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Oljira H, Rata A, Mulatu B, Abera T. Partner notification service utilization and associated factors among clients attending anti-retroviral therapy clinics of public health facilities in Gimbi Town, West Ethiopia, 2023: a facility-based mixed-method cross-sectional study. BMC Public Health 2024; 24:687. [PMID: 38438988 PMCID: PMC10913634 DOI: 10.1186/s12889-024-18196-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/23/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Partner Notification Service is among the strategies used to conduct targeted Human Immunodeficiency Virus Testing Service by obtaining information about sexual contacts of index clients to refer for testing. But most people living with Human Immunodeficiency Virus are still unaware of their status, including Ethiopia. Limited studies are available on the magnitude of partner notification service utilization and associated factors in Ethiopia. OBJECTIVE The aim of this study was to assess the magnitude of partner notification service utilization and associated factors among people living with Human Immunodeficiency Virus attending anti-retroviral therapy clinics of public health facilities in Gimbi town, West Ethiopia. METHODS A facility-based mixed-method cross-sectional study design was used. Total of 455 study participants were selected by systematic random sampling for quantitative data and health workers were purposively selected for qualitative data until saturation of ideas was reached. The study was conducted from December 1, 2022 to January 30, 2023. Structured questionnaires and key informant interview guides were used for data collection. Quantitative data were analyzed using Statistical Package for Social Science version 25. Open code 4.02 software was used for qualitative data analysis. Frequencies and proportions were used to summarize descriptive statistics. Bivariable and multivariable logistic regression was used to identify associated factors then variables with a p value < 0.05 were declared to have an association with the dependent variable. RESULT Exactly 298 (65.5%) of the study participants were notified their HIV status to their sexual partners. Factors associated with Partner Notification Service Utilization were depression AOR: 0.12 (95% CI: 0.07, 0.20), urban settlers AOR: 2.21 (95% CI: 1.2, 3.83), fear of support loss AOR: 0.24 (95% CI: 0.14, 0.40) and intimate partner violence AOR: 0.55 (95% CI: 0.31, 0.97). From qualitative part of this study, factors associated to Partner Notification service utilization were fear of stigma, discrimination and fear of divorce. CONCLUSION Two-third of the study participants were utilized partner notification service, and efforts are important to prevent depression and intimate partner violence. Local government bodies and stakeholders should implement economic strengthening and strategies to address the rural community for HIV/AIDS prevention. Promotion of supportive and inclusive environment for PLHIV should also considered as way to increase PNS utilization.
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Affiliation(s)
- Habtamu Oljira
- Department of Biomedical Science, School of Medicine, Wallaga University, Nekemte, Oromia, Ethiopia.
| | - Abiriham Rata
- Nekemte Blood Bank, Oromia Health Beuareu, Nekemte, Oromia, Ethiopia
| | - Befirdu Mulatu
- Department of Public Health, Institute of Health Science, Wallaga University, Nekemte, Oromia, Ethiopia
| | - Tesfaye Abera
- Department of Nursing, School of Nursing and Midwifery, Wallaga University, Nekemte, Oromia, Ethiopia
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Greensides D, Bishop K, Manfredini L, Wong V. Do No Harm: A Review of Social Harms Associated with HIV Partner Notification. GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:e2300189. [PMID: 38135515 PMCID: PMC10749648 DOI: 10.9745/ghsp-d-23-00189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 11/19/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION HIV partner notification services (PNS) are highly effective in identifying people living with HIV, but the complex risks and repercussions associated with HIV testing and disclosure must be examined. The benefits of assisting people to learn their HIV status and link with treatment or prevention based on their results must be considered alongside the risks of adverse events or social harms. METHODS The study team systematically searched the PubMed, EBSCO, and Web of Science electronic databases (2015-2021), as well as abstracts from the International AIDS Society Conference (2016-2020) and the Conference on Retroviruses and Opportunistic Infections (2015-2020). Fifteen studies and 1 conference abstract met the inclusion criteria for this narrative review. RESULTS AND DISCUSSION Incidence of social harms across studies ranged from 0%-6.3%, with the higher range occurring among women with a previous history of intimate partner violence (IPV). The majority of the studies (69%) reported that less than or equal to 1% of participants experienced social harms as a result of PNS. Social harms included relationship dissolution, IPV, and loss of financial support. CONCLUSIONS Evidence from a limited set of studies suggests that although social harms associated with HIV partner notification do occur, they are rare. Considering the rapid global scale-up of PNS, additional research and oversight are needed to provide countries with recommended minimum standards to support providers, clients, and their partners with safe partner notification.
