{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:59:36Z","timestamp":1785326376330,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T00:00:00Z","timestamp":1563494400000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 A1099974"],"award-info":[{"award-number":["R01 A1099974"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Identifying HIV\u2010positive individuals is increasingly recognized as one of the most important and most challenging of the UNAIDS 90\u201090\u201090 goals. Assisted partner notification services (aPNS) involves tracing and offering HIV testing to partners of HIV\u2010positive individuals, and is effective and safe when provided to newly diagnosed HIV\u2010positive patients. Voluntary aPNS is now part of the World Health Organization's guidelines for HIV prevention and care. However, uptake of aPNS is significantly lower among adults with established HIV infection already engaged in care compared to newly diagnosed individuals. We sought to describe barriers encountered and potential opportunities to providing aPNS to established patients living with HIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted focus group discussions and in\u2010depth interviews at Nairobi's largest public HIV clinic in April to May 2016 to elucidate barriers to and opportunities for aPNS among established patients engaged in HIV care. Participants included HIV\u2010positive adults in care, their partners, and healthcare workers (HCWs). Qualitative data analysis took a grounded theory approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Barriers to aPNS fell under three main categories. Fear of disclosure to partners included concerns over relationship repercussions, loss of trust, blame and violence. Stigma and discrimination were described in the healthcare setting, at church and in general society. Participants described difficulties approaching communication, including cultural barriers and differences in education. For almost every barrier a potential solution was also identified, and a barrier\u2010opportunity relationship emerged. Opportunities included using couples testing centres to aid in disclosure, focusing on the ambiguous introduction of the infection, and sensitization of HCWs and community leaders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>aPNS among established HIV patients is associated with different barriers and opportunities than aPNS among newly diagnosed patients, and HCWs should build their capacity to support aPNS in this population. There is a strong need for increased training and sensitization on the use of aPNS in different circumstances and for different clients, taking into consideration factors such as timing of partner notification, characteristics of the relationship and duration of knowledge discordance. The overall success of this intervention among populations living with HIV may rely on customization of services and key messages to meet the patients\u2019 specific needs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25315","type":"journal-article","created":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T07:03:43Z","timestamp":1563519823000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Assisted partner notification services for patients receiving HIV care and treatment in an HIV clinic in Nairobi, Kenya: a qualitative assessment of barriers and opportunities for scale\u2010up"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8843-3462","authenticated-orcid":false,"given":"Aliza","family":"Monroe\u2010Wise","sequence":"first","affiliation":[{"name":"Departments of Global Health and Medicine University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Maingi Mutiti","sequence":"additional","affiliation":[{"name":"Kenyatta National Hospital Voluntary Counseling and Testing Centre Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harun","family":"Kimani","sequence":"additional","affiliation":[{"name":"Department of Community Health Kenyatta University Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hellen","family":"Moraa","sequence":"additional","affiliation":[{"name":"Kenyatta National Hospital Voluntary Counseling and Testing Centre Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E","family":"Bukusi","sequence":"additional","affiliation":[{"name":"Kenyatta National Hospital Voluntary Counseling and Testing Centre Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carey","family":"Farquhar","sequence":"additional","affiliation":[{"name":"Departments of Global Health and Medicine University of Washington Seattle WA USA"},{"name":"Department of Epidemiology University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,19]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"UNAIDS.90\u201090\u201090: an ambitious treatment target to help end the AIDS epidemic[Internet].2014[cited 2018 Mar 7]. Available from:http:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/90-90-90_en.pdf"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2015-000010"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0186316"},{"key":"e_1_2_10_5_1","unstructured":"UN Joint Programme on HIV\/AIDS (UNAIDS) Knowledge is power \u2010\u2010 Know your status know your viral load 2018"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001555"},{"key":"e_1_2_10_7_1","unstructured":"Kenya AIDS and STI Control Programme.Kenya AIDS indicator survey 2012[Internet].2014[cited 2018 Mar 8]. Available from:http:\/\/nacc.or.ke\/wp-content\/uploads\/2015\/10\/KAIS-2012.pdf"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(16)30214-4"},{"key":"e_1_2_10_9_1","unstructured":"National AIDS Control Council.Kenya AIDS response progress report 2016[Internet].2016[cited 2018 Mar 8]. Available from:http:\/\/nacc.or.ke\/wp-content\/uploads\/2016\/11\/Kenya-AIDS-Progress-Report_web.pdf"},{"key":"e_1_2_10_10_1","volume-title":"Guidelines on HIV self\u2010testing and partner notification: supplement to consolidated guidelines on HIV testing services","author":"World Health Organization","year":"2016"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199201093260205"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000529"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e318202bf7d"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-011-0094-9"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1750-5"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000032"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315616624"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckp231"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2006.096263"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-014-0729-8"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2007.01923.x"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-13-198"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2016.0151"},{"key":"e_1_2_10_24_1","volume-title":"Constructing grounded theory","author":"Charmaz K","year":"2014"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001638"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1936-x"},{"issue":"4","key":"e_1_2_10_27_1","doi-asserted-by":"crossref","first-page":"140","DOI":"10.4314\/mmj.v27i4.5","article-title":"Maximizing HIV partner notification opportunities for index patients and their sexual partners in Malawi","volume":"27","author":"Kamanga G","year":"2015","journal-title":"Malawi Med J"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-2890-7"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjia2.25315","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25315","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jia2.25315","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25315","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T15:08:49Z","timestamp":1694272129000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.25315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":27,"journal-issue":{"issue":"S3","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1002\/jia2.25315"],"URL":"https:\/\/doi.org\/10.1002\/jia2.25315","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7]]},"assertion":[{"value":"2018-10-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e25315"}}