HIV Partner Notification Across Different Sexual Partner Types Among Men Who Have Sex with Men in Guangzhou, China.

HIV partner notification (PN), defined as a voluntary process wherein trained providers ask people diagnosed with HIV about their sexual partners or drug-injecting partners, and with consent of the HIV-positive client, offers these partners HIV testing service. Strategies of HIV PN, including provider-initiated, patient-initiated, and contractedreferral HIV PN, have been recommended for use in diverse settings. The benefits of HIV PN have been well documented. Studies have demonstrated that HIV PN can increase case identification, improve linkage to care, and prevent onward HIV transmission. However, HIV PN for people diagnosed with HIV has not been routinely implemented in lowand middle-income countries (LMICs). Data on HIV PN from LMICs are limited, especially for HIV-infected men who have sex with men (MSM). MSM can have both regular and casual male partners, as well as female partners. A few studies on the uptake of HIV PN among MSM suggest that HIV PN for regular partners may be significantly higher than that for casual partners. Yet, studies on HIV PN seldom compare PN across sexual partner types, and factors influencing HIV PN in different partner types remain unknown. The main HIV PN strategy used in China is patient initiated, in which responsibility of PN falls mainly on the index cases. We conducted a cross-sectional survey among HIV-infected MSM attending HIV care clinics in Guangzhou, China who had sex partner(s) in the past 6 months. The aims were to assess the uptake of HIV PN and to examine factors associated with HIV PN in different sexual partner types among HIV-infected MSM in Guangzhou, China. Ethics approval was obtained from the ethics review board of the Guangzhou Center for Disease Control and Prevention. In this study, HIV PN was defined as report by index patient of notifying his male partner(s) (either regular or casual partner) about risk of exposure to HIV infection and offering HIV testing, regardless of the partner’s testing decision. The overall HIV PN rate was defined as the index patient notified at least one of his partner(s) (either regular or casual partner). We differentiated the HIV PN rate with respect to regular partner and casual partner. HIV PN to a regular partner was defined as the index patient notified his regular partner(s). HIV PN to a casual partner was defined as the index patient notified at least one of his casual partner(s). Descriptive statistics were used to describe demographic and behavioral characteristics with respect to different types of sexual partners. Univariate and multivariable logistic regression were used to examine the correlation between the successful notification rates (among regular partner and casual partner) and the following factors: demographics, sexual behaviors, the perception of social discrimination against HIV/AIDS, and the awareness of the HIV PN strategy. Statistical analysis was performed by using SAS 9.3. All hypothesis tests were two-tailed with a = 0.05. –In this study, 340 men were recruited. We excluded 87 men who had no sex partners and 69 men who had known their HIV infection status for less than 6 months, leaving 184 participants for analysis. The median age of the participants was 29 (interquartile range: 25–32). Among them, 82.1% (151/184) of the participants had a regular partner, 60.3% (111/184) had a casual partner, and 42.4% (78/184) had both regular and casual male sexual partners in the recent 6 months. The overall HIV PN rate was 63.6% (117/184). HIV PN rate to a regular partner was 66.2% (100/151), of which, 20.0% (20/100) of the index patients reported their relationship with a regular partner became worse after the notification, and 14.0% (14/100) reported that the relationship ended after the notification. HIV PN rate to a casual partner was 41.4% (46/111), of which, 39.1% (18/46) had notified all of their casual partners. The top three reasons for failing HIV PN to a regular partner were ‘‘felt pressure and not knowing how to tell’’