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Affiliation(s)
- Dawn Greensides
- Global Health Technical Assistance and Mission Support Project, supporting the Office of HIV/AIDS, Prevention, Care, and Treatment Division, U.S. Agency for International Development, Washington, DC, USA
| | - Kristina Bishop
- U.S. Agency for International Development, Washington, DC, USA
| | - Liz Manfredini
- Global Health Training, Advisory, and Support Contract, Credence Management Solutions, LLC, supporting the Office of HIV/AIDS, Prevention Care and Treatment Division, U.S. Agency for International Development, Washington, DC, USA.
| | - Vincent Wong
- U.S. Agency for International Development, Washington, DC, USA
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Kassaye SG, Grossman Z, Vengurlekar P, Chai W, Wallace M, Rhee SY, Meyer WA, Kaufman HW, Castel A, Jordan J, Crandall KA, Kang A, Kumar P, Katzenstein DA, Shafer RW, Maldarelli F. Insights into HIV-1 Transmission Dynamics Using Routinely Collected Data in the Mid-Atlantic United States. Viruses 2022; 15:68. [PMID: 36680108 PMCID: PMC9863702 DOI: 10.3390/v15010068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
Background: Molecular epidemiological approaches provide opportunities to characterize HIV transmission dynamics. We analyzed HIV sequences and virus load (VL) results obtained during routine clinical care, and individual’s zip-code location to determine utility of this approach. Methods: HIV-1 pol sequences aligned using ClustalW were subtyped using REGA. A maximum likelihood (ML) tree was generated using IQTree. Transmission clusters with ≤3% genetic distance (GD) and ≥90% bootstrap support were identified using ClusterPicker. We conducted Bayesian analysis using BEAST to confirm transmission clusters. The proportion of nucleotides with ambiguity ≤0.5% was considered indicative of early infection. Descriptive statistics were applied to characterize clusters and group comparisons were performed using chi-square or t-test. Results: Among 2775 adults with data from 2014−2015, 2589 (93%) had subtype B HIV-1, mean age was 44 years (SD 12.7), 66.4% were male, and 25% had nucleotide ambiguity ≤0.5. There were 456 individuals in 193 clusters: 149 dyads, 32 triads, and 12 groups with ≥ four individuals per cluster. More commonly in clusters were males than females, 349 (76.5%) vs. 107 (23.5%), p < 0.0001; younger individuals, 35.3 years (SD 12.1) vs. 44.7 (SD 12.3), p < 0.0001; and those with early HIV-1 infection by nucleotide ambiguity, 202/456 (44.3%) vs. 442/2133 (20.7%), p < 0.0001. Members of 43/193 (22.3%) of clusters included individuals in different jurisdictions. Clusters ≥ four individuals were similarly found using BEAST. HIV-1 viral load (VL) ≥3.0 log10 c/mL was most common among individuals in clusters ≥ four, 18/21, (85.7%) compared to 137/208 (65.8%) in clusters sized 2−3, and 927/1169 (79.3%) who were not in a cluster (p < 0.0001). Discussion: HIV sequence data obtained for HIV clinical management provide insights into regional transmission dynamics. Our findings demonstrate the additional utility of HIV-1 VL data in combination with phylogenetic inferences as an enhanced contact tracing tool to direct HIV treatment and prevention services. Trans-jurisdictional approaches are needed to optimize efforts to end the HIV epidemic.
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Affiliation(s)
- Seble G. Kassaye
- Department of Medicine, Georgetown University, Washington, DC 20057, USA
| | - Zehava Grossman
- HIV Dynamics and Replication Program, National Cancer Institute, Frederick, MD 21702, USA
- School of Public Health, Tel Aviv University, Tel Aviv 69978, Israel
| | | | - William Chai
- Warren Alpert Medical School, Brown University, Providence, RI 02912, USA
| | - Megan Wallace
- Department of Medicine, Georgetown University, Washington, DC 20057, USA
| | - Soo-Yon Rhee
- Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | | | | | - Amanda Castel
- Department of Epidemiology, George Washington University, Washington, DC 20052, USA
| | - Jeanne Jordan
- Department of Epidemiology, George Washington University, Washington, DC 20052, USA
| | - Keith A. Crandall
- Computational Biology Institute, George Washington University, Ashburn, VA 20147, USA
| | - Alisa Kang
- Department of Medicine, Georgetown University, Washington, DC 20057, USA
| | - Princy Kumar
- Department of Medicine, Georgetown University, Washington, DC 20057, USA
| | | | - Robert W. Shafer
- Department of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Frank Maldarelli
- HIV Dynamics and Replication Program, National Cancer Institute, Frederick, MD 21702, USA
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Gonzalez Rodriguez H, Barrington C, McCallister KN, Guy J, Hightow-Weidman L, Hurt CB, McNeil CJ, Sena AC. Perceptions, experiences, and preferences for partner services among Black and Latino men who have sex with men and transwomen in North Carolina. ETHNICITY & HEALTH 2022; 27:1241-1255. [PMID: 33734826 PMCID: PMC8448793 DOI: 10.1080/13557858.2021.1899137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 03/01/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES In the United States, sexually transmitted infections (STIs) disproportionately affect men who have sex with men (MSM) and transwomen of color. Partner services can prevent STI transmission by facilitating testing and treatment for partners of individuals diagnosed with an STI. Understanding client perspectives towards partner services is critical to their acceptance and uptake. This study examined perceptions, experiences, and preferences for partner services among Black and Latino MSM and transwomen in North Carolina. DESIGN We conducted seven audio-recorded focus groups in English (n = 5) and