Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA.
Health Policy & Administration, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA.
J Int AIDS Soc. 2023 Jun;26(6):e26132. doi: 10.1002/jia2.26132.
Assisted partner notification (APN) safely and effectively increases partner awareness of HIV exposure, testing and case identification in community settings. Nonetheless, it has not been specifically developed or evaluated for use in prison settings where people with HIV often are diagnosed and may have difficulty contacting or otherwise notifying partners. We developed Impart, a prison-based APN model, and evaluated its efficacy in Indonesia to increase partner notification and HIV testing.
From January 2020 to January 2021, 55 incarcerated men with HIV were recruited as index participants from six jail and prison facilities in Jakarta in a two-group randomized trial comparing the outcomes of self-tell notification (treatment as usual) versus Impart APN in increasing partner notification and HIV testing. Participants voluntarily provided names and contact information for sex and drug-injection partners in the community with whom they had shared possible HIV exposure during the year prior to incarceration. Participants randomized to the self-tell only condition were coached in how to notify their partners by phone, mail or during an in-person visit within 6 weeks. Participants randomized to Impart APN could choose between self-tell notification or anonymous APN by a two-person team consisting of a nurse and outreach worker. We compared the proportion of partners in each group who were notified of exposure by the end of 6 weeks, subsequently tested and HIV diagnosed.
Index participants (n = 55) selected 117 partners for notification. Compared to self-tell notification, Impart APN resulted in nearly a six-fold increase in the odds of a named partner being notified of HIV exposure. Nearly two thirds of the partners notified through Impart APN (15/24) completed HIV testing within 6 weeks post notification compared to none of those whom participants had self-notified. One-third of the partners (5/15) who completed HIV testing post notification were diagnosed as HIV positive for the first time.
Voluntary APN can be successfully implemented with a prison population and within a prison setting despite the many barriers to HIV notification that incarceration presents. Our findings suggest that the Impart model holds considerable promise to increase partner notification, HIV testing and diagnosis among sex and drug-injecting partners of HIV-positive incarcerated men.
辅助性伴侣通知（APN）可安全有效地提高社区环境中伴侣对 HIV 暴露、检测和病例识别的认识。尽管如此，它并未专门针对监狱环境进行开发或评估，在监狱环境中，HIV 感染者通常会被诊断出来，并且可能难以联系或通知伴侣。我们开发了 Impart，一种基于监狱的 APN 模型，并在印度尼西亚评估了其在增加伴侣通知和 HIV 检测方面的效果。
2020 年 1 月至 2021 年 1 月，从雅加达的六家监狱和监狱设施中招募了 55 名感染 HIV 的被监禁男性作为指数参与者，进行了一项两臂随机试验，比较了自我告知通知（常规治疗）与 Impart APN 在增加伴侣通知和 HIV 检测方面的效果。参与者自愿提供在入狱前一年与他们在社区中发生过可能 HIV 暴露的性伴侣和注射毒品的伴侣的姓名和联系信息。随机分配到仅自我告知条件的参与者接受了如何在 6 周内通过电话、邮件或亲自拜访通知伴侣的指导。随机分配到 Impart APN 的参与者可以选择由护士和外展工作者组成的两人小组进行自我告知通知或匿名 APN。我们比较了两组中在 6 周结束时通知到暴露情况的伴侣的比例，随后进行了 HIV 检测和诊断。
指数参与者（n=55）选择了 117 名伴侣进行通知。与自我告知通知相比，Impart APN 使被通知的伴侣的 HIV 暴露通知比例增加了近六倍。通过 Impart APN 通知的近三分之二（15/24）的伴侣在通知后 6 周内完成了 HIV 检测，而通过参与者自行通知的伴侣则没有。三分之一（5/15）完成 HIV 检测的伴侣首次被诊断出 HIV 阳性。
尽管监禁带来了许多 HIV 通知障碍，但自愿性伴侣通知可以成功地在囚犯群体中实施，并在监狱环境中实施。我们的研究结果表明，Impart 模型具有很大的潜力，可以增加 HIV 阳性被监禁男性的性伴侣和注射毒品的伴侣的伴侣通知、HIV 检测和诊断。
