Partner Services Research Articles

HIV Positivity, Linkage to Medical Care, Interview for Partner Services, and Pre-Exposure Prophylaxis Awareness and Referral Among Men Who Have Sex With Men Tested in Non-healthcare Settings in the United States, 2019.

Gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. This study reports data on HIV testing program outcomes among MSM tested for HIV in non-healthcare settings in the United States. We analyzed Centers for Disease Control and Prevention's National HIV Prevention Program Monitoring and Evaluation data collected in 2019. Descriptive and multivariate robust Poisson regression analyses were conducted to summarize the patterns of HIV testing program outcomes [ie, positivity, linkage to HIV medical care within 30 days of diagnosis, interview for partner services (PS), and pre-exposure prophylaxis (PrEP) awareness and referral] by demographic characteristics, HIV prevalence, and testing site type. A total of 123,251 HIV tests were conducted among MSM; of these, 1773 (1.4%) were newly diagnosed with HIV. Among MSM newly diagnosed with HIV, 75% were linked to HIV medical care and 80% were interviewed for PS. Among MSM who tested HIV-negative, 63% were aware of PrEP and 47% of those who were eligible for PrEP were referred to PrEP providers. Referral or linkage to services varied by demographic characteristics or other factors. Linkage to HIV medical care and interview for PS among MSM newly diagnosed with HIV in non-healthcare settings were below national or funding program targets. Most MSM with risk factors for HIV infection were not referred to PrEP providers. Expanded efforts to address barriers to equitable access to services may help improve HIV-related outcomes among MSM and contribute to ending the HIV epidemic in the United States.

‘My people perish for lack of knowledge’: barriers and facilitators to integrated HIV and hypertension screening at the Kenyatta National Hospital, Nairobi, Kenya

IntroductionHIV and cardiovascular disease (CVD) are the two main causes of death in Kenya with hypertension as CVD’s leading risk factor and HIV infection a risk factor for hypertension. We...

OPTIMALISASI PENJUALAN DAN DISTRIBUSI PADA UMKM RENGGINANG CRISPY SRI REJEKI PASCA PANDEMI MELALUI JASA DELIVERY ONLINE DI WILAYAH LAMONGAN KOTA

This situation of course greatly affects the Indonesian economy, especially the MSMEs in Lamongan City. The decrease in turnover that occurred in MSMEs was also very significant, including a decrease in business fields, namely the food and beverage sector. Online sales can be used as a strategy and means to boost economic life during a pandemic. The object of this research is the Rengginang Crispy Sri Rejeki MSME located in Geneng Hamlet near Lamongan Regency. This research aims to enable Rengginang Crispy Sri Rejeki SMEs to optimize the use of delivery services as marketing and distribution media. The method for obtaining data in the research is using a qualitative approach and conducting direct interviews with informants from the Rengginang Crispy Sri Rejeki UMKM business actors in Lamongan and also using a SWOT analysis. The results showed that sales and distribution of Rengginang Crispy Sri Rejeki through delivery services, especially local delivery in Lamongan such as cita delivery, boss delivery, and others. Collaboration between MSMEs by utilizing delivery partner services can optimize the distribution and promotion of Rengginang Crispy Sri Rejeki MSMEs so that goods can be ensured to arrive at their place and be received by consumers in intact condition.

Field Services-Facilitated Treatment and Prevention: Challenges and Opportunities.

Assisted partner services (APS) is a longstanding public health strategy to reduce transmission of sexually transmitted infection (STI) and human immunodeficiency virus in the United States. However, with rapidly increasing rates of STI, innovations to APS are needed to allow health departments to conserve limited public health resources while improving the effectiveness of APS. Disease Intervention Specialists (DIS), public health staff who conduct APS, have a wealth of experience in identifying, locating, and interviewing index patients and their sexual partners, but are currently limited in the services that they are able to provide in the field. Although several state and local health departments are working to expand the role of DIS to incorporate less traditional APS activities, such programs are uncommon. We discuss several services that DIS could conceivably provide in the field, such as STI testing, treatment, and vaccination, and identify critical issues to be addressed to implement these changes in DIS activities on a larger scale. Broadening the scope of DIS activities may result in multiple benefits to health departments, including more effectively delivering STI testing and treatment to hard-to-reach populations, imparting more responsibility to DIS, thereby potentially increasing job satisfaction, and building a workforce that is better prepared for public health crises. Effective approaches to address variable state level regulations governing DIS scope of practice are needed.

