Characteristics of Male Partners Accessing Assisted Partner Services in Western Kenya

Abstract

APS involves notifying and testing sexual or drug injecting partners of people living with HIV (PLHIV) also known as index participants. Using data from an implementation science study in Western Kenya, we aim to analyze the characteristics in HIV exposed male partners named by female index participants to assess characteristics associated with male partner APS uptake and HIV testing. We analyzed data from HIV positive female indexes and their male partners from 31 facilities in Western Kenya from May 2018 to March 2020. We compared socio-demographic characteristics by APS enrollment (enrolled vs not enrolled) as well as HIV status (newly HIV positive, known HIV positive, HIV negative). We used multivariate binomial regressions to assess associations between characteristics and enrollment and HIV status. 1,724 female index clients enrolled and 5,141 male partners were elicited. Of these, 4,422 (86%) male partners enrolled into the study. APS uptake did not vary by age, marital status, education, income and county for female indexes whose male partners refused APS. Further, age, relationship status and occupation were statistically significantly associated in male partners who refused. Of the enrolled male partners, 1,291 (29.3%) were known HIV positive, 2,590 (58.8%) HIV negative and 524 (11.9%) were newly HIV positive. Male partners who newly tested positive for HIV were more likely to have four or more sexual partners (aRR 1.7, 95% CI 0.0-66.5). All other characteristics were not associated with male partners newly testing positive for HIV. APS has high acceptability among male partners regardless of age, relationship status and occupation. 91.8% of newly HIV positive and 98.7% of known HIV positive male partners initiated ART. Findings from this study suggest that APS scale-up can aid in reaching the ambitious UNAIDS 95-95-95 goal in terms of testing and HIV care cascade in sub-Saharan Africa.