A systematic review of HIV partner counseling and referral services: client and provider attitudes, preferences, practices, and experiences

HIV seropositive drug users' attitudes towards partner notification (PCRS): results from the SHIELD study in Baltimore, Maryland

OBJECTIVE

To assess the attitudes of HIV seropositive current or former drug users towards HIV partner counseling and referral services (PCRS) and to determine if opinion varies by partner type.

METHODS

We used a cross-sectional survey using structured and semi-structured questions to measure attitudes towards PCRS.

RESULTS

The majority of the sample was African-American (97%), male (63%) and had been diagnosed with HIV for a mean of 7.9 years. Most agreed that PCRS would help stop the spread of HIV and AIDS (87%). A range of reactions to scenarios of their drug and sex partners being informed were observed and included positive reactions (e.g. PCRS as a means to facilitate testing of their partners and early treatment) to negative (e.g. feelings about guilt, shame and concern about partner responses).

CONCLUSION

Data from this study indicate that HIV positive drug users view PCRS as a viable practice for preventing the spread of HIV, though barriers exist to engaging clients to identify partners.

PRACTICE IMPLICATIONS

The range of reactions noted in this study underscore the importance of providing flexible options for PCRS based on partner type. Additional training for counselors, time for case-management and meetings with sex and drug partners and fieldwork for locating contacts are important considerations for providers.

Approaching "HIV elimination": Interventions for acute HIV infection

Recent observations from several groups suggest that individuals with acute (antibody negative) HIV infections (AHI) may present for "routine" HIV testing in unanticipated numbers. Most of these papers have highlighted the use of group testing strategies to screen antibody negative testing sera for HIV RNA using nucleic acid amplification tests. At the same time, accumulating evidence indicates that AHI is a time of briefly, but substantially elevated risk for transmission of HIV. In this paper, we review these new data with attention to their implications for HIV prevention strategies. By calling attention to a subset of patients that are both recently infected and at transiently very high risk of transmitting their new infection to partners, AHI detection makes it possible to use traditional, network notification-based public health strategies effectively in the fight against HIV.