"Everything…Fell Apart Once COVID-19 Hit"-Leveraging the COVID-19 Response to Strengthen Public Health Activities toward Ending the HIV Epidemic: A Qualitative Study.

COVID-19 caused widespread disruption of activities for Ending the HIV Epidemic (EHE). In this study we assessed public health perspectives on leveraging the COVID-19 response to advance the goals of EHE. We conducted a qualitative study with 33 public health partners in the Midwestern and Southern United States from October 2020 to February 2022. Participants were asked how the strategies developed for COVID-19 could be applied to the HIV epidemic. Interviews were recorded, transcribed, and examined using rapid qualitative analysis. Four themes emerged: (1) Rebuilding teams and adapting culture for success in EHE activities; (2) Recognizing and modernizing the role of disease intervention specialists (DIS); (3) Enhanced community awareness of the public health role in disease response and prevention; and (4) Leveraging COVID-19 data systems and infrastructure for EHE activities. The COVID-19 pandemic called attention to the dearth of public health funding and outdated information technology (IT) infrastructure used for HIV activities. It also led to greater public health knowledge, including increased familiarity with partner services and molecular epidemiology of HIV, and opportunities to develop new data systems for surveillance that can be applied to efforts for EHE.

HIV Diagnoses Through Partner Services in the United States in 2019 and Opportunities for Improvement.

HIV partner services in 2019 resulted in 1214 diagnoses (3.5% of diagnoses in the United States) with 22.7% new positivity among partners without prior diagnosis. Areas for improvement are identified. Background HIV partner services (HIV PS) is an effective strategy for diagnosing HIV infection. Sex/needle-sharing partners of individuals diagnosed with HIV are notified about potential exposure and offered HIV testing and other services. We assessed the HIV PS contribution to HIV diagnoses in the United States and assessed priority areas for improvements. Methods National HIV Monitoring and Evaluation Partner Services and case surveillance data reported to the Centers for Disease Control and Prevention for 2019 were used for this analysis. The percentage of all new diagnoses that HIV PS programs reported is described nationally and by state. Linkage to HIV medical care among newly diagnosed partners is described. Potential increases in diagnosing HIV infection are assessed by HIV PS step to identify priority areas for improvement. Results HIV PS contributed 1214 of 35,164 (3.5%) of all diagnoses nationally in 2019, and contributions ranged from 0% to 31.8% by state. Of partners tested with nonmissing data, 22.7% were newly diagnosed. An estimated 1692 new partner diagnoses were lost during HIV PS steps. Steps resulting in the highest losses included index patients not being interviewed, partners not being tested for HIV, and index patients not being located. Seventy-two percent of partners newly diagnosed with HIV were linked to HIV medical care. Conclusions HIV PS is an effective strategy for diagnosing HIV, and a high percent of sex/needle-sharing partners was newly diagnosed with HIV. Expanded HIV PS in some states and targeted improvements in HIV PS steps can enhance the contribution of HIV PS toward achieving national goals.

Employee Assistance Programs: A Misunderstood and Underused Resource for Nurses.

As the focus on nurse well-being evolves, an important consideration is the role of an organization's employee assistance program (EAP). Employee assistance programs are historically underused by employees and are not understood in terms of the depth of services and partnerships they can offer. Nurse executives have a key role in maximizing EAP services and utilization as ones who refer staff and who can influence and decide on an EAP partner and related programs and services. This column discusses how EAPs can be a significant tool for nurse leaders in supporting employees.

Assisted Partner Services for People Who Inject Drugs: Index Characteristics Associated With Untreated HIV in Partners.

