Factors Associated with Uptake of Hiv Index Testing Among Plhiv and Their Sexual Partners in Tanga Region, Tanzania. A Cross-Sectional Study

Factors Associated with Uptake of Hiv Index Testing Among Plhiv and Their Sexual Partners in Tanga Region, Tanzania. 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A Cross-Sectional Study Faraja Daniel Gabriel, Andrew Kigombola, Selemani Msangi, Brown Mwakibambo, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7180477/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background Identifying people living with HIV (PLHIV) is recognized as an important and challenging goal of the UNAIDS 95-95-95. 87% of PLHIV worldwide and 83% in Tanzania are unaware of their HIV status. HIV index testing (also called partner notification services) involves elicitation of sexual partners and biological children, tracing and offering an HIV test, and linkage to care. Index testing has been proven to be a safe and effective intervention in Sub-Saharan Africa. We sought to determine factors affecting the uptake of HIV testing among sexual partners through the index client modality among adults in Tanga Region Methodology A quantitative cross-sectional study was carried out across 8 high-volume CTCs in Tanga region. We recruited 435 participants enrolled in CTC from January 2018 to August 2020 using convenient sampling, we also purposefully selected 70 health providers. Data was collected using questionnaires and analysed descriptively using SPSS. Results Of the 435 participants, 55.6% were aged 26-35 years, 66% were female, 59.3% were farmers or petty traders, and 80.9% were on ART for one year or more. About 74% listed at least one sexual partner with an elicitation ratio of 1:1.3.159 out of 287 contacts with unknown HIV status were reached and tested (55.4%), 54 were HIV+ (34%). Having multiple sexual partners (aOR = 23.04) and non-disclosure (aOR = 2.22) were significantly associated with increased odds of listing sexual partners. Leading challenges in contact tracing include a wrong address (20%), unreachable phone numbers (19%), long distances from facilities (7%), and clients’ travel (16%). Conclusion Index testing is an acceptable and effective intervention to reach previously PLHIV. Support and scale-up of this intervention to all facilities offering HIV testing and care services is warranted. Addressing identified challenges will further improve the intervention’s effectiveness. HIV Testing Sexual Partners Index testing partner notification services PLHIV Figures Figure 1 Introduction UNAIDS reported 39.9 million people living with HIV in 2024, and the majority are in Sub-Saharan Africa (SSA). While progress has been made in reducing new HIV infections, nonetheless, 1.3 million people acquired HIV worldwide (1). Similarly, in Tanzania, approximately 1.6 million people are living with HIV (PLHIV). The country has an annual incidence of 0.18%, which translates into 60,000 new HIV cases per year (2). Tanzania has been implementing HIV prevention programmes since the first three cases of HIV were reported in the country in the year 1983(2).The current HIV prevention approach in Tanzania is based on “combination prevention”, a comprehensive approach comprising behavioural, social, and biomedical interventions for the general population and vulnerable groups. In 2014, UNAIDS and partners launched the 90–90–90 targets, which were revised in 2019 to 95-95-95 targets by 2030 . The aim was to diagnose 95% of all HIV-positive persons, provide antiretroviral therapy (ART) for 95% of those diagnosed, and achieve viral suppression for 95% of those treated by 2020 (3). While progress has been made in achieving the second and third 95, the first one is lagging, UNAIDS estimates only 87% of the PLHIV know their status, which translates into 5.3 million people. In Tanzania, a recent survey has shown only 83% of PLHIV are aware of their HIV status(2). This calls for innovative and cost-effective approaches to reach, diagnose, and link PLHIV to care. HIV partner notification (also known as HIV index testing) has proved to be one of the most effective and feasible case identification approaches and one of the best opportunities for HIV treatment and prevention (4). A growing evidence base supports an expansion of partner notification in HIV testing services (HTS) in sub-Saharan Africa. Literature review has shown that index testing is acceptable among PLHIV and has a high positivity rate among sexual partners (5,6). In Tanzania, the index testing modality is being practised across all care and treatment sites, and it is one of the priority strategies narrated in the National Accelerated