Between 2018 and 2020, Kenya housed 31 health care clinics across the country which provided HIV Assisted Partner Services (APS), according to the Lancet Global Health. HIV Assisted Partner Services (APS) is a trial facility available to females who have tested positive for HIV and their male partners. Through the APS Program, these women termed “index clients,” and their male partners, underwent routine HIV testing via various referral processes.

The program ensured the follow-up of index clients and their partners through on year with a 90% participation rate. The follow-up and eagerness of the candidates led to an increase in HIV care procedures as well as the suppression of viral HIV.

APS Methodology

Before commencing the trial, health care staff in the clinics got training on the subject, which was essential for the smooth flow of the trial. The focus of the trial was to “assess the impact of APS in reaching male individuals in sub-Saharan Africa, who have lower rates of HIV testing than female individuals.”

Women aged 18 and above as well as emancipated minors who tested positive for HIV in sub-Saharan Africa were eligible for HIV Assisted Partner Services. Females who participated in the trials consented to give the contact information of all their male sexual partners in the past three years and the staff informed those partners about their potential exposure to HIV. The staff offered the partners to choose between community-based or facility-based HIV testing. The former includes testing at home, at select venues, or as a part of a workplace campaign whereas the latter meant that all testing would be done at medical facilities.

All the candidates for the trial went through testing periodically at six weeks, six months and then 12 months after enrollment. It evaluated the success of the antiretroviral treatment that had been provided.

The Outcome of the Trial

Having a very high participation rate of 1,724 female candidates out of a total of 1,910 opting to take part, the trial was an enormous success. This targeted HIV Assisted Partner Service Methodology was twice as successful as any other randomized trial in Kenya. The trial found that 95% of all HIV-affected male candidates were virally suppressed — due to the positive effects of the medication. In addition, their viral load of HIV was so low that tests could not detect it.

Reported Success

• Due to this trial, APS has been identified as a viable and efficient method by which people unaware of their HIV status can be tested and treated appropriately. Within a set of approximately three females diagnosed with HIV, at least one of their male partners tested positive for HIV as well.

• Another reason that the trial was successful was that it did not rely on a client-driven approach and instead of asking the female clients to contact their sexual partners. Skilled staff contacted the potential candidates and inform them of the situation.

• This process avoided much hesitation and shame on the end of the female index clients. Also, it guaranteed that all the potential male candidates got the information about the potentially life-threatening situation that they were in.

• The anonymity of the entire operation was the key to its substantial success. The staff did not inform potential male candidates about the female index client the clinic staff was calling on behalf of. This led to fewer issues and altercations between the female index clients and the potential male candidates that took part in HIV Assisted Partner Services.

After the success of this trial, “APS has been fully integrated into the national HTS procurement and logistics systems,” according to the PLOS Global Public Health Journal. The HIV Assisted Partner Services has been noted to be a sustainable program to detect HIV on a larger scale and medical clinics that run the program have been set to receive a routine supply of HIV test kits and gloves. As a result, it helps further reduce the burden of HIV in Kenya and other countries in sub-Saharan Africa.

– Vahisté Sinor
Photo: Flickr