Assisted Partner Notification Success Story: Kawempe Home Care, Kampala, Uganda

By Faridah Akuju September 28, 2018

Coauthered by Sarah Komugisha, Kawempe Home Care and Faridah Akuju, NASTAD

Utilizing new methods to link individuals to HIV prevention, care, and treatment services is imperative to end the HIV epidemic. Assisted Partner Notification (APN) is one of those methods. APN is an innovative service where PLWH are interviewed to elicit information about their partners. They are then offered the opportunity to have a trained disease intervention specialist (DIS) confidentially notify their partners of their potential exposure and offer them HIV testing and referrals to HIV prevention and treatment services. 

In October 2017, APN was introduced at the Kawempe Home Care facility in Kampala, Uganda, as a strategy to enhance identification of people living with HIV. The Infectious Diseases Institute (IDI) trained Kawempe health workers in APN in January 2018. Initially, only 43% of partners notified through APN received an HIV test, resulting in a yield of 22%. The reasons for this low proportion included: 

  • only counselors implemented APN;
  • some clients who were notified did not have time to go or were not interested in going to the facility for HIV testing; and 
  • when clients did go to the facility, there were long waiting times at the laboratory, which caused some clients to leave.

With these stats and proportions in mind, the Kawempe team applied a new approach to increase the proportion of partners who were notified and received HIV testing, which included the following interventions:

  • involvement of community volunteers who conducted HIV testing in the community for partners who could not come to the facility;
  • involvement of clinicians in partner elicitation among clients with STIs and community volunteers eliciting partners during community outreach events;
  • during phone notification, the counselors assured partners that they would be given priority and seen first if they came for HIV testing at the facility;
  • to reduce wait time, counselors gave HIV testing to partners who came to the facility;
  • strengthened the APN committee by including all representatives implementing APN, such as medical managers, monitoring and evaluation focal person, clinicians, community managers, all counselors, key populations focal person, and APN focal person;
  • APN team held bi-weekly meetings that reviewed weekly APN data and provided feedback to the APN providers, including the community team; and
  • facility leadership regularly motivated the community volunteers through recognition and provision of incentives for good performance.

A community volunteer conducting the HIV Testing Service from the garage where the partner works

Through this process, the Kawempe Home Care team learned many valuable lessons, such as:

  • a community approach to APN increases the likelihood of reaching partners who fail to come to the health facility for HIV testing;
  • good coordination and teamwork among the health care providers is a key to the success of the APN program; and
  • monitoring progress through performance reviews helps to identify areas for improvement, which the team can then address through continuous quality improvement.

The Kawempe Home Care staff, the APN committee, IDI, and the NASTAD team worked very hard to achieve success and their efforts are greatly appreciated.

Results: The proportion of partners who were notified and received an HIV test increased from 43% in January 2018 to 78% in June 2018. The yield of newly identified HIV positives among partners tested also improved from 22% in January 2018 to 43% in June 2018.