New partner notification guidelines were introduced in Edmonton in April 2010. Before 2010, no systematic process for partner notification existed. Since 2010, a dedicated partner notification nurse has provided partner notification services to all people newly diagnosed with HIV. Alberta Health Services evaluated the impact of the new guidelines using data from chart reviews and local databases between April 2010 and December 2013.1
During the study period, a total of 346 people were diagnosed with HIV (index clients). Of the 346 people diagnosed with HIV, 70% (243) provided information on partners who may have been exposed to the virus. A total of 642 partners were reported to public health staff; 77% (495) lived in the Edmonton region. Of the partners that lived in the Edmonton area, 18% (91) were already known to be HIV positive. Of the remaining partners (those that lived in Edmonton and were not known to be HIV positive), 86% (346) were located by a public health nurse and 88% (305) of them were tested.
Seven percent (20) of all located partners were newly diagnosed with HIV. Data suggests that finding new HIV infections was more likely among high prevalence populations such as gay men and other men who have sex with men (MSM) and people who use injection drugs. The number of index clients needed to be interviewed to find one new HIV-positive person was about 10 for MSM and about 12 for people who use drugs, but 144 for heterosexual index clients.
The new partner notification process also found people living with HIV who were not adequately engaged in care. Of the 91 contacts already known to be living with HIV, 45% were not on treatment at all, and more than 40% of those who were on treatment did not have a suppressed viral load. The study did not mention whether efforts were made to help people engage in care.
Although partner notification services are mandated in all provinces and territories, varying models exist across the country to deliver these services. Both the sexual and drug-using partners of people recently diagnosed with HIV are at high risk for HIV infection and should be offered HIV testing and counselling at the earliest opportunity. In Edmonton, a partner notification process using a dedicated partner notification nurse was effective at finding people who didn't know they were living with HIV, and at identifying people living with HIV in the community who were not adequately engaged in care.
Logan Broeckaert holds a Master's degree in History and is currently a researcher/writer at CATIE. Before joining CATIE, Logan worked on provincial and national research and knowledge exchange projects for the Canadian AIDS Society and the Ontario Public Health Association.
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