Assisted partner services (APSs) is a feasible, acceptable, and effective strategy that increases uptake of HIV testing; however, it has not been used widely among people who inject drugs (PWID) in Africa to notify sexual and injecting partners of potential exposures to HIV and provide testing services. Nairobi, Kilifi, and Mombasa counties in Kenya. PWID living with HIV (indexes) were enrolled and asked to provide contact information for sexual and injecting partners who were traced and offered HIV testing. APS efficiency was assessed by the number of indexes needed to interview (NNTI) to find 1 additional partner who was unaware of their HIV status or not on antiretroviral therapy (ART). We defined index participant characteristics associated with greater efficiency, defined as lower NNTIs. Among 783 indexes, the NNTI to identify one partner unaware of their HIV status was 7.1 and to identify one HIV-positive partner not on ART (regardless of status awareness) was 4.1. APS was provided to 977 partners and was more efficient in identifying partners who were not on ART (n = 201) among indexes who were female (NNTI = 2.9 vs. 5.7, P < 0.001), unaware of their HIV status (NNTI = 2.2 vs. 4.2, P = 0.009), not on ART (NNTI = 2.1 vs. 4.9; P < 0.001), not enrolled in a methadone program (NNTI = 3.3 vs. 10.4, P < 0.001), reported injecting <5 years (NNTI = 3.3 vs. 5.0; P = 0.005), or from Nairobi (NNTI = 3.2 vs. 5.6, P < 0.001). Scaling up APS among PWID living with HIV with certain characteristics could result in more efficient APS and greater partner engagement in HIV care.

The Role of HIV Partner Services in the Modern Biomedical HIV Prevention Era: A Network Modeling Study.

HIV partner services can accelerate the use of antiretroviral-based HIV prevention tools (antiretroviral therapy [ART] and preexposure prophylaxis [PrEP]), but its population impact on long-term HIV incidence reduction is challenging to quantify with traditional partner services metrics of partner identified or HIV screened. Understanding the role of partner services within the portfolio of HIV prevention interventions, including using it to efficiently deliver antiretrovirals, is needed to achieve HIV prevention targets. We used a stochastic network model of HIV/sexually transmitted infection transmission for men who have sex with men, calibrated to surveillance-based estimates in the Atlanta area, a jurisdiction with high HIV burden and suboptimal partner services uptake. Model scenarios varied successful delivery of partner services cascade steps (newly diagnosed "index" patient and partner identification, partner HIV screening, and linkage or reengagement of partners in PrEP or ART care) individually and jointly. At current levels observed in Atlanta, removal of HIV partner services had minimal impact on 10-year cumulative HIV incidence, as did improving a single partner services step while holding the others constant. These changes did not sufficiently impact overall PrEP or ART coverage to reduce HIV transmission. If all index patients and partners were identified, maximizing partner HIV screening, partner PrEP provision, partner ART linkage, and partner ART reengagement would avert 6%, 11%, 5%, and 18% of infections, respectively. Realistic improvements in partner identification and service delivery were estimated to avert 2% to 8% of infections, depending on the combination of improvements. Achieving optimal HIV prevention with partner services depends on pairing improvements in index patient and partner identification with maximal delivery of HIV screening, ART, and PrEP to partners if indicated. Improving the identification steps without improvement to antiretroviral service delivery steps, or vice versa, is projected to result in negligible population HIV prevention benefit.

Strengthening assessment and response to mental health needs for Aboriginal and Torres Strait Islander children and adolescents in primary care settings: study protocol for the Ngalaiya Boorai Gabara Budbut implementation project

IntroductionOpportunities for improved mental health and wellbeing of Aboriginal and Torres Strait Islander children and young people lie in improving the capability of primary healthcare services to identify mental healthcare...

Superwomen: Battles of Work-Family

The purpose of this paper to examine the influence of work characteristics and family characteristics towards interference in work and interference in family amongst working Indonesian women.The data for this study were collected using questionnaire directed towards working women who are still holding family related roles. A total of 209 respondents was used in this study. Data analysis was done using Structural Equation Modelling approach using the help of SPPS AMOS. The study found that work characteristics and family characteristics all influence work interference family and family interference with work. In addition, the support of family, partner, network, and other services plays at a significant moderate to either affect positively or negatively towards work interference to family or family interference to work. The study's findings showcased women are involved in the gig economy, when like in the case due the pandemic, many women jump into work for additional income for their households. With working women awareness towards work interference with family, workplaces for women should need to put in place policies that would not let the work compete to her priorities in family. The study showcased that there is a significant moderating effect of support towards work interference with family and family interference with work. And both variable work interference with family and family interference with work could be studied separately.

