HIV testing uptake and yield among sexual contacts of HIV-positive men who have sex with men in Zhejiang Province, China, 2014-2016: a cross-sectional pilot study of a choice-based partner tracing and testing package
Abstract Background Measures to effectively expand tracing and testing to identify undiagnosed HIV infections are significant for the control of HIV/AIDS epidemic among men who have sex with men (MSM). We piloted a combination tracing and testing package aimed at improving contact tracing and uptake and yield of HIV testing for sexual contacts of newly diagnosed HIV positive MSM. We describe the package components and outcomes. Methods The choice-based tracing and testing package was piloted in Hangzhou and Ningbo cities, June 2014 to June 2016. The package adopted four modes, including couples HIV counselling and testing (CHCT), information-driven assisted partner notification (IDAPN), peer-assisted HIV self-testing (HIVST), and patient referral. If sexual contacts tested positive, they were invited to enroll in the pilot. Contact tracing continued through selected modes until inability to contact, refusal to test, or positive test results exhausted all contacts. Socio-demographic factors, sexual behaviors between HIV-positive MSM and their sexual contacts were collected, as well as tracing and testing outcomes of each mode. Results Among 2,495 newly diagnosed HIV-positive MSM, 446(18%) were enrolled as index cases (ICs) through two rounds of contact tracing. The ICs disclosed a total of 4,716 sexual contacts, of whom 548 (12%) were reachable. The pilot resulted in a testing uptake of 87%(478/548) and a yield of 16% (74/478) among sexual contacts. Logistic regression analysis showed that the odds of a reachable sexual contact enrolled in information-driven mode taking an HIV test were 90% more than that of one enrolled in patient referral (95%CI:0.8, 4.4). Conclusions Choice-based tracing and testing package is feasible in expanding HIV-testing uptake among sexual contacts of HIV-positive MSM and are feasible for case-finding among a high-risk population. IDAPN may be an acceptable option to reach sexual contacts for whom limited contact information is available.