Abstract Body

The World Health Organization recommends that all persons diagnosed with HIV be offered assisted partner notification services (APS). There are limited data on the safety of APS as implemented in public health programs.

From January 2015 to March 2019, persons with newly diagnosed with HIV infection in 3 clinics in Maputo, Mozambique received APS using an APS model that relied on disclosure counseling and patient referral of sex partners, sometimes with a counselor’s assistance (dual referral). APS staff routinely followed-up with APS recipients (index-cases [IC]) to determine if they had experienced adverse events following partner notification, including the following outcomes: 1) pushing, abandonment, or yelling; 2) being hit; or 3) loss of financial support or being expelled from the house.

18,965 persons tested HIV positive in the three clinics, 13,475 (71%) of whom were evaluated for APS eligibility, and 9,314 (69% of evaluated persons) were eligible to receive APS (Figure 1). Common reasons for ineligibility included reporting no sex partners in the prior 24 months (n=1,750, 42% ineligible), having already registered for HIV care at another clinic (n=784, 19% ineligible), and diagnosis as a partner of someone with HIV and reporting no other partners (n=483, 12% ineligible). Among eligible persons, 2,904 (31%) were excluded from analysis, either because they had no untested partners (n=1,335) or because they did not notify any partners (n=850) or had no follow-up interview (n=719). Staff collected follow-up data from 5,980 ICs (95% of cases not excluded from analysis), among whom 71 reported an adverse event following partner notification. Adverse events occurred in 50 (1.3%) of 3,855 women and 21 (1%) of 2,125 men. Twenty-nine (0.5%) ICs reported experiencing violence after notifying a partner. 190 ICs reported a fear of adverse events at their initial APS interview, of whom 165 nevertheless elected to notify 205 partners, 96 (50%) of whom tested HIV positive. Four (2%) of 190 ICs who reported fear of adverse events experienced an adverse event following partner notification vs. 65 (1%) of 5,602 who had no such fear (p=0.238).

Adverse events following receipt of APS in Mozambique is uncommon. Although Mozambique’s APS program did not promote partner notification among ICs who feared adverse events following partner notification, most ICs who had such a fear still elected to notify their partners and very few suffered adverse events.