Factors associated with the uptake of assisted partner notification services among newly diagnosed HIV-positive adults on care in Ndhiwa Sub-County; Homa Bay County, Kenya

Abstract

Background: With over 38 million people living with HIV worldwide, the virus continues to be a serious public health challenge. Kenya and other countries continue to carry the greatest burden of HIV, with almost 67% of incidences. Homa Bay County has an HIV prevalence of 19.6% and recorded 5,643 new HIV infections in 2022. Ndhiwa sub-County reported 892 new cases, the highest among all sub-counties in the county. Objectives: To determine what percentage of newly diagnosed HIV-positive people receiving treatment informed their sexual partners through assisted partner notification services (aPNS), determine the preferred method of referral and describe the factors that influence the uptake of aPNS. Methods: A cross-sectional study was conducted among newly diagnosed HIV clients enrolled in HIV care and treatment services in Ndhiwa Sub-County. Using systematic sampling, a total of 254 participants were selected from the sampled health facilities. Data was collected through semi-structured questionnaires. The analysis of continuous variables was done using measures of central tendency and dispersion, whereas categorical variables were presented using frequencies and percentages. Associations between independent variables and the uptake of aPNS were assessed using crude odds ratios (cOR) with 95% confidence intervals (CI). Variables with a p- value <0.05 were considered statistically significant Results: Of the 254 participants in the study, 63.4% were female. The proportion of index clients who disclosed their HIV status to their sexual partners was 78.7%. The provider referral method was preferred by the majority of the study participants, accounting for 43.7%. Uptake of aPNS was independently associated with the testing location of the index client (aOR=3.8; 95% CI: 1.46-9.83, p-value=0.006), knowledge of the HIV status of their sexual partner(s) (aOR =5.2; 95% CI: 2.09–11.43; p-value= 0.002) and absence of intimate partner violence (aOR=15.0; 95% CI: 4.92-45.80, p- value <0.001). Conclusion: There was a high uptake of aPNS among newly diagnosed HIV-positive clients. The provider referral was the most preferred method. Testing location, knowledge of partner’s HIV status, and absence of intimate partner violence increased the uptake od aPNS. Recommendation: Provider referral should be promoted as the preferred option among index clients. The HIV care settings should incorporate routine IPV screening, counseling, and support services to ensure client safety and facilitate safe disclosure. Longitudinal studies should be recommended to monitor trends in aPNS uptake and associated factors over time.