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"The targets…are driving the agenda and that probably needs to change": stakeholder perspectives on HIV partner notification in sub-Saharan Africa.

作者信息

McGowan Maureen, Bärnighausen Kate, Berner-Rodoreda Astrid, McMahon Shannon A, Mtaita Caroline, Mauti Joy, Neuhann Florian

机构信息

Heidelberg Institute of Global Health, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.

School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

BMC Public Health. 2024 Feb 19;24(1):521. doi: 10.1186/s12889-023-17422-9.


DOI:10.1186/s12889-023-17422-9
PMID:38373972
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10877856/
Abstract

BACKGROUND: Voluntary assisted partner notification (VAPN) in HIV contact tracing is a globally recommended strategy to identify persons who have been exposed to HIV and link them to HIV testing and follow-up. However, there is little understanding about how VAPN is experienced by stakeholders in sub-Saharan African (SSA) contexts. We conducted a multi-level and multi-national qualitative analysis evaluating stakeholder perspectives surrounding VAPN implementation to inform the development of future VAPN policies. METHOD: We conducted in-depth interviews (IDIs) with VAPN stakeholders at global (n = 5), national (n = 6), and community level (n = 4) across a total of seven SSA countries. Eligible participants were ≥ 18 years old and had experience developing, implementing, or overseeing VAPN policies in SSA. We sought to understand stakeholder's perspectives on policy development, implementation, and perceived outcomes (barriers and facilitators). Interviews were audio recorded, transcribed, and analyzed thematically using a combination of inductive and deductive approaches. RESULTS: Between December 2019 and October 2020 we conducted 15 IDIs. While participants agreed that VAPN resulted in a high yield of people newly diagnosed with HIV; they noted numerous barriers surrounding VAPN implementation across global, national, and community levels, the majority of which were identified at community level. Barriers at global and national level included high target setting, contradictory laws, and limited independent research disenfranchising the experiences of implementing partners. The barriers identified at community level included client-level challenges (e.g., access to healthcare facilities and fear of adverse events); healthcare worker challenges (e.g., high workloads); limited data infrastructure; and cultural/gender norms that hindered women from engaging in HIV testing and VAPN services. In response to these barriers, participants shared implementation facilitators to sustain ethical implementation of VAPN services (e.g., contact tracing methods) and increase its yield (e.g., HIV self-testing integrated with VAPN services). CONCLUSION: Overall, stakeholders perceived VAPN implementation to encounter barriers across all implementation levels (global to community). Future VAPN policies should be designed around the barriers and facilitators identified by SSA stakeholders to maximize the implementation of (ethical) HIV VAPN services and increase its impact in sub-Saharan African settings.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1167/10877856/347f79292448/12889_2023_17422_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1167/10877856/347f79292448/12889_2023_17422_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1167/10877856/347f79292448/12889_2023_17422_Fig1_HTML.jpg

相似文献

[1]
"The targets…are driving the agenda and that probably needs to change": stakeholder perspectives on HIV partner notification in sub-Saharan Africa.

BMC Public Health. 2024-2-19

[2]
'You Can Get That Person on ART but You Can't Give Them Back Their Social System': A Qualitative Analysis of Voluntary Assisted Partner Notification for HIV for Marginalised and Vulnerable Populations.

J Int Assoc Provid AIDS Care. 2024

[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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J Acquir Immune Defic Syndr. 2011-4-15

[10]
Outcomes and Experiences of Men and Women with Partner Notification for HIV Testing in Tanzania: Results from a Mixed Method Study.

AIDS Behav. 2018-1

本文引用的文献

[1]
"I feel good because I have saved their lives": Acceptability of assisted partner services among female index clients and male sexual partners in Kenya.

PLOS Glob Public Health. 2023-5-24

[2]
Real-world impact of integrating HIV assisted partner services into 31 facilities in Kenya: a single-arm, hybrid type 2 implementation-effectiveness study.

Lancet Glob Health. 2023-5

[3]
Integration of assisted partner services within Kenya's national HIV testing services program: A qualitative study.

PLOS Glob Public Health. 2023-2-10

[4]
Promoting health equity in HIV prevention and treatment research: a practical guide to establishing, implementing, and sustaining community advisory boards.

Ther Adv Infect Dis. 2023-2-3

[5]
Achieving the 95 95 95 targets for all: A pathway to ending AIDS.

PLoS One. 2022

[6]
"It is a process" - a qualitative evaluation of provider acceptability of HIV assisted partner services in western Kenya: experiences, challenges, and facilitators.

BMC Health Serv Res. 2022-5-7

[7]
Development of a Blended Learning Approach to Delivering HIV-Assisted Contact Tracing in Malawi: Applied Theory and Formative Research.

JMIR Form Res. 2022-4-19

[8]
A Systematic Review of HIV Testing Implementation Strategies in Sub-Saharan African Countries.

AIDS Behav. 2022-5

[9]
Addition of HIV self-test kits to partner notification services to increase HIV testing of male partners of pregnant women in Zambia: two parallel randomised trials.

Lancet Glob Health. 2021-12

[10]
Overview of the epidemiological conditions of HIV among key populations in Africa.

J Int AIDS Soc. 2021-7

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