Impact of the COVID‑19 Pandemic on HIV Testing and Assisted Partner Notification Services, Western Kenya

HIV/TB Research 28 Aug 2023

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The impact of the COVID-19 pandemic will likely be most devastating to people living in resource-constrained settings, including sub-Saharan Africa, where its effects are compounded by high poverty rates, inadequately resourced health systems, and co-occurring HIV epidemics. There is growing concern that COVID-19 will result in services disruptions for HIV testing and treatment, resulting in excess HIV-related deaths and onward transmission.[1] Assisted partner notification services (aPS), or provider notification and HIV testing for sexual partners of persons diagnosed HIV-positive (index clients), is one such program facing negative consequences from the COVID-19 pandemic. World Health Organization issued guidelines in 2016 recommending aPS as a targeted strategy to identify new HIV cases in response to numerous studies demonstrating effectiveness of aPS in reaching partners with high proportions testing HIV positive (30–60%).[2–8] Our team (University of Washington, PATH, and Kenya Ministry of Health) is conducting a large-scale aPS implementation science project in facilities in western Kenya using government-employed healthcare workers who perform aPS as part of routine clinic duties. Implementation began in 2018, and to date, aPS has been integrated into 31 clinics in Homa Bay and Kisumu counties. Overall, 2089 females have tested HIV-positive and 1863 (90%) accepted aPS and provided contact information for their male sexual partners. Of 4636 male partners named, 79% have been successfully traced and accepted HIV testing, 41% of whom were found to be HIV-positive (N = 1512). Although programmatically, aPS is being offered to both male and female index clients as part of routine HIV services, we only collect data on female indexes and their male partners.
On March 13, 2020, the first case of COVID-19 was confirmed in Kenya. In response, national guidelines were enacted to prevent its spread. Clinics and HIV programs were faced with the challenge of balancing the safety of staff with healthcare needs of the community. Here we report the impact of COVID-19 on clinics providing aPS services in western Kenya using programmatic data to assess trends over time and conversations with in-country staff to explore perspectives and challenges associated with aPS provision during COVID-19.