Outcome of HIV Partner Notification Service Among People Living With HIV Infection in North-Central Nigeria

Abstract

Introduction: According to the Nigeria National HIV/AIDS Indicator and Impact Survey (NAIIS) conducted in 2018 but released in 2019 the current HIV prevalence in Nigeria is 1.4% among adults aged 15–49 years. This implies that there are about 1.9 million people living with HIV in Nigeria. Yet the percentage of Nigerians that had access to HIV counselling and testing services was just 37% in 2018 and about 46.9% of PLHIV aged 15-64 years knew their HIV status according to NAIIS 2018 report. . To improve on the HIV testing coverage, HIV testing services programming must be focused on utilizing strategies that maximise efficiency while expanding access to accurate, high-quality services. One of such strategies is to prioritise index case testing services for sexual partners of index clients. Partner Notification Services (PNS) Partner HIV Testing service is a type of index case testing among sexual network of an index case. Methods: Partner Notification Services (PNS) is a voluntary process where sexual partners of HIV-infected persons are contacted, counselled and are offered HIV test administered by a trained counselor. Each infected contact can then become the starting point for new contact tracing, until no more contacts can be found. This study was a retrospective review of the hospital records of HIV positive clients who participated in the HIV partner notification services. Results: A total of 705 HIV patients (Female-68%, Male-32%) enrolled in care at the two centers accessed the HIV partner notification services (PNS). These index cases were counselled and brought their 719 sexual partners to the hospitals for HIV testing. About 27% of the sexual partners were HIV infected and 71% were HIV negative while 2% were of unknown HIV status because they did not take the HIV test. Viral load suppression rate was about 48% among the index cases., more female are virally suppressed than men (71% vs 29%). About 100% of the index with suppressed viral load had one sexual partner while for index cases with unsuppressed viral load 80% had one sexual partner, 19% had two sexual partners and 1% had 3 sexual partners. The frequency of unmarried sexual partners was higher among index cases with suppressed viral load (22%) compared with index cases with unsuppressed viral load (36%). Surprisingly, incidence of HIV infection was higher at 36% among partners of index cases with suppressed viral load when compared with HIV incidence of 11% among partners of index with unsuppressed viral load. Conclusion and Recommendations: Uptake of PNS was 100% among index cases while 98% of their sexual contacts received HIV testing services. This shows PNS as a very effective strategy in increasing HIV testing services. Likewise, the HIV testing yield of 27% was higher than the yield from routine walk-in clients at the centers. It is therefore recommended that PNS be the standard of care at all centers offering HIV testing services