Abstract

Setting: Four selected antiretroviral therapy (ART) canters of Gujarat State, India, which accounts for 8% of the human immunodeficiency virus (HIV) burden in India.
Objectives: 1) To assess the proportion of people living with HIV (PLHIV) whose partners were not tested for HIV; 2) to assess sociodemographic and clinical characteristics of index cases associated with partner testing; and 3) to understand perceived facilitators and barriers to partner testing and make suggestions on how to improve testing from the perspective of the health-care provider.
Design: A mixed-method design with a quantitative phase that involved reviewing the programme records of married PLHIV enrolled during 2011–2015, followed by a qualitative phase of key informant interviews.
Results: Of 3884 married PLHIV, 1279 (33%) did not have their partners tested for HIV. Factors including index cases being male, illiterate, aged >25 years, belonging to key populations, substance use and being in advanced clinical stages were more likely to be associated with partner non-testing. Non-disclosure of HIV status (due to fear of marital discord) and lack of awareness and risk perception were the key barriers to testing.
Conclusion: One third of PLHIV did not have their partners tested for HIV. Several factors were identified as being associated with the non-testing of partners, and solutions were explored that need to be implemented urgently if we are to achieve the 90–90–90 targets and end HIV.