. Follow-up for females not emotionally ready or who had insufficient time for aPS in their clinic visit can improve coverage.