Action Plan on HIV Testing Services 2019 – 2020 (7). Index testing is also advocated as one of the most effective modalities in both HIV case finding and even disclosure aid among sexual partners (8). Successful index testing is affected by several factors, such as low elicitation rate and risk of intimate partner violence (9,10)A cross-sectional study conducted in 2015 in the Njombe region of Tanzania aimed to evaluate the outcome and experience of partner notification within facility-based HIV testing services (11). The study revealed that stigma, fear of intimate violence, and abandonment were barriers for index testing, especially for women, due to gender roles and social norms (11). In this study, we describe factors affecting the uptake of HIV index testing among PLHIV and their sexual partners in Tanga Region. Methods Study Design This was a cross-sectional study conducted in 2021. Clients living with HIV and attending Care and Treatment facilities (CTC) were interviewed on demographics, acceptance of index testing services, and elicitation of sexual partners. Study Population The primary study population was adult clients (≥ 18 years) living with HIV enrolled in care and treatment services from January 2018 to August 2020. We also interviewed the facility staff responsible for the provision of index testing services. Sample Size and Sample Selection The sample size was determined using the Kish-Leslie formula, with the assumption that 50% of index clients would elicit their sexual partners(12). With a 5% level of precision, a standard critical value of 1.96 with a 95% confidence interval, and adjusting for a non-response rate of 10%, a minimum sample size of 424 participants was computed. Four hundred and thirty-five (435) clients and 70 index service providers were involved in the study. Clients were conveniently selected as they visited the health care facilities per their scheduled appointments. Health providers were purposively selected based on their engagement in HTS and index testing services. Data Collection Procedure . Using trained research assistants, the questionnaire was administered to participants in a private room to ensure privacy. The interviews commenced after the signing of the informed consent. The questionnaires for service providers were self-administered with minimal support from research assistants, where clarification was needed [see supplementary files]. Variables and Measurements The independent variables for this study were social demographic information (age, sex, marital status, education level, occupation, disclosure, and duration on ART. The dependent variables are whether the index client elicited at least one sexual partner, the number of sexual contacts elicited, and uptake of HIV testing among sexual partners of index clients. Data Analysis Data entry was done using Microsoft Excel 365. Data checks and cleaning were done to correct all data entry errors and missing values. Analysis was done using SPSS software version 26. Descriptive analysis was done to summarize important variables in the data. Association between outcome and independent variables such as age, sex, socio-economic status, marital status, and number of sexual partners was done using binary logistic regression. Findings are presented using different tools such as frequency distribution tables, statistical diagrams, and ORs as the measure of effect. P-values equal to or less than 0.05 were considered statistically significant. Ethical Clearance Ethical clearance was sought and obtained from the Institutional Review Board (IRB) of the Muhimbili University of Health and Allied Sciences (MUHAS). Permission to conduct the study was sought from regional, district, and facility-level authorities. After explaining the purpose of the study and data collection methods, informed consent was sought from all participants. Results Sociodemographic characteristics This study involved a total of 435 adult clients living with HIV (18-49 years) and 70 staff from the 8 high-volume CTCs in Tanga region. Of the 435 clients from CTC, 287 (66%) were females, and 231 respondents (53.1%) were married. The median age was 32 years (range 18-49 years), while the most common group was 26-35 years (55.6%). Most clients were farmers (33.1%) or engaged in petty trade (26.2%). Table 1 summarizes sociodemographic characteristics of the clients: Table 1. Socio-demographic characteristics of clients living with HIV Variable Category Frequency (n) Percent (%) Age 18 - 25 61 14.0 26 - 35 242 55.6 >35 132 30.3 Sex Male 148 34.0 Female 287 66.0 Marital status Married 231 53.1 Separated 67 15.4 Single 104 23.9 Widowed 33 7.6 Highest