Spanish (n = 2). The audio was transcribed verbatim and we inductively analyzed data using field notes, systematic coding, and thematic comparison. RESULTS Black MSM reported the most exposure and experiences with partner services, and most perceived partner services negatively. Feeling supported and having flexibility characterized positive experiences with partner services among Black MSM; feeling judged or harassed characterized negative experiences. Black transwomen had less exposure to partner services and had a mix of positive reactions to the approach, along with concerns about client confidentiality. Most Latino participants were unaware of partner services and expressed openness to their potential. All participants preferred self-notifying and wanted flexible, discreet, supportive partner services with linkages to other wellness resources. CONCLUSION Building off positive partner services experiences and responding to client preferences can enhance trust, acceptability, and service use.
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Affiliation(s)
- Humberto Gonzalez Rodriguez
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Clare Barrington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katherine Nicole McCallister
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jalila Guy
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lisa Hightow-Weidman
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christopher Browning Hurt
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Candice Joy McNeil
- Department of Medicine, Section on Infectious Diseases, Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Arlene Carmela Sena
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Rodriguez-Hart C, Boone CA, Del Río-González AM, Kutner BA, Baral S, Burns PA, German D, Eaton L, Lucas L, Remien RH, Ellis M, Dale SK. Monitoring Intersectional Stigma: A Key Strategy to Ending the HIV Epidemic in the United States. Am J Public Health 2022; 112:S350-S355. [PMID: 35763745 PMCID: PMC9241480 DOI: 10.2105/ajph.2022.306733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Cristina Rodriguez-Hart
- Cristina Rodriguez-Hart is with the New York City Department of Health and Mental Hygiene, New York, NY. Cheriko A. Boone and Ana María del Río-González are with the Department of Psychological and Brain Sciences, George Washington University, Washington, DC. Bryan A. Kutner and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute, New York, NY. Stefan Baral and Lisa Lucas are with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Paul A. Burns is with the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson. Danielle German is with the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health. Lisa Eaton is with the University of Connecticut, Department of Human Development and Family Sciences, Storrs. Marcia Ellis is with the DC Center for AIDS Research, Washington, DC. Sannisha K. Dale is with the Department of Psychology, University of Miami, Miami, FL
| | - Cheriko A Boone
- Cristina Rodriguez-Hart is with the New York City Department of Health and Mental Hygiene, New York, NY. Cheriko A. Boone and Ana María del Río-González are with the Department of Psychological and Brain Sciences, George Washington University, Washington, DC. Bryan A. Kutner and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute, New York, NY. Stefan Baral and Lisa Lucas are with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Paul A. Burns is with the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson. Danielle German is with the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health. Lisa Eaton is with the University of Connecticut, Department of Human Development and Family Sciences, Storrs. Marcia Ellis is with the DC Center for AIDS Research, Washington, DC. Sannisha K. Dale is with the Department of Psychology, University of Miami, Miami, FL
| | - Ana María Del Río-González
- Cristina Rodriguez-Hart is with the New York City Department of Health and Mental Hygiene, New York, NY. Cheriko A. Boone and Ana María del Río-González are with the Department of Psychological and Brain Sciences, George Washington University, Washington, DC. Bryan A. Kutner and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute, New York, NY. Stefan Baral and Lisa Lucas are with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Paul A. Burns is with the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson. Danielle German is with the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health. Lisa Eaton is with the University of Connecticut, Department of Human Development and Family Sciences, Storrs. Marcia Ellis is with the DC Center for AIDS Research, Washington, DC. Sannisha K. Dale is with the Department of Psychology, University of Miami, Miami, FL
| | - Bryan A Kutner
- Cristina Rodriguez-Hart is with the New York City Department of Health and Mental Hygiene, New York, NY. Cheriko A. Boone and Ana María del Río-González are with the Department of Psychological and Brain Sciences, George Washington University, Washington, DC. Bryan A. Kutner and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute, New York, NY. Stefan Baral and Lisa Lucas are with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Paul A. Burns is with the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson. Danielle German is with the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health. Lisa Eaton is with the University of Connecticut, Department of Human Development and Family Sciences, Storrs. Marcia Ellis is with the DC Center for AIDS Research, Washington, DC. Sannisha K. Dale is with the Department of Psychology, University of Miami, Miami, FL
| | - Stefan Baral
