Stopping HIV with differentiated partner notification services

July 21, 2019 by PATH

How one small measure is making a big difference in the fight to end HIV.

Controlling HIV requires successful intervention on three fronts: testing those most at risk, offering prevention services to those that are HIV negative, and expanding treatment access for people living with HIV. On all three fronts, one approach is making a big difference: partner notification.

Partner notification is exactly what you think it is—sexual partners, injecting partners, and children that are at risk for infection being notified (either directly or indirectly) by a newly HIV diagnosed individual, health care worker, or community provider.

Those same partners and children are then offered HIV testing and, following their results, linked to prevention services (if negative) or treatment (if positive).

The whole process can either be passive (entirely patient-driven) or assisted (with varying degrees of support from a trained provider). Though it all sounds simple in concept, partner notification services must be customized—or “differentiated”—to increase uptake and effectively meet the needs of clients and their partners.

Differentiation in practice

PATH has offered differentiated partner notification services to a variety of populations: helping reach men in western Kenya; working to address an epidemic concentrated among miners, fishing communities, and long-distance truck drivers in the Democratic Republic of the Congo; targeting micro-epidemics among networks of key populations in Vietnam; and supporting at-risk populations within prisons and community settings in Ukraine.*

Let’s look at two of these examples in greater depth—Kenya and Vietnam.

In Kenya, PATH’s Afya Ziwani project integrates secondary distribution of HIV self-testing kits to reach more partners—particularly male partners. That means, in cases where there is no risk of intimate partner violence, individuals who opt to HIV self-test are given additional self-testing kits to share with their partners. PATH also offers mobile testing services near workplaces and community areas where male partners have noted a preference for being tested by a provider, who can link those that are HIV-negative to prevention services like pre-exposure prophylaxis, and those that are HIV-positive to treatment.

An HIV self-testing kit being distributed to a client in Vietnam. Photograph: PATH/Matthew Dakin.

An HIV self-testing kit being distributed to a client in Vietnam. Photograph: PATH/Matthew Dakin.

In Vietnam, the USAID/PATH Healthy Markets program partners with and equips community-based organizations to offer HIV lay testing, self-testing, and partner notification counseling. These groups—each one key population-led—have been very successful with partner notification because of the trust and confidence they share with their communities.

The use of digital technology is another differentiating factor in Vietnam. Smartphone apps and social media have played a major role in community outreach and partner tracing there, allowing counselors to raise awareness and share critical information with populations that, otherwise, might never be reached.

To learn more about PATH’s differentiated services and the specific results of each program, read our technical brief.

Consistent principles, tailored application

Though each new context requires differentiation to meet client needs, it’s important that each new iteration follows the same key principles:

  • Strict adherence to the five Cs—consent, confidentiality, counseling, correct HIV test results, and connection to care and treatment.
  • Routinely offering partner notification services—following diagnosis, annually as part of treatment services, and after a change in relationship status.
  • Minimizing risk of violence including intimate partner violence through active screening and a “do no harm” approach.

Ending the epidemic

In both healthcare and community settings, differentiated partner notification services allow providers to reach HIV-positive individuals faster, confirm diagnoses earlier, and ensure rapid enrollment in antiretroviral therapy for better health outcomes.

And, by actively offering prevention services to those who are HIV negative, these same services critically disrupt chains of HIV transmission. Scaling access to client-centered, differentiated partner notification is key to our global goal—ending AIDS by 2030.

*Editor's note: This work has been made possible thanks to funding from the United States Agency for International Development through the United States President’s Emergency Plan for AIDS Relief.