education level High school 14 3.2 No formal education 75 17.2 Primary education 203 46.7 Secondary education 120 27.6 College/University 23 5.3 Occupation Business 44 10.1 Farmer 144 33.1 Government employee 25 5.7 Petty trader 114 26.2 Private sector 58 13.3 Unemployed 50 11.5 Duration on ART < 1 Year 83 19.1 ≥1 Year 352 80.9 Sociodemographic Characteristics of Index Testing Service Providers Of the 70 providers, 50 were females (71%), and most of the providers were young, aged 18-25 years (59%), while the smallest group was that aged >35 years (8%). The lowest education level was Primary education (mostly the lay counsellors), while the highest education level was a diploma (31%). Most were trained to a certificate level (47%), and only 52 (74%) providers were trained on index testing services. Elicitation of Sexual Partners 322 (74%) out of the 435 respondents had listed at least one sexual partner, while 113 clients had listed no sexual partners. A total of 403 sexual partners were listed (elicitation ratio 1:1.3), of whom 116 were already known HIV+ and 287 (71%) had unknown HIV status, therefore eligible for testing. Furthermore, the sexual partner elicitation rate among index clients was assessed, where 178 (55%) clients had mentioned only 1 sexual partner (Low Elicitation Rate), and 144 (45%) clients fell in the high elicitation category with ≥2 sexual partners listed. The highest number of sexual partners listed per respondent was five (5). These findings are summarized in Table 2. Table 2. Elicitation of Sexual Partners of Adult Index Clients Variable Category Frequency (n) Denominator (d) Percent (%) Listed at least 1 Partner Yes 322 435 74 No 113 435 26 Index Elicitation Ratio Low Elicitation Ratio (1 SP) 178 322 55 High Elicitation Ratio (≥2 SP) 144 322 45 HIV Status of Sexual Partner Known 116 403 29 Unknown 287 403 71 Factors associated with the elicitation of sexual partners. In addition to socio-demographic factors, the study also assessed client/social demographic factors that affected the elicitation of sexual contacts through open-ended questions, which required the respondents to list the factors. The responses were coded into four major factors: infidelity, lack of disclosure, fear of separation, and geographical distance/separation. 296 participants (68%) mentioned disclosure as a major barrier to the elicitation of sexual partners. Separation/geographical distance ranked second with 168 respondents (39%), while fear of separation and infidelity factors were the least mentioned. However, from Table 3, the only statistically significant factor was the number of sexual partners in the past 2 years (with P -Value <0.001), which revealed that individuals with a larger number of sexual partners are more likely to elicit their partners than those with one partner. Almost 95% of clients with more than 2 partners had listed at least 1 partner with unknown status, while only 50% of those involved with 1 sexual partner in the past two years managed to list at least one sexual partner. Table 3. Client/Socio-demographic factors affecting the elicitation of sexual partners ≥ 1 sexual partner elicited Total Number (Denominator) Variable Category Yes n (%) No n (%) P - value Age (years) 18 – 25 44 (72.1) 17 (27.9) 61 0.445 26 – 35 161 (66.5) 81 (33.5) 242 >35 83 (62.9) 49 (37.1) 132 Sex Male 107 (72.3) 41 (27.7) 148 0.054 Female 181 (63.1) 106 (36.9) 287 Marital status Married 159 (68.8) 72 (31.2) 231 0.062 Separated 40 (59.7) 27 (40.3) 67 Single 73 (70.2) 31 (29.8) 104 Widowed 16 (48.5) 72 (31.2) 33 Education level No formal education 54 (72.0) 21 (28.0) 75 0.586 Primary 127 (62.6) 76 (37.4) 203 Secondary 83 (69.2) 37 (30.8) 120 High school 9 (64.3) 5 (35.7) 14 University 15 (65.2) 8 (34.8) 23 Occupation Business 32 (72.7) 32 (72.7) 44 0.535 Farmer 98 (68.1) 98 (68.1) 144 Government employee 19 (76.0) 19 (76.0) 25 Petty trader 74 (64.9) 74 (64.9) 114 Private sector 34 (58.6) 34 (58.6) 58 Unemployed 31 (62.0) 31 (62.0) 50 Number of Sexual partners One 100 (49.8) 101 (50.2) 201 < 0.001 Two 102 (88.7) 13 (11.3) 115 More than two 86 (94.5) 5 (5.5) 91 Duration on ART (years) <1 61(73.5) 22 (26.5) 83 0.072 ≥1 227 (64.5) 125 (35.5) 352 Infidelity Yes 35 (68.6) 16 (31.4) 51 0.697 No 253 (65.9) 131 (34.1) 384 Disclosure Yes 202 (68.2) 94 (31.8) 296 0.19 No 86 (61.9) 53 (38.1) 139 Fear of Separation Yes 54 (70.1) 124 (34.6) 77 0.422 No 234 (65.4) 23 (29.9) 358 Separation/Geographical Distance Yes 113 (67.3) 55 (32.7) 168 0.712 No 175 (65.5) 92 (34.5) 267 Univariable and Multivariable Analyses Univariable and multivariable analyses were used to determine the factors significantly associated with index testing