- Cristina Rodriguez-Hart is with the New York City Department of Health and Mental Hygiene, New York, NY. Cheriko A. Boone and Ana María del Río-González are with the Department of Psychological and Brain Sciences, George Washington University, Washington, DC. Bryan A. Kutner and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute, New York, NY. Stefan Baral and Lisa Lucas are with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Paul A. Burns is with the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson. Danielle German is with the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health. Lisa Eaton is with the University of Connecticut, Department of Human Development and Family Sciences, Storrs. Marcia Ellis is with the DC Center for AIDS Research, Washington, DC. Sannisha K. Dale is with the Department of Psychology, University of Miami, Miami, FL
| | - Paul A Burns
- Cristina Rodriguez-Hart is with the New York City Department of Health and Mental Hygiene, New York, NY. Cheriko A. Boone and Ana María del Río-González are with the Department of Psychological and Brain Sciences, George Washington University, Washington, DC. Bryan A. Kutner and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute, New York, NY. Stefan Baral and Lisa Lucas are with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Paul A. Burns is with the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson. Danielle German is with the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health. Lisa Eaton is with the University of Connecticut, Department of Human Development and Family Sciences, Storrs. Marcia Ellis is with the DC Center for AIDS Research, Washington, DC. Sannisha K. Dale is with the Department of Psychology, University of Miami, Miami, FL
| | - Danielle German
- Cristina Rodriguez-Hart is with the New York City Department of Health and Mental Hygiene, New York, NY. Cheriko A. Boone and Ana María del Río-González are with the Department of Psychological and Brain Sciences, George Washington University, Washington, DC. Bryan A. Kutner and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute, New York, NY. Stefan Baral and Lisa Lucas are with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Paul A. Burns is with the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson. Danielle German is with the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health. Lisa Eaton is with the University of Connecticut, Department of Human Development and Family Sciences, Storrs. Marcia Ellis is with the DC Center for AIDS Research, Washington, DC. Sannisha K. Dale is with the Department of Psychology, University of Miami, Miami, FL
| | - Lisa Eaton
- Cristina Rodriguez-Hart is with the New York City Department of Health and Mental Hygiene, New York, NY. Cheriko A. Boone and Ana María del Río-González are with the Department of Psychological and Brain Sciences, George Washington University, Washington, DC. Bryan A. Kutner and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute, New York, NY. Stefan Baral and Lisa Lucas are with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Paul A. Burns is with the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson. Danielle German is with the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health. Lisa Eaton is with the University of Connecticut, Department of Human Development and Family Sciences, Storrs. Marcia Ellis is with the DC Center for AIDS Research, Washington, DC. Sannisha K. Dale is with the Department of Psychology, University of Miami, Miami, FL
| | - Lisa Lucas
- Cristina Rodriguez-Hart is with the New York City Department of Health and Mental Hygiene, New York, NY. Cheriko A. Boone and Ana María del Río-González are with the Department of Psychological and Brain Sciences, George Washington University, Washington, DC. Bryan A. Kutner and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute, New York, NY. Stefan Baral and Lisa Lucas are with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Paul A. Burns is with the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson. Danielle German is with the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health. Lisa Eaton is with the University of Connecticut, Department of Human Development and Family Sciences, Storrs. Marcia Ellis is with the DC Center for AIDS Research, Washington, DC. Sannisha K. Dale is with the Department of Psychology, University of Miami, Miami, FL
| | - Robert H Remien
- Cristina Rodriguez-Hart is with the New York City Department of Health and Mental Hygiene, New York, NY. Cheriko A. Boone and Ana María del Río-González are with the Department of Psychological and Brain Sciences, George Washington University, Washington, DC. Bryan A. Kutner and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute, New York, NY. Stefan Baral and Lisa Lucas are with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Paul A. Burns is with the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson. Danielle German is with the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health. Lisa Eaton is with the University of Connecticut, Department of Human Development and Family Sciences, Storrs. Marcia Ellis is with the DC Center for AIDS Research, Washington, DC. Sannisha K. Dale is with the Department of Psychology, University of Miami, Miami, FL
| | - Marcia Ellis
- Cristina Rodriguez-Hart is with the New York City Department of Health and Mental Hygiene, New York, NY. Cheriko A. Boone and Ana María del Río-González are with the Department of Psychological and Brain Sciences, George Washington University, Washington, DC. Bryan A. Kutner and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute, New York, NY. Stefan Baral and Lisa Lucas are with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Paul A. Burns is with the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson. Danielle German is with the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health. Lisa Eaton is with the University of Connecticut, Department of Human Development and Family Sciences, Storrs. Marcia Ellis is with the DC Center for AIDS Research, Washington, DC. Sannisha K. Dale is with the Department of Psychology, University of Miami, Miami, FL
