Abstract
BackgroundAssisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW). This study aimed to explore the awareness of and need for HIV partner notification, as well as to outline potential strategies for APNS based on identified barriers and facilitators.MethodsWe conducted semi-structured interviews to explore partner notification with MSM, TW, and counselors. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS.ResultsMost participants reported experiences with informal partner notification and serostatus disclosure, but not with APNS. Only one counselor indicated assisting notification systematically. The main barriers for notifying or disclosing mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier to inform a formal partner, conditional of being well informed about HIV. Given current stigma and lack of awareness, it was suggested that APNS should be preceded by HIV awareness efforts, and be provided by counselors or peers to mitigate potential rejection or violent reactions.ConclusionsWhile APNS are not formally implemented in Mexico, all participants supported the service, indicating that APNS could potentially enhance early HIV diagnosis in Mexico. Strategies to implement such services need to be flexible addressing the individual needs of participants, guaranteeing the safety of more vulnerable participants.
Highlights
Assisted partner notification services (APNS) may increase Human immunodeficiency virus (HIV) testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW)
Early diagnosis is key to treat HIV successfully [1]. It allows for early initiation of antiretroviral therapy (ART), which has been found to reduce the risk of HIV transmission [2], development of a non-Acquired immunodeficiency syndrome (AIDS)-defining illness, progression to AIDS, or death [3]
Between January and March 2019, a total of 28 interviews were conducted among 12 MSM, eleven TW, and five counselors, all of whom resided in the Mexico City Metropolitan Area
Summary
Assisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW). Diagnosis is key to treat HIV successfully [1]. In order to undertake the challenge of scaling up HIV diagnosis, new approaches to improve the efficiency and coverage of HIV testing services are needed. This is can be difficult because PLWH do not always present symptoms that lead to seeking health services and they often belong to unsuccessfully reached key populations. HIV assisted partner notification services (APNS) have been strongly recommended by the World Health Organization as one such approach [10]. APNS are services offered to inform partners of a person diagnosed with HIV that they are at risk of having HIV and should seek testing [11]
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