uptake. In univariable analysis, the number of sexual partners was found to have a significant association with the uptake of the index test, whereby those participants with two or more sexual partners had higher odds of mentioning their sexual partners compared to those with one sexual partner. In multivariable analysis, the number of sexual partners and disclosure of HIV+ status were found to be the factors significantly associated with uptake of Index testing. Having more than two sexual partners (aOR = 23.04), having two sexual partners (aOR = 9.53), and lack of disclosure (aOR = 2.22) were significantly associated with increased odds of listing sexual partners for HIV testing. The results are summarized in Table 5 Table 5: Analysis of factors associated with elicitation of at least one SP Univariate analysis Multivariate analysis Variable F (n) cOR 95% CI P -value aOR 95% CI P - value Age group (years) 18 – 25 61 1.53 0.79 – 2.96 0.209 1.47 0.54 – 3.99 0.454 26 - 35 242 1.17 0.75 – 1.83 0.479 0.65 0.35 – 1.22 0.179 >35 132 Ref Sex Male 148 1.53 0.99 – 2.36 0.055 1.08 0.62 – 1.87 0.796 Female 287 Ref Marital status Separated 67 0.67 0.38 – 1.18 0.164 1.06 0.49 – 2.30 0.884 Single 104 1.07 0.64 – 1.77 0.803 0.70 0.33 – 1.51 0.363 Widowed 33 0.43 0.20 – 0.89 0.023 0.99 0.31 – 3.19 0.982 Married 231 Ref Number of sexual partners More than two 91 17.37 6.77 – 44.61 < 0.001 23.04 8.65 - 61.39 < 0.001 Two 115 7.93 4.18 – 15.03 < 0.001 9.53 4.86 – 18.69 < 0.001 One 201 Ref Disclosure Not disclosed 152 0.76 0.50 – 1.15 0.191 2.22 1.17 – 4.21 0.015 Disclosed to SP 283 Ref Duration on ART (years) 2 12 Ref Key: cOR: crude odds ratio, aOR: adjusted odds ratio, Ref: Reference group, SP: Sexual partner, F: frequency Uptake of HIV testing among sexual partners of index clients On further analysis of testing coverage among elicited partners, of the 287 sexual partners eligible for testing (those who had unknown HIV status), 159 contacts were reached and tested for HIV (55.4%). The index testing positive yield was as high as 34%, as 54/159 sexual contacts tested HIV positive. Facility/programmatic factors associated with contact tracing To further understand challenges in reaching elicited contacts, health care providers were interviewed during data collection. Common reasons for not reaching elicited sexual partners include wrong address/locator provided, unreachable phone numbers, long geographical distance from the facility, and clients' unavailability due to travel. Figure 1 summarizes challenges in contact tracing. Discussion From our findings, 322 clients (74%) out of the 435 clients agreed to index testing services and listed at least one sexual partner (SP), while 113 clients did not list sexual partners. Three hundred and twenty-two (322) clients listed 403 sexual partners, hence an elicitation ratio of 1:1.3. The number of sexual partners listed by a single index client ranged from one to five. The index testing acceptance rate was higher than found in studies done in Dar es Salaam (56%) ( 13 ) and Njombe (60%) ( 11 ) in Tanzania. But studies in Lesotho and Malawi showed that comparable acceptance rates ranging from 75%-89%( 5 , 6 ). Similar elicitation ratios were observed in these studies ( 5 , 6 , 11 ). Fear of stigma, discrimination, and rejection by the partner were associated with lower elicitation rates ( 14 ). Also, women and married clients, regardless of gender, were less likely to elicit their sexual partners, especially the casual ones ( 15 ). Other studies have reported higher elicitation rates ( 15 , 16 ), indicating a difference in context and partner notification approaches. Creating trust, supporting newly diagnosed clients with counselling, and offering different options for partner notifications have been shown to improve elicitation ratios ( 17 ). High HIV positivity rates (yield) are the hallmarks of the index testing services. Among the tested eligible partners, 34% tested positive. Similar high positivity rates have been observed in various studies. A positivity rate of 12–86% has been noted in a systematic review including ten studies from eight countries( 18 ). Comparable positivity rates were observed in Kenya and Zimbabwe( 19 , 20 ). Higher positivity rates, ranging from 52 to 64% were noted in Njombe ( 12 ), Kilimanjaro ( 21 ), Malawi ( 5 ) and Cameroon ( 22 ). High positivity rates underscore the effectiveness of index testing in reaching previously undiagnosed PLHIV and linking them to care. Having ≥ 2 sexual partners and non-disclosure of HIV status were significantly associated with elicitation of sexual partners. Studies in Nigeria and Ethiopia have indicated that HIV status