| | - Sannisha K Dale
- Cristina Rodriguez-Hart is with the New York City Department of Health and Mental Hygiene, New York, NY. Cheriko A. Boone and Ana María del Río-González are with the Department of Psychological and Brain Sciences, George Washington University, Washington, DC. Bryan A. Kutner and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies, NY State Psychiatric Institute, New York, NY. Stefan Baral and Lisa Lucas are with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Paul A. Burns is with the John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson. Danielle German is with the Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health. Lisa Eaton is with the University of Connecticut, Department of Human Development and Family Sciences, Storrs. Marcia Ellis is with the DC Center for AIDS Research, Washington, DC. Sannisha K. Dale is with the Department of Psychology, University of Miami, Miami, FL
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Rahmalia A, Wisaksana R, Laga M, van Crevel R, Peeters Grietens K. Facilitators and barriers to status disclosure and partner testing of women living with HIV in Indonesia: a mixed methods study. Sex Reprod Health Matters 2022; 30:2028971. [PMID: 35167424 PMCID: PMC8856062 DOI: 10.1080/26410397.2022.2028971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This mixed-methods study investigated HIV status disclosure and partner testing of women living with HIV (WLWH) in a concentrated epidemic setting in Bandung, Indonesia. The qualitative exploratory strand used theoretical sampling to carry out semi-structured interviews with 47 HIV-infected women with varying anti-retroviral therapy status. The quantitative strand included 122 female patients receiving HIV care at a referral clinic. HIV diagnosis made women reassess their sexual partnerships. Some lost their partner due to death or divorce. Women with a longstanding HIV infection often formed new partnerships. They disclosed their status to new partners without assistance from health providers; the type and stability of the partnership influenced decision to disclose. Fear of rejection prevented initial disclosure prior to bringing the new partners to a health provider. Disclosure did not always result in partner testing because of low risk-awareness or denial of the partner. Despite a similar proportion of status disclosure to partner (92.8%), only 53.7% of new partners of WLWH were tested in contrast to 89.7% of partners tested among WLWH who stayed with the same partner. In antenatal care, where same-day testing was often done for pregnant couples, more partners were tested. Overall, consistent condom use was low and HIV status forced WLWH who continued sex work to work at settings where condom use was not enforced. WLWH face barriers to HIV status disclosure and partner testing and would benefit from partnership counselling. Guidelines for partner notification and testing should include specific strategies for women with longstanding HIV infection.
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Affiliation(s)
- Annisa Rahmalia
- Researcher, Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia; Infectious Diseases and Global Health, Radboud University Medical Centre, Nijmegen, The Netherlands. Correspondence:
| | - Rudi Wisaksana
- Head of HIV Research Group, Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia; Department of Internal Medicine, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Marie Laga
- Professor, Sexual Health and HIV, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Reinout van Crevel
- Professor, Radboud Centre for Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Koen Peeters Grietens
- Professor, Head of Socio-Ecological Health Research (SEHR) Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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7
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Wirtz AL, Page KR, Stevenson M, Guillén JR, Ortíz J, López JJ, Ramírez JF, Quijano C, Vela A, Moreno Y, Rigual F, Case J, Hakim AJ, Hladik W, Spiegel PB. HIV surveillance and research for migrant populations: a protocol integrating respondent-driven sampling, case finding, and medicolegal services for Venezuelans living in Colombia (Preprint). JMIR Res Protoc 2021; 11:e36026. [PMID: 35258458 PMCID: PMC8941430 DOI: 10.2196/36026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background Epidemiologic research among migrant populations is limited by logistical, methodological, and ethical challenges, but it is necessary for informing public health and humanitarian programming. Objective We describe a methodology to estimate HIV prevalence among Venezuelan migrants in Colombia. Methods Respondent-driven sampling, a nonprobability sampling method, was selected for attributes of reaching highly networked populations without sampling frames and analytic methods that permit estimation of population parameters. Respondent-driven sampling was modified to permit electronic referral of peers via SMS text messaging and WhatsApp. Participants complete sociobehavioral surveys and rapid HIV and syphilis screening tests with confirmatory testing. HIV treatment is not available for migrants who have entered Colombia through irregular pathways; thus, medicolegal services integrated into posttest counseling provide staff lawyers and legal assistance to participants diagnosed with HIV