Adults Aged ≥50 Years Reached by the Centers for Disease Control and Prevention's HIV Testing Programs in the United States and US Dependent Areas, 2019.

Older adults represent nearly half of people living with HIV in the United States. The objective of this analysis was to describe HIV testing, demographic characteristics, and risks of adults aged ≥50 years (older adults) reached in 2019 by HIV testing programs funded by the Centers for Disease Control and Prevention (CDC). We collected data from 101 CDC-funded community-based organizations and 61 health departments. All funding recipients submitted deidentified program service data for 2019 through a secure online CDC-supported system. We used multivariable robust Poisson regression to assess the association between demographic and risk characteristics and the proportion of tests that resulted in a new diagnosis. We also assessed the proportion of people who received a positive test result, were linked to HIV medical care, and were interviewed for partner services. During 2019, among 2 452 507 CDC-funded HIV tests provided in the United States, 412 164 (16.8%) were provided to older adults. Among the 1059 (0.26% positivity) older adults with newly diagnosed HIV infection for whom we had data, 582 (68.4%) were linked to HIV medical care within 30 days of diagnosis and 494 (72.1%) were interviewed for partner services. Among the 2858 older adults with previously diagnosed HIV infection, 1321 (46.2%) reported not being in HIV medical care at the time of the test; of those with linkage data, 425 (49.9%) were linked to HIV medical care within 30 days of testing HIV positive. More rapid disease progression and higher morbidity and mortality rates among older adults suggest that services are needed to ensure early diagnosis, rapid linkage, and interview for partner services.

Prioritizing syphilis control: Now is the time for action.

Syphilis control programs and research received fewer resources and attention compared to HIV and other sexually transmitted infections (STIs) in the pre-pandemic era. The neglect of syphilis within comprehensive STI control efforts may be related to diagnostic (poor diagnostics), historical (legacies of racism in research), public health (limited partner services), and social problems (limited public engagement). At the same time, there are increasingly compelling reasons to prioritize syphilis control programs and research by harnessing lessons learned and advances during COVID-19. The closure of many STI facilities has accelerated new syphilis diagnostic pathways (e.g., syphilis self-testing), providing new ways for people to be screened outside of clinics. COVID-19 has underlined health inequities that fuel syphilis transmission, providing an opportunity to reckon with the historical legacy of racism that is linked to syphilis research. COVID-19 partner tracing efforts have also contributed to additional resources for partner services which may enhance syphilis control efforts. Finally, COVID-19 has demonstrated the importance of public engagement, making the case for greater public involvement in syphilis control and prevention programs. Urgent action is needed to prioritize syphilis control in a wide range of settings.

How Does Partner Diversity Matter for Service Innovativeness?

The global and digital economy has witnessed a rising importance of the service sector. Along with this trend, service innovation has attracted growing academic attention. Service innovation is distinctive from product innovation in the manufacturing sector because service innovation involves more intangible characteristics and requires intensive interaction with partners. Previous studies on the linkage between partner diversity and product innovation indicate that partner diversity is a double-edged sword. How partner diversity matters for service innovativeness remains unclear. Utilizing a sample of 709 service firms in Taiwan, this study investigates how partner domain diversity and geographical diversity influence service innovativeness, and how firm absorptive capacity and scope of firm internationalization moderate the relationship between partner diversity and service innovativeness. The empirical result suggests that firm absorptive capacities and scope of firm internationalization matter for realizing the positive impact of partner diversity on service innovativeness. The study advances research in service innovation and has key implications for management practice.

