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Knowledge of HIV Status in Kenya

Explore the efficacy of Assisted Partner Notification Services (aPNS) in Kenya through a cluster RCT study. Results show a significant increase in partner testing rates, HIV diagnosis, and linkage to care without cases of intimate partner violence attributed to the intervention.

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Knowledge of HIV Status in Kenya

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  1. Knowledge of HIV Status in Kenya Proportion aware of HIV+ status, KAIS 2007 and 2012 • >50% PLWH unaware of HIV+ status in 2012 • HIV testing gap greater among men than women

  2. Cluster RCT on Assisted Partner Notification Services (aPNS) in Kenya • Main study conducted 2013-2015 • 18 rural and urban areas in central and western Kenya • Intervention arm: Immediate aPNS • Control arm: Delayed aPNS by 6 weeks • Results: • Partner testing rates increased 5-fold • Rates of first-time HIV testing increased 15-fold • Rates of testing HIV positive increased 5-fold • No intimate partner violence (IPV) cases were attributable to intervention Cherutich et al. Lancet HIV 2017

  3. Do Index Characteristics Modify aPNS Efficacy? • For 1119 index clients, characteristics included: • High vs. low HIV prevalence region (range 3.8% to 23.7%) • Rural/peri-urban vs. urban location • Gender (62% female) • Age (median 30 years) • Knowledge of HIV status (new dx for 82%) • For 1286 partners (~1.3 per index), outcomes included: • Partner testing rates • Rates of first-time HIV testing • Rates of testing HIV positive • Linkage to care • Generalized Estimating Equations (GEE) used to calculate incidence rate ratios

  4. HIV Testing Outcomes for Partners • Higher rates of HIV testing for index who are: • In high HIV prevalence region • In rural or peri-urban facilities • Female • Newly diagnosed • Identifying new HIV positives was more likely if aPNS offered to female index compared to male index.

  5. Why are there differences? • Increased aPNS efficacy for index client location and gender may be attributed to: • Reduced access to HIV testing in rural areas and western Kenya • Low baseline testing rates among men in all locations

  6. Why should we care?

  7. Conclusion aPNS can reduce the gap in HIV testing, diagnosis and linkage to care gap between men and women Target populations must have access to HIV treatment and prevention services for these populations, including resources for IPV

  8. Acknowledgements • UW, KNH and NASCOP Study Team members Sarah Masyuko, Peter Cherutich, Mathew Golden, Beatrice Wamuti, Felix Abuna, Betsy Sambai, Peter Maingi, David Bukusi, Paul Macharia, Matt Dunbar, Barbara Richardson, Ann Ng’ang’a • Ministry of Health, Kenya Mary Mugambi, Martin Sirengo • All Health Advisors and study participants • US National Institutes of Health for funding: NIAID R01 A1099974 and Fogarty International Center D43 TW009580.

  9. Graçias! Asante Sana! Thank you!

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