or syphilis for sustained access to treatment through the national health system. Case finding is integrated into respondent-driven sampling to allow partner referral. This study is implemented by a local community-based organization providing HIV support services and related legal services for Venezuelans in Colombia. Results Data collection was launched in 4 cities in July and August 2021. As of November 2021, 3105 of the target 6100 participants were enrolled, with enrollment expected to end by February/March 2022. Conclusions Tailored methods that combine community-led efforts with innovations in sampling and linkage to care can aid in advancing health research for migrant and displaced populations. Worldwide trends in displacement and migration underscore the value of improved methods for translation to humanitarian and public health programming. International Registered Report Identifier (IRRID) DERR1-10.2196/36026
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Affiliation(s)
- Andrea L Wirtz
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Center for Humanitarian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Kathleen R Page
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Center for Humanitarian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Division of Infectious Diseases, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Megan Stevenson
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | | | | | | | | | | | | | | | | | - James Case
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Avi J Hakim
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Wolfgang Hladik
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Paul B Spiegel
- Center for Humanitarian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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8
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Glaspy S, Cosmaro L, Botsi C, Stamou M, Giannopoulou M, Isari AM, Downey C, Hugh TM, Avramovic G, Lambert JS. Integrating partner notification and contact tracing services across Europe: findings from the Integrate project. BMC Infect Dis 2021; 21:796. [PMID: 34517838 PMCID: PMC8438812 DOI: 10.1186/s12879-021-06445-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 07/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partner notification/contact tracing (PN/CT) is a process whereby people diagnosed with an infectious disease notify their sexual and needle-sharing partners/close contacts and invite them for testing and treatment due to exposure to the disease. PN is a necessary testing and prevention tool supported by the European Centre for Disease Prevention and Control (ECDC) and World Health Organization (WHO). Traditionally, PN efforts have been siloed within disease areas, with separate pathways and systems responsible for specific diseases. The INTEGRATE project sought to improve PN/CT outcomes by sharing knowledge across diseases and countries. METHODS INTEGRATE used two mapping exercises to assess the PN landscape in Europe and identify areas for integration and cross-learnings for Sexually Transmitted Infections (STIs) and Tuberculosis. Mapping exercises were surveys to 29 consortium partners and in-depth qualitative interviews at four selected pilot sites: Ireland, Greece, Romania and Italy. RESULTS Areas for the improvement of PN/CT emerged: lack of resources and insufficient staff training, different modes of disease transmission, country-specific laws and regulations, the advent of General Data Protection Regulation (GDPR), differences in healthcare system pathways, historical concerns, and cultural differences. Activities highlighted key areas PN/CT outcomes could be improved, including PN/CT specific trainings for staff, improving knowledge on laws, regulations, guidelines and pathways and creating a country/region specific Standard Operating Procedures (SOPs) for PN/CT, incorporating information on all four disease areas. Findings were analyzed and three key areas were identified and implemented for knowledge transfer namely the creation of an online repository of European country guidelines, the transfer of SOPs and PN training in pilot sites. CONCLUSION A major finding of the project was challenges associated with incorporating Tuberculosis (TB) contact tracing alongside other infectious diseases. Professionals in the field, emphasized that integrating TB contact tracing with the other disease areas would be challenging and arguably unjustified, due to the different ways of transmission of TB and because well-established historical pathways for TB in public health systems already exist. However, the success of TB services presents an ideal model to draw from when strengthening PN systems for other infectious diseases.
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Affiliation(s)
- Shannon Glaspy
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Lella Cosmaro
- Fondazione LILA Milano, Italian League for Fighting AIDS, Milan, Italy
| | - Chryssoula Botsi
- National Public Health Organization (NPHO)/EODY, Marousi, Greece.,Unit of Infectious Diseases Andreas Syggros Hospital, Athens, Greece
| | - Maria Stamou
- National Public Health Organization (NPHO)/EODY, Marousi, Greece
| | | | | | - Cheyenne Downey
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Tina Mc Hugh
- School of Medicine, University College Dublin, Dublin, Ireland.,Infectious Diseases Department, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Gordana Avramovic
- School of Medicine, University College Dublin, Dublin, Ireland.,Fondazione LILA Milano, Italian League for Fighting AIDS, Milan, Italy
| | - John S Lambert
- School of Medicine, University College Dublin, Dublin, Ireland. .,Infectious Diseases Department, Mater Misericordiae University Hospital, Dublin, Ireland.