Pendampingan Menulis Kreatif untuk Publikasi Artikel Ilmiah di Jurnal Akademik (Covid 19 New Normal)

The implementation of this service aims to share knowledge and increase potential for teachers in the region, especially in the Gunung Pandak Village area, Kec. Performances, Kab. Malang during the pandemic, to increase knowledge about the world of writing scientific journals. The method follows the drawings of each component of the implementation, including observation, identification of problems related to authentic assessments with partners, as well as plans offered to the implementing team for partner service. Analysis of solving problems faced by teachers, namely: needs analysis related to the renewal of an authentically based assessment system. Authentic assessment needs to be introduced to all components, procedures, and developments in learning, while problem analysis is carried out in the form of teacher abilities related to evaluations that have been carried out through participant activities being able to make articles for academic journals that they can use for the purposes of rank or certification. In the implementation process, it is influenced by various factors, including the appeal of the principal who does not require to write a journal. This activity was carried out by an assistant to MINU teachers while learning to write scientific journal articles, namely the writing movement for teachers to gain more useful knowledge.

Gaps in HIV Preexposure Prophylaxis Continuum of Care Following State Partner Services for Massachusetts Primary and Secondary Syphilis Cases, 2017 to 2018.

Human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) reduces HIV acquisition. We used a PrEP continuum of care to measure impact of field epidemiologist-facilitated referrals for PrEP-naive infectious syphilis cases across multiple clinical and pharmacy sites of care. Retrospective analysis of 2017 to 2018 primary and secondary syphilis cases, medical charts, and pharmacy data to identify PrEP education, referral offer, referral acceptance, first visit, prescription pickup (PrEP initiation) and 2 to 3 months (PrEP persistence). The HIV seroconversion was determined using database match at syphilis diagnosis date and at 12 months. χ 2 or Fisher's exact tests were used to compare demographic characteristics associated with steps with lower progression rates. Of 1077 syphilis cases, partner services engaged 662 of 787 (84%) HIV-negative cases; 490 were PrEP-naive, 266 received education, 166 were offered referral, 67 accepted referral, 30 attended an initial appointment, and 22 were prescribed PrEP. Of 16 with pharmacy data, 14 obtained medication, and 8 persisted on PrEP at 2 to 3 months. Continuum progression was lowest from (1) PrEP-naïve to receiving PrEP education, (2) offered referral to referral acceptance, and (3) referral acceptance to initial PrEP appointment. Men with male partners were more likely to receive PrEP education or accept a referral. Higher social vulnerability was associated with increased PrEP referral acceptance. Few individuals accepted PrEP referrals and persisted on PrEP. Field and clinic data capture were inconsistent, possibly underestimating referral volume and impact of field engagement. Efforts aimed at increasing referral acceptance and clinic attendance may improve PrEP uptake especially among women and heterosexual men with syphilis.

Leandro Mena: advancing sexual health in the USA

“There are many challenges, it's a very complex problem”, says Leandro Mena about the prevention of sexually transmitted diseases (STD) in the USA. As the Director of the Division of STD Prevention in the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA, USA, he comments: “We have seen over the past two decades an effective reduction of the buying power of public funding for the control and prevention of STDs, which has resulted in reductions in screening, treatment, prevention, and partner services.

Contraceptive use among cisgender women with bacterial sexually transmitted infections: A cross-sectional study.

Data on contraceptive use among women with bacterial sexually transmitted infections (STIs) are sparse, despite this population's high risk for unplanned pregnancy. This cross-sectional study included 1623 cisgender women recently diagnosed with a bacterial STI who completed a public health Partner Services interview between January 2017 and December 2019 in King County, WA, USA. Contraceptive methods were categorized as: (1) highly or moderately effective and (2) least effective or no method. Poisson regression models were used to assess associations between individual characteristics and contraceptive method. Almost two thirds of the women (62.6%) reported using highly or moderately effective contraception, with 30.3% of women using long-acting contraception (LARC). More than one in three women (37.4%) reported using least effective methods or no method. Black women were less likely to report using a highly or moderately effective method compared to White women (aRR 0.58, 95% CI 0.43-0.80) and women with private insurance were more likely to report using a highly or moderately effective method compared to those with public insurance (aRR 1.67, 95% CI 1.28-2.19). Given that many women with bacterial STIs are not desiring pregnancy, this study highlights the need for additional reproductive health services for women with recent STI diagnoses.