disclosure is associated with the uptake of index testing services, including elicitation ( 23 , 24 ) in contrast to our study findings. Multiple sexual partners may indicate non-committed relationships; hence, ease of eliciting the casual partners without a fear of separation or IPV. Age, sex, marital status, duration on ART, and fear of separation or intimate partner violence (IPV) were not associated with elicitation of sexual partners. In contrast with our findings, demographic factors have been linked with the elicitation of sexual partners. A study in Dar es salaam showed that women were 13% less likely to name SP compared to men, and married clients were likely to list their SP beyond their spouses. Also, fear of IPV was associated with lower elicitation rates ( 15 ). Similarly, in Njombe, women were less likely to elicit partners compared to men ( 12 ). Fear of support loss and IPV have been linked with lower elicitation and uptake of index testing services ( 25 ). Among elicited partners, of the 287 sexual partners eligible for testing (those who had unknown HIV status), 159 were reached and tested for HIV (55.4%). Almost half of the elicited contacts were not reached for counselling and HIV testing. During interviews with health providers offering index testing services; wrong address/locator, unreachable phone numbers, geographical distance, and travel accounted for 72% of the mentioned reasons. Study in Njombe had similar findings, where 36.8% were far from the facility due to travel or residence ( 12 ). In Malawi, 17% of elicited partners had no locator information. Partners with no locator information were more likely to be short-term/casual ( 5 ). Similarly, in Kenya, challenges of elicitation and contacting sexual partners included wrong locators and phone numbers ( 26 ). This calls for a client-centered approach to index testing, where sexual contacts residing far from the facility can be tested where they currently reside, and results are shared with the index facility. Although fear of violence from partners accounted for 15% of the reasons for not reaching/contacting, no actual incident of IPV was reported. This may be attributed to the national index testing guideline, which requires screening for IPV and other red flags before sexual partners are contacted. Concerns for social harms and adverse events following HIV partner notification have been raised in the literature, but few have been reported. No index client reported a perceived risk of IPV from a listed sexual partner ( 12 ). A randomized trial in Keya did not observe any association between IPV and index testing ( 27 ). Similar findings were observed in Malawi ( 5 , 28 ). Study Limitations and Mitigation The study had a few limitations. Non-random methods were used during sampling and recruitment of participants. Index clients were conveniently selected as they attend their regular clinics and were recruited for the study; this may limit the generalizability of the study findings. Recall bias is another limitation, as clients may forget to list all sexual partners and whether they were reached and provided with HIV testing services. To minimize this, we triangulated the provided information with the recorded data in the Index and HIV testing registers. Finally, some clients may limit the elicitation of their casual sexual partners for fear of being judged promiscuous and irresponsible. Our interviewers were trained to use a non-judgmental approach during the interview, and participants were assured of privacy and protection of information provided. We did not collect any personal identifying information Conclusion This study highlights the high acceptability and effectiveness of index testing as a modality to reach undiagnosed people living with HIV. About 74% of the recruited participants listed at least one sexual partner, indicating high acceptability of the intervention. Among elicited contacts tested, 34% were HIV+, cementing the effectiveness of the intervention. This reinforces existing evidence in the literature on the index testing effectiveness. This calls for the continuation of this intervention and scale-up to all facilities offering HIV testing and care services. Declarations Ethical Clearance The study was approved by the Muhimbili University of Health and Allied Sciences Institutional Review Board (Ref. IRB#: MUHAS-REC-06-2020-284). This study adhered to ethical guidelines outlined in the Declaration of Helsinki. Informed consent was obtained from participants, and confidentiality was maintained throughout the study. Consent for Publication Not Applicable Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing Interests The authors declare that they have no competing interests Funding No specific fund was received for this study Authors’ Contribution FG oversaw data collection and initial analysis. FG and AK finalized the analysis and developed the first draft. BM, SM, AM and RM reviewed the draft and provided inputs. RM provided the final review and approval. All authors read and approved the final manuscript. Acknowledgements My sincere appreciation to my supervisor Prof. Rose Mpembeni for the guidance and support during my entire research work. Special gratitude CIHEB Tanzania and its leadership for supporting me during my studies. 