Records of 183 index clients in the period between January 2017 to August 2018 reviewed. Mean age for the index clients was 39 [SD ± 13.1] and most were female 118 [65%]. Table 1 below shows socio-demographic characteristics for the 183 index clients and 216 sexual partners elicited. Most of the index clients 100 [55%] reported to be married monogamous, 41 [22%] were single, while only four [2%] were in polygamous marriage.
Youth and teenagers aged 24 years and below were 13% [23] among the index clients and 15% [31] among the sexual partners elicited.
Table 1
Socio-demographic characteristics of index clients and sexual partners
| Index Clients [N = 183] | Sexual Partners [N = 216] |
| | Frequency | Percent | Frequency | Percent |
Sex | Male | 65 | 36% | 119 | 55% |
Female | 118 | 64% | 97 | 45% |
Age Category in Years | ≤ 24 | 23 | 13% | 31 | 15% |
25–34 | 62 | 34% | 85 | 39% |
35–45 | 48 | 25% | 55 | 25% |
46+ | 52 | 28% | 45 | 21% |
Occupation | Formal Employment | 16 | 9% | 5 | 2% |
Informal Employment | 45 | 25% | 64 | 30% |
Not employed | 26 | 14% | 25 | 12% |
Self employed | 96 | 52% | 122 | 56% |
Marital Status | Divorced/Separated | 28 | 15% | No data* | No data* |
| Married monogamous | 100 | 55% |
| Married polygamous | 4 | 2% |
| Single | 41 | 22% |
| Windowed | 10 | 6% |
* The PNS registers did not capture the marital status of the sexual partners |
PNS Acceptance
Overall, 162 [89%] index clients accepted PNS as shown in Fig. 2 below. Acceptance rate was higher among male index clients [92%] than in female [86%]. The rate of acceptance per health facility slightly varied with Ngelelya dispensary having a 100% acceptance rate and the lowest was Ithanga health centre, 81% as shown in Fig. 1 below. Of the 21 index clients who did not accept PNS, most were female 16 [76%]. Acceptance rate was highest among index clients aged 25-34yrs [56,93%] with the lowest being among index clients aged 35-45yrs [43,83%].
Among the index clients, 21 [27%] elicited two or more sexual partners and 27 of them were secondary index clients. {Secondary Index client is one who had been listed by another index client}.
PNS Approach And Relationship Status
The most preferred approach of contacting and tracing the sexual partners was Provider referral [92, 50%], and the least preferred was Dual referral [7, 4%] as shown in Fig. 3 below. Only 50% of SPs followed through dual referral approach were successfully reached and tested followed by provider referral approach where 84% were successfully reached and tested. Contract referral approach recorded the highest success rate in reaching SPs where 97% were successfully reached and tested.
Majority of index clients reported they were not currently living with their listed sexual partners [154, 57%]. While only 15% [34] of sexual partners had their HIV status known by their index clients, for most of the sexual partners [182, 85%] HIV status was unknown to the index clients.
Elicitation Of Sexual Partners
Among male index client 25[42%] listed two or more sexual partners which is higher than that of female index clients where only 25[25%] listed two or more sexual partners as shown in Table 2 below. For index clients aged below 25 years 9[43%] elicited 2 or more sexual partners while among index clients with formal employment 56% elicited 2 or more sexual partners.
Table 2
Table showing demographics of index clients by number of partners elicited
| | Index clients who elicited one or Zero Sexual partner | Index clients who elicited 2 or more Sexual partners | |
| | No. | Percent | No. | Percent | Total |
Age Category | < 25 | 12 | 57% | 9 | 43% | 21 |
25–35 | 38 | 66% | 20 | 34% | 58 |
36–46 | 22 | 59% | 15 | 41% | 37 |
> 47 | 40 | 87% | 6 | 13% | 46 |
Sex | Female | 77 | 75% | 25 | 25% | 102 |
| Male | 35 | 58% | 25 | 42% | 60 |
| | | | | | |
Marital Status | Divorced/Separated | 17 | 71% | 7 | 29% | 24 |
Married monogamous | 68 | 72% | 27 | 28% | 95 |
Married polygamous | 2 | 50% | 2 | 50% | 4 |
Single | 21 | 64% | 12 | 36% | 33 |
Windowed | 4 | 67% | 2 | 33% | 6 |
Employment Type | Formal Employment | 7 | 44% | 9 | 56% | 16 |
Informal Employment | 27 | 64% | 15 | 36% | 42 |
Not Employed | 15 | 83% | 3 | 17% | 18 |
Self employed | 63 | 73% | 23 | 27% | 86 |
Outcome For Sexual Partner Tracing
For the 172 SPs who attempts to reach them was made by health care providers, 157 [91%] were successfully reached. Of the sexual partners who only one attempt had been done, 99% were reached and the rate reduces with more attempts to reach the sexual partners where only 70% of the sexual partners with three attempts made to reach them were successfully reached. [Table 3 below]
Table 3
Table showing number of sexual partners reached and number of attempts made [n = 172]
Attempts to reach | Sexual partners | Sexual partners |
sexual partners | reached[%] | not reached[%] |
First attempt | 91(53%) | 1(1%) |
Second attempt | 51(30%) | 8(3%) |
Third attempt | 14(8%) | 6(9%) |
Total | 157(91%) | 15(9%) |
Ngelelya dispensary had the highest positivity rate of 59% followed by Ithanga Hc with 49% and the lowest positivity rate was reported in Gatura Hc [10%]. [Table 4 below].
The ratio of sexual partners to index clients varied across the health facilities where Gatura had the highest ratio of 2.10:1. Overall ratio of sexual partners to index clients was 1.33:1 as shown in Table 4 below. Out of 182 sexual partners eligible for HIV testing, 141[77%] were successfully tested with 46 [32.6%] identified as HIV positive.
Table 4
Table showing outcomes of sexual partners tracing and HIV testing per health facility
Health facility | Index clients accepted PNS | Sexual partners elicited | Ratio of partners to index clients | Sexual partners eligible for testing | HIV tested | Positivity rate |
Kirwara | 63 (91%) | 89 | 1.41 | 65 | 44 (68%) | 11 (25%) |
Ithanga | 38 (81%) | 37 | 0.97 | 37 | 37 (100%) | 18 (49%) |
Gatunyu | 31 (86%) | 29 | 0.94 | 21 | 13 (62%) | 4 (31%) |
Gatura | 21 (95%) | 44 | 2.10 | 42 | 30 (71%) | 3 (10%) |
Ngelelya | 9 (100%) | 17 | 1.89 | 17 | 17(100%) | 10(59%) |
Total | 162(89%) | 216 | 1.33 | 182 | 141(77%) | 46(32.6%) |