Experience in Growth Monitoring and Promotion Integrated With Immunization Services in a City Corporation of Bangladesh

ObjectivesWe aim to share the experience of the USAID's Strengthening Multi-sectoral Nutrition Programming through Implementation Science Activity (MSNP), which has been integrating Growth Monitoring (GMP) and Expanded Program of Immunization (EPI) for children under two years in Khulna City Corporation (KCC), Ministry of Local Government Rural Development and Cooperatives (LGRD), Bangladesh.MethodsThe team analyzed the GMP and EPI service data, observed client-provider interactions (service delivery) (n = 3 nutrition counselors), conducted semi-structured interview with health assistants (n = 6) and informal discussion with mothers (n = 10) who visited the GMP/EPI service facilities from October 2021 to January 2022.ResultsBoth health assistants and nutrition counselors delivered GMP and EPI services, serving as key enablers of EPI-GMP integration. Reminder text messages were sent by MSNP project to mothers of children lost-for-follow-up to encourage their service return. From October 2021 to January 2022 GMP-EPI integrated services were provided to 1518 children (October: 32; November: 281; December: 583; January: 622).Major challenges included coordination gaps between service activities; space constraints to conduct GMP; overburdening of health assistants to fulfil EPI lost-to-follow-up targets during COVID-19 pandemic and priority for vaccination of COVID-19 to EPI; lack of awareness among caregivers of the importance of appropriate nutrition during the child's first 1000 days for healthy physical and mental development.ConclusionsAlthough this experience suggests integration of GMP into EPI can work, improvements are needed. The MSNP project will increase coordination among donors, Ministry of Health and LGRD, KCC and partner NGOs, service providers and mothers to ensure sustained and effective GMP-EPI integration; provide need-based infant and young child feeding counseling and train caregivers on community-based management of acute malnutrition, and strengthen service provision by providing supportive supervision to them.Funding SourcesUnited States Agency for International Development (USAID).

“It is a process” – a qualitative evaluation of provider acceptability of HIV assisted partner services in western Kenya: experiences, challenges, and facilitators

BackgroundAssisted partner service (APS) is effective for increasing HIV testing services (HTS) uptake among sexual partners of people diagnosed with HIV with rare social harm. The acceptability of APS to HTS providers is important for the quality and effectiveness of APS delivery. Within a larger ongoing implementation science study of APS in western Kenya, we qualitatively evaluated the provider acceptability of APS.MethodsFrom May–June 2020, we conducted virtual, semi-structured in-depth interviews with 14 HTS providers recruited from 8 of 31 study health facilities in Homa Bay and Kisumu counties. Participants were selected using criteria-based purposive sampling to maximize variation on patient volume (assessed by the number of index clients tested for HIV) and APS performance (assessed by sexual partners elicitation and enrollment). Interviews inquired providers’ experiences providing APS including challenges and facilitators and the impact of contextual factors. Data were analyzed using an inductive approach.ResultsOverall, HTS providers found APS acceptable. It was consistently reported that doing APS was a continuous process rather than a one-day job, which required building rapport and persistent efforts. Benefits of APS including efficiency in HIV case finding, expanded testing coverage in men, and increased HIV status awareness and linkage to care motivated the providers. Provider referral was perceived advantageous in terms of independent contact with partners on behalf of index clients and efficiency in partner tracing. Challenges of providing APS included protecting clients’ confidentiality, difficulty obtaining partners’ accurate contact information, logistic barriers of tracing, and clients’ refusal due to fear of being judged for multiple sexual partners, fear of breach of confidentiality, and HIV stigma. Building rapport with clients, communicating with patience and nonjudgmental attitude and assuring confidentiality were examples of facilitators. Working in rural areas and bigger facilities, training, supportive supervision, and community awareness of APS promoted APS delivery while low salaries, lack of equipment, and high workload undermined it.ConclusionsHTS providers found APS acceptable. Delivering APS as a process was the key to success. Future scale-up of APS could consider encouraging provider referral instead of the other APS methods to improve efficiency and reduce potential harm to clients.