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Supplementary Files SupplementaryFileQuestionnaires.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 27 Aug, 2025 Reviewers agreed at journal 27 Aug, 2025 Reviewers invited by journal 26 Aug, 2025 Editor assigned by journal 20 Aug, 2025 Editor invited by journal 29 Jul, 2025 Submission checks completed at journal 27 Jul, 2025 First submitted to journal 27 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7180477","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":506397661,"identity":"fd72cc83-6c69-4426-b754-f32aa53fdf6a","order_by":0,"name":"Faraja Daniel Gabriel","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3ElEQVRIie2PIQvCQBiGbwy2cnJNviHDvzBZWRD8K7cyq9FgMNl0dcOfYBkcXF6yDevkipY1YUmWxN0wexcF7wkv38H78H2HkMHwg7jbPgAhK5UvutJQcPlRcunSQFfpsYph0FLc6t5GG+6zyylubwGaknGpUPAyBDiLkNcPBv1hs/xIvysLlCAAR8S8rgqp0EAoFEwau4OXiFlWsU5PgcQBbyfiguy55hZonMg7iDCrRzyiAaj/gkliC3gKP00rdu3W8ymZKBSJDTJhaIK6LrFamaTUaxsMBsP/8QZPRkWA+F2NZAAAAABJRU5ErkJggg==","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":true,"prefix":"","firstName":"Faraja","middleName":"Daniel","lastName":"Gabriel","suffix":""},{"id":506397663,"identity":"a5f3c09b-3a1c-49c7-91f7-7cac5a1ca91d","order_by":1,"name":"Andrew Kigombola","email":"","orcid":"","institution":"CIHEB Tanzania","correspondingAuthor":false,"prefix":"","firstName":"Andrew","middleName":"","lastName":"Kigombola","suffix":""},{"id":506397665,"identity":"f6624857-a95c-4d25-aba9-1ad79865db76","order_by":2,"name":"Selemani Msangi","email":"","orcid":"","institution":"Regional Health Management Team (RHMT)","correspondingAuthor":false,"prefix":"","firstName":"Selemani","middleName":"","lastName":"Msangi","suffix":""},{"id":506397666,"identity":"b8adf56b-622a-40d6-9178-32576a3744a3","order_by":3,"name":"Brown Mwakibambo","email":"","orcid":"","institution":"Amref Health Africa – Ali Hassan road","correspondingAuthor":false,"prefix":"","firstName":"Brown","middleName":"","lastName":"Mwakibambo","suffix":""},{"id":506397667,"identity":"73cb179b-5cac-4b5d-a0a7-a0bc4b94a495","order_by":4,"name":"Abubakar Maghimbi","email":"","orcid":"","institution":"CIHEB Tanzania","correspondingAuthor":false,"prefix":"","firstName":"Abubakar","middleName":"","lastName":"Maghimbi","suffix":""},{"id":506397668,"identity":"96c4ff18-ae3d-4359-8620-7e3b728db114","order_by":5,"name":"Rose Mpembeni","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"prefix":"","firstName":"Rose","middleName":"","lastName":"Mpembeni","suffix":""}],"badges":[],"createdAt":"2025-07-21 19:38:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7180477/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7180477/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90472871,"identity":"07705a9d-dbbb-4c8c-86e3-aac2de30f1cd","added_by":"auto","created_at":"2025-09-03 06:37:22","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":61619,"visible":true,"origin":"","legend":"\u003cp\u003eChallenges related to index contact tracing for testing\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7180477/v1/9971da9220efa19f5f6e7492.png"},{"id":90474907,"identity":"ba0a6fda-9c9a-49ee-a457-a657e3d7abf1","added_by":"auto","created_at":"2025-09-03 06:53:22","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1245424,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7180477/v1/ee64eac9-8e63-4538-9896-c34afb250152.pdf"},{"id":90472876,"identity":"ef7d5efb-a2e0-4bdc-a585-dc6734e84867","added_by":"auto","created_at":"2025-09-03 06:37:22","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":19154,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryFileQuestionnaires.docx","url":"https://assets-eu.researchsquare.com/files/rs-7180477/v1/62c2727a884dcd2a7358b6da.