1. Tanzanian Men More Successful Than Women in Referring Sexual Partners to HIV Testing via Partner Notification
Kelly Curran1,2, Marya Plotkin1, Catherine Kahabuka3, Alice Christensen1, Renatus Kisendi4, Werner Maokola4, Myra Betron1, Kristina Grabbe1, Mary Drake1, Erick Mlanga5, and Vincent Wong5
1Jhpiego; 2Johns Hopkins Bloomberg School of Public Health; 3CSK Research Solutions; 4National AIDS Control Programme; 5United States Agency for International Development
This presentation is made possible by the generous support of the American people through the United States President's Emergency Plan for AIDS Relief (PEPFAR) and the United States Agency for International Development (USAID), under the terms of the Technologies for Health AID-OAA-A The contents are the responsibility of the authors and do not necessarily reflect the views of PEPFAR, USAID, or the United States Government.

2. Of 653 newly diagnosed persons, 390 (60%) enrolled
Cross-sectional study evaluating effectiveness and feasibility of PNS at 3 facilities among newly diagnosed men and women from VCT and PITC
Of 653 newly diagnosed persons, 390 (60%) enrolled
438 sexual partners listed (average 1.1 partners/index client)
249 (56.8%) partners referred to facility
239 (96%) tested for HIV
148 (61.8%) tested HIV-positive (all newly diagnosed)
104 (70.3%) newly diagnosed were enrolled in HIV care and treatment
Initial selection for notification approaches 402 (91.6%) passive referral
In all but 3 cases, index client initial selection was successful
Initial selection for notification approaches 402 (91.6%) passive referral
Passive referral for 402 (91.6%) partners
Contract referral for 2 (0.5%) partners
Provider referral for 14 (3.2%) partners
In all but 3 cases, index client initial selection was successful
2 cases client chose provider referral but then brought partner on their own
1 case client chose passive referral but then requested provider assistance

3. Results

4. Results, cont.
Men were 6.2 (2.7–14.1) times more likely than women to list more than one sexual partner (p<0.001).
Men were 2.2 (1.4–3.5) times more likely than women to successfully refer at least one listed sexual partner (p<0.001).
Married clients were 2.5 (2.3–5.8) times more likely to successfully refer at least one listed sexual partner (p<0.001).

5. Qualitative Study Themes
Three main themes emerged:
Barriers/facilitators to testing:
Geographic distance
Absence of symptoms as a barrier to testing
Type of relationship and success in referral
Language used in notifying partner
Index client MTH203/trace/F/39/Married: “I called him, I told him that you are needed here; he asked ‘what for!?’ I told him to come because they have told me that I have anemia. You have to come, for you to get the information by yourself; they need to tell you many things.” Index client MTH-090/no trace/F/28/Single: “Even if I recall them, it won’t be easy for me to give them this information … because others have their own families already. We just met as ‘friends for a day.’ If you met someone just for a day, do you think you can tell him this matter?”

6. Conclusions
As previously reported, partner notification using an index client approach in health facilities in Tanzania is an effective way to reach previously undiagnosed HIV-infected individuals:
55.9% of male partners and 66.4% of female partners of index clients who were successfully referred tested positive
Success at referral to HTS varied by sex and marital status.
Male index clients were 2.2 times more likely to succeed in referring at least one sexual partner
Married index clients were 2.5 times more likely to be successful in referring at least one sexual partner to HTS.
Partner notification programs should conduct formative assessments to understand local gender norms and increase awareness of differences that may exist between male and female index clients’ experience with partner notification.