Assisted HIV partner notification services in resource‐limited settings: experiences and achievements from Cameroon

Abstract Introduction In 2007, the Cameroon Baptist Convention Health Services ( CBCHS ) initiated an assisted partner notification services ( aPNS ) public health programme to increase HIV case identification and reduce HIV incidence in the most affected regions of Cameroon. We describe large‐scale implementation of aPNS and overall programmatic achievements in a resource‐limited setting through 2015. Methods CBCHS trained health advisors ( HA s) from 16 CBCHS facilities and 22 non‐ CBCHS facilities to integrate aPNS into their existing jobs in five of the ten Cameroon regions. HA s recorded basic demographic, clinical and risk factor information from consenting index persons ( IP s) and similar information about their sexual partners’/contact persons ( CP s) on interview records and aPNS registers. These data were entered into an Epi‐Info database. HA s provided pre‐test counselling to CP s and offered them HIV testing in their home or other location. HA s educated IP s and CP s on HIV prevention and risk reduction, and referred IP s and HIV positive CP s to HIV care and treatment centres. Starting in 2014, HA s re‐interviewed IP s 30 days after their initial aPNS interview to ascertain instances of social harms following partner notification. Continuous predictor and outcome variables were summarized using median and interquartile range, while categorical variables were summarized using percentages from 2007 to 2015. Results A total of 18,730 IP s (71% women) received aPNS over nine years. IP s identified 21,057 CP s (67% men) (mean CP / IP 1.12), of whom 12,867 (61.1%) were notified of their exposure to HIV . A total of 9202 (71.5% of notified CP s) tested for HIV , 4764 (51.8%) of whom tested HIV positive (number of IP s needed to interview = 3.9); 3112 (65.3%) HIV ‐positive partners were referred to HIV care and treatment centres. Of the 976 IP s receiving aPNS in 2014 to 2015, for whom follow‐up data were available, 11 (1.1%) reported physical intimate partner violence from CP s. Thus, 44.3% of 1224 CP s were notified through provider referral. Of the 784 CP s who tested for HIV , 157 were newly diagnosed and the overall HIV prevalence was 41.6% (326/784). Conclusions aPNS is feasible, can be brought to scale, yields a high level of case identification, and is infrequently associated with social harms and intimate partner violence.