Integrating Pr<scp>EP</scp>into<scp>HIV</scp>care clinics could improve partner testing services and reinforce mutual support among couples: provider views from a Pr<scp>EP</scp>implementation project in Kenya

Abstract Introduction Partner notification services ( PNS ) increase the HIV status knowledge and linkage to care and treatment. However, it is unclear if PNS can facilitate linkage of HIV ‐negative partners to prevention services such as pre‐exposure prophylaxis (Pr EP ). Using qualitative methods, we explored provider perspective regarding the interaction of Pr EP availability, PNS and antiretroviral treatment ( ART ) outcomes within a project integrating Pr EP services into HIV care clinics in eight counties in western and central Kenya. Methods From May 2017 to August 2018, data on integrated Pr EP service delivery including its interaction with PNS were collected through 71 key informant in‐depth interviews with healthcare providers and 24 standardized technical assistance reports summarizing implementation at the participating clinics. Thus, the perspective was from that of providers; analyses focused on emergent themes relating PNS to Pr EP and ART services. Results Providers found that Pr EP integration provided an additional concrete prevention option for HIV ‐negative partners and created a motivation to offer PNS to persons living with HIV . Pr EP availability also seemed to operate as an incentive for those living with HIV to participate in PNS , which in turn enhanced identification of potential Pr EP clients and created an environment for discussing HIV transmission risk. Providers commented that initiating HIV ‐negative partners on Pr EP enhanced mutual monitoring of health outcomes, including improved adherence to ART by partners living with HIV . Clinics noted prioritizing people living with HIV with detectable viral loads for PNS in order to identify HIV ‐negative partners who would benefit most from Pr EP . Providers felt motivated by the apparent synergistic interaction of PNS , Pr EP and ART . Conclusions Providers felt that the integration of Pr EP into HIV care clinics stimulated the provision of PNS , and PNS was used to improve the identification of potential Pr EP clients. The integrated combination of PNS , Pr EP and ART is synergistic and should be promoted in HIV clinics.