Department of Epidemiology, University of Washington, Seattle, WA.
Department of Voluntary Counseling and Testing (VCT) and HIV Prevention Unit, Kenyatta National Hospital, Nairobi, Kenya.
J Acquir Immune Defic Syndr. 2018 May 1;78(1):16-19. doi: 10.1097/QAI.0000000000001638.
HIV assisted partner services (APS) are a notification and testing strategy for sex partners of HIV-infected index patients. This cluster-randomized controlled trial secondary data analysis investigated whether history of intimate partner violence (IPV) modified APS effectiveness and risk of relationship dissolution.
Eighteen HIV testing and counseling sites in Kenya randomized to provide immediate APS (intervention) or APS delayed for 6 weeks (control).
History of IPV was ascertained at study enrollment and defined as reporting ever experiencing physical or sexual IPV. Those reporting IPV in the month before enrollment were excluded. We tested whether history of IPV modified intervention effectiveness and risk of relationship dissolution using population-averaged Poisson and log-binomial generalized estimating equation models. Exploratory analyses investigated associations between history of IPV and events that occurred after HIV diagnosis using log-binomial generalized estimating equation models.
The study enrolled 1119 index participants and 1286 partners. Among index participants, 81 (7%) had history of IPV. History of IPV did not modify APS effectiveness in testing, newly diagnosing, or linking partners to care. History of IPV did not modify the association between receiving immediate APS and relationship dissolution during the study.
Among participants who had not experienced IPV in the last month but had experienced IPV in their lifetimes, our results suggest that APS is an effective and safe partner notification strategy in Kenya. As APS is scaled up in different contexts, these data support including those reporting past IPV and closely monitoring adverse events.
HIV 辅助伴侣服务（APS）是一种针对 HIV 感染患者性伴侣的通知和检测策略。本项集群随机对照试验的二次数据分析旨在研究既往亲密伴侣暴力（IPV）史是否改变了 APS 的效果和关系破裂的风险。
肯尼亚的 18 个艾滋病毒检测和咨询点被随机分为立即提供 APS（干预组）或延迟 6 周提供 APS（对照组）。
在研究入组时确定 IPV 史，并定义为报告曾经历过身体或性 IPV。在入组前一个月报告有 IPV 的人被排除在外。我们使用人群平均泊松和对数二项式广义估计方程模型来检验既往 IPV 史是否改变了干预效果和关系破裂的风险。探索性分析使用对数二项式广义估计方程模型来研究既往 IPV 史与 HIV 诊断后发生的事件之间的关联。
本研究纳入了 1119 名指数参与者和 1286 名伴侣。在指数参与者中，有 81 人（7%）有 IPV 史。既往 IPV 史并未改变 APS 在检测、新诊断或将伴侣联系到护理方面的效果。既往 IPV 史也没有改变立即接受 APS 与研究期间关系破裂之间的关联。
在过去一个月内没有经历过 IPV 但有过 IPV 经历的参与者中，我们的结果表明 APS 是肯尼亚一种有效的、安全的伴侣通知策略。随着 APS 在不同环境中的推广，这些数据支持包括那些报告过去 IPV 史的人，并密切监测不良事件。