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9
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Godongwana M, Chewparsad J, Lebina L, Golub J, Martinson N, Jarrett BA. Ethical Implications of eHealth Tools for Delivering STI/HIV Laboratory Results and Partner Notifications. Curr HIV/AIDS Rep 2021; 18:237-246. [PMID: 33772406 PMCID: PMC8057984 DOI: 10.1007/s11904-021-00549-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 11/28/2022]
Abstract
Purpose of Review eHealth tools are increasingly utilized for communication with patients. Although efficacious and cost-effective, these tools face several barriers that challenge their ethical use in sexual health. We reviewed literature from the past decade to pick illustrative studies of eHealth tools that deliver results of laboratory tests for sexually transmitted infections, including the human immunodeficiency virus, as well as partner notifications. We describe ethical implications for such technologies. Recent Findings Our review found that despite widespread research on the use of eHealth tools in delivering laboratory results and partner notifications, these studies rarely measured or reported on the ethical implications. Such implications can be organized according to the four major principles in bioethics: beneficence, patient autonomy, non-maleficence, and justice. The beneficence of eHealth typically measures efficacy in comparison to existing standards of care. Patient autonomy includes the ability to opt in or out of eHealth tools, right-based principles of consent, and sovereignty over healthcare data. To adhere to the principle of non-maleficence, relevant harms must be identified and measured—such as unintentional disclosure of illness, sexual orientation, or sexual activity. Justice must also be considered to accommodate all users equally, irrespective of their literacy level, with easy-to-use platforms that provide clear messages. Summary Based on case studies from this review, we developed a list of recommendations for the ethical development and evaluation of eHealth platforms to deliver STI/HIV results to patients and notifications to partners.
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Affiliation(s)
- Motlatso Godongwana
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. .,Programme in Demography and Population Studies, University of the Witwatersrand, Schools of Public Health and Social Sciences, Johannesburg, South Africa.
| | - Juanita Chewparsad
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Limakatso Lebina
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jonathan Golub
- Center for TB Research, Johns Hopkins University, Baltimore, MD, USA
| | - Neil Martinson
- Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Brooke A Jarrett
- Programme in Demography and Population Studies, University of the Witwatersrand, Schools of Public Health and Social Sciences, Johannesburg, South Africa.,Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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10
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Wirawan GBS, Januraga PP, Mahendra IGAA, Harjana NPA, Mahatmi T, Luhukay L, Rewari BB, Johnson C, Katz DA. Perspectives on voluntary assisted partner notification among providers, people with HIV and the general population in Indonesia: a formative qualitative study. BMC Public Health 2021; 21:254. [PMID: 33516201 PMCID: PMC7847236 DOI: 10.1186/s12889-021-10332-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 01/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Voluntary assisted partner notification (aPN) services are effective in increasing access to and uptake of HIV testing among partners of people with HIV. Following recommendations by the World Health Organization in 2016, Indonesia evaluated various approaches to aPN. We present the lessons learned from formative operational research undertaken to understand provider and patient perspectives on aPN from three demonstration sites in cities with a high HIV burden. METHODS We conducted a formative qualitative study in three cities: Jakarta, Semarang, and Denpasar between September and October 2019. We conducted six focus group discussions (FGDs) (n = 44 participants) among health-care providers, people living with HIV and the general population. We explored participant preferences and concerns about how aPN should be delivered, including the methods of and messaging for contacting partners. All FGDs were conducted in the Indonesian language. Qualitative data were analysed using thematic analysis. RESULTS aPN was acceptable across different participant populations, although with caveats. Some differences were observed between the general population, providers and people living with HIV. People living with HIV were mainly concerned with confidentiality of the procedure and preferred the use of telecommunication and messages that avoid explicit mention of HIV exposure. Providers preferred similar approaches but for different reasons, being concerned mainly with self-efficacy and security. There was consensus regarding dual referral models. The use of phone calls and short messages were preferred as these are perceived to minimize negative reactions and stigma, protect client confidentiality and are suitable in the current legal situation. The general population was mainly concerned with effectiveness and prefer direct provider-led approaches, such as preferring in-person meeting with explicit notification of potential HIV exposure. CONCLUSIONS We found consensus among stakeholders on acceptance of aPN, especially dual referral methods. Development and implementation of aPN protocols should also consider clients' individual situations and concerns regarding safeguarding of confidentiality, and offer a range of options to accommodate all stakeholders involved.
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Affiliation(s)
- Gede Benny Setia Wirawan
- Center for Public Health Innovation, Faculty of Medicine, Udayana University, Bali, Denpasar, Indonesia
| | - Pande Putu Januraga
- Center for Public Health Innovation, Faculty of Medicine, Udayana University, Bali, Denpasar, Indonesia.
