Health Policy & Administration, School of Public Health, University of Illinois Chicago, Chicago, IL, USA.
Human Development and Family Sciences, College of Education and Human Development, University of Delaware, Newark, DE, USA.
BMC Health Serv Res. 2023 Jan 24;23(1):71. doi: 10.1186/s12913-022-08943-x.
Assisted partner notification (APN) is recommended as a public health strategy to increase HIV testing in people exposed to HIV. Yet its adoption in many countries remains at an early stage. This qualitative study sought the opinions of HIV health service providers regarding the appropriateness and feasibility of implementing APN in Indonesia where such services are on the cusp of adoption.
Four focus group discussions totaling 40 health service providers were held in Jakarta, Indonesia to consider APN as an innovative concept and to share their reactions regarding its potential implementation in Indonesia. Voice-recorded discussions were conducted in Bahasa, transcribed verbatim, and analyzed.
Participants recognized APN's potential in contacting and informing the partners of HIV-positive clients of possible viral exposure. They also perceived APN's value as a client-driven service permitting clients to select which of three partner notification methods would work best for them across differing partner relationships and settings. Nonetheless, participants also identified personal and health system challenges that could impede successful APN adoption including medical and human resource limitations, the need for specialized APN training, ethical and equity considerations, and lack of sufficient clarity concerning laws and government policies regulating 3 party disclosures. They also pointed to the job-overload, stress, personal discomfort, and the ethical uncertainty that providers might experience in delivering APN.
Overall, providers of HIV services embraced the concept of APN but forecast practical difficulties in key service areas where investments in resources and system change appeared necessary to ensure effective and equitable implementation.
辅助性伴侣通知（APN）被推荐为一种公共卫生策略，以增加暴露于 HIV 下的人群进行 HIV 检测。然而，在许多国家，它的采用仍处于早期阶段。这项定性研究旨在了解 HIV 服务提供者对在印度尼西亚实施 APN 的适宜性和可行性的看法，因为在那里，这种服务正处于采用的边缘。
在印度尼西亚雅加达举行了总共 40 名卫生服务提供者的 4 个焦点小组讨论，以考虑 APN 作为一个创新概念，并分享他们对其在印度尼西亚潜在实施的反应。以巴哈萨语进行了录音讨论，逐字转录，并进行了分析。
参与者认识到 APN 在接触和告知 HIV 阳性客户的伴侣可能存在病毒暴露方面的潜在作用。他们还认为 APN 作为一种以客户为驱动的服务具有价值，允许客户在不同的伴侣关系和环境下选择最适合他们的三种伴侣通知方法。然而，参与者也确定了可能阻碍 APN 成功采用的个人和卫生系统挑战，包括医疗和人力资源限制、对专门的 APN 培训的需求、道德和公平考虑，以及关于规范三方披露的法律和政府政策的足够清晰度的缺乏。他们还指出，提供者在提供 APN 时可能会面临工作超负荷、压力、个人不适和道德不确定性。
总体而言，HIV 服务提供者接受了 APN 的概念，但预测在关键服务领域会出现实际困难，需要在资源和系统变革方面进行投资，以确保有效和公平的实施。