| | | | - Ngakan Putu Anom Harjana
- Center for Public Health Innovation, Faculty of Medicine, Udayana University, Bali, Denpasar, Indonesia
| | - Tiara Mahatmi
- World Health Organization Indonesia, Jakarta, Indonesia
| | | | | | - Cheryl Johnson
- Global HIV, Hepatitis and STI Programme, World Health Organization, Geneva, Switzerland
| | - David A Katz
- Department of Global Health, University of Washington, Seattle, USA
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11
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Parmley LE, Rosen JG, Nuh O, Venegas M, Sunday A, İ Nergiz A, Thiim A. Nothing about us without us: considerations for ensuring rights-affirming index case testing for young people. J Int AIDS Soc 2020; 23:e25595. [PMID: 32779384 PMCID: PMC7417867 DOI: 10.1002/jia2.25595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/07/2020] [Accepted: 07/15/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Joseph G Rosen
- Department of International HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
| | - Oğuzhan Nuh
- Social PolicyGender Identity, and Sexual Orientation Studies AssociationIstanbulTurkey
| | - Manuel Venegas
- defeatHIV Community Advisory BoardFred Hutch Cancer Research CenterSeattleWAUSA
| | - Aaron Sunday
- African Network of Adolescents and Young Persons Development (ANAYD)KadunaKaduna StateNigeria
- Association of Positive Youth Living with HIV in Nigeria (APYIN)AbujaNigeria
| | - Ali İ Nergiz
- Cerrahpasa Medical SchoolIstanbul University‐CerrahpasaIstanbulTurkey
| | - Aron Thiim
- Program RISEJustice Resource InstituteFraminghamMAUSA
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12
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Culbert GJ, Waluyo A, Earnshaw VA. Exploring the acceptability of HIV partner notification in prisons: Findings from a survey of incarcerated people living with HIV in Indonesia. PLoS One 2020; 15:e0234697. [PMID: 32603363 PMCID: PMC7326233 DOI: 10.1371/journal.pone.0234697] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 06/01/2020] [Indexed: 01/28/2023] Open
Abstract
Assisted HIV partner notification services provide a safe and effective way for people living with HIV (PLHIV) to inform their partners about the possibility of exposure and to offer them testing, treatment, and support. This study examined whether or not PLHIV in prison might be willing to participate in assisted HIV partner notification services and their reasons for and against disclosing their HIV-positive status to their partners. PLHIV (n = 150) recruited from Jakarta's two largest all-male prisons completed an interviewer-administered questionnaire collecting demographic and risk behavior data, and attitudes toward HIV disclosure and partner services. Among those who were sexually active and/or injecting drugs before incarceration, two-thirds (66.4%, 91/137) endorsed provider referral as an acceptable way to notify their sex partners, and nearly three quarters (72.4%, 89/123) endorsed provider referral to notify their drug-injecting partners. Only a quarter (25.1%) of participants reported that their main sex partner had ever received an HIV test. Participants with anticipated stigma were less likely to endorse provider referral for sex partners (adjusted odds ratio [aOR] = 0.58, 95% CI: 0.35, 0.96) and drug-injecting partners (aOR = 0.54, 95% CI: 0.29, 1.00). Relationship closeness was associated with higher odds of endorsing provider referral for drug-injecting partners (aOR = 2.08, 95% CI: 1.25, 3.45). Protecting partners from infection and a moral duty to inform were main reasons to disclose, while stigma and privacy concerns were main reasons not to disclose. Most incarcerated PLHIV have at-risk partners in the community who they would be willing to notify if provided with assistance. Assisted partner notification for prison populations offers a promising public health approach to accelerate diagnosis, treatment, and prevention of HIV infection in the community, particularly among women.
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Affiliation(s)
- Gabriel J. Culbert
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, United States of America
- Center for HIV/AIDS Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- * E-mail:
| | - Agung Waluyo
- Center for HIV/AIDS Nursing Research, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
| | - Valerie A. Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE, United States of America
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13
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Katz DA, Wong VJ, Medley AM, Johnson CC, Cherutich PK, Green KE, Huong P, Baggaley RC. The power of partners: positively engaging networks of people with HIV in testing, treatment and prevention. J Int AIDS Soc 2019; 22 Suppl 3:e25314. [PMID: 31321909 PMCID: PMC6639670 DOI: 10.1002/jia2.25314] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 05/15/2019] [Indexed: 01/09/2023] Open
Affiliation(s)
- David A Katz
- Department of Global HealthUniversity of WashingtonSeattleWAUSA
| | - Vincent J Wong
- Global Health BureauOffice of HIV/AIDSUnited States Agency for International Development (USAID)WashingtonDCUSA
| | - Amy M Medley
- Division of Global HIV and TBCenter for Global HealthU.S. Centers for Disease Control and Prevention (CDC)AtlantaGAUSA
| | | | - Peter K Cherutich
- National AIDS/Sexually Transmitted Diseases Control ProgrammeMinistry of HealthNairobiKenya
| | | | - Phan Huong
- Vietnam Authority of HIV/AIDS Control, Ministry of HealthHanoiVietnam
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