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eFactors Associated with Uptake of Hiv Index Testing Among Plhiv and Their Sexual Partners in Tanga Region, Tanzania. A Cross-Sectional Study\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eUNAIDS reported 39.9 million people living with HIV in 2024, and the majority are in Sub-Saharan Africa (SSA). While progress has been made in reducing new HIV infections, nonetheless, 1.3 million people acquired HIV worldwide (1). Similarly, in Tanzania, approximately 1.6 million people are living with HIV (PLHIV). The country has an annual incidence of 0.18%, which translates into 60,000 new HIV cases per year (2).\u003c/p\u003e\n\u003cp\u003eTanzania has been implementing HIV prevention programmes since the first three cases of HIV were reported in the country in the year 1983(2).The current HIV prevention approach in Tanzania is based on “combination prevention”, a comprehensive approach comprising behavioural, social, and biomedical interventions for the general population and vulnerable groups.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn 2014, UNAIDS and partners launched the 90–90–90 targets, which were revised in 2019 to 95-95-95 targets by 2030\u003cstrong\u003e. \u0026nbsp;\u003c/strong\u003eThe aim was to diagnose 95% of all HIV-positive persons, provide antiretroviral therapy (ART) for 95% of those diagnosed, and achieve viral suppression for 95% of those treated by 2020 (3). While progress has been made in achieving the second and third 95, the first one is lagging, UNAIDS estimates only 87% of the PLHIV know their status, which translates into 5.3 million people. In Tanzania, a recent survey has shown only 83% of PLHIV are aware of their HIV status(2). This calls for innovative and cost-effective approaches to reach, diagnose, and link PLHIV to care. HIV partner notification (also known as HIV index testing) has proved to be one of the most effective and feasible case identification approaches and one of the best opportunities for HIV treatment and prevention (4). A growing evidence base supports an expansion of partner notification in HIV testing services (HTS) in sub-Saharan Africa. Literature review has shown that index testing is acceptable among PLHIV and has a high positivity rate among sexual partners (5,6). In Tanzania, the index testing modality is being practised across all care and treatment sites, and it is one of the priority strategies narrated in the National Accelerated Action Plan on HIV Testing Services 2019 – 2020 (7). Index testing is also advocated as one of the most effective modalities in both HIV case finding and even disclosure aid among sexual partners (8).\u003c/p\u003e\n\u003cp\u003eSuccessful index testing is affected by several factors, such as \u0026nbsp;low elicitation rate and risk of intimate partner violence (9,10)A cross-sectional study conducted in 2015 in the Njombe region of Tanzania aimed to evaluate the outcome and experience of partner notification within facility-based HIV testing services (11). The study revealed that stigma, fear of intimate violence, and abandonment were barriers for index testing, especially for women, due to gender roles and social norms\u0026nbsp;(11).\u003c/p\u003e\n\u003cp\u003eIn this study, we describe factors affecting the uptake of HIV index testing among PLHIV and their sexual partners in Tanga Region.\u003c/p\u003e"},{"header":"Methods","content":"\u003ch2\u003eStudy Design\u003c/h2\u003e\n\u003cp\u003eThis was a cross-sectional study conducted in 2021. Clients living with HIV and attending Care and Treatment facilities (CTC) were interviewed on demographics, acceptance of index testing services, and elicitation of sexual partners.\u003c/p\u003e\n\u003ch2\u003eStudy Population\u003c/h2\u003e\n\u003cp\u003eThe primary study population was adult clients (≥ 18 years) living with HIV enrolled in care and treatment services from January 2018 to August 2020. We also interviewed the facility staff responsible for the provision of index testing services.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eSample Size and Sample Selection\u003c/h2\u003e\n\u003cp\u003eThe sample size was determined using the Kish-Leslie formula, with the assumption that 50% of index clients would elicit their sexual partners(12). With a 5% level of precision, a standard critical value of 1.96 with a 95% confidence interval, and adjusting for a non-response rate of 10%, a minimum sample size of 424 participants was computed. Four hundred and thirty-five (435) clients and 70 index service providers were involved in the study. Clients were conveniently selected as they visited the health care facilities per their scheduled appointments. Health providers were purposively selected based on their engagement in HTS and index testing services.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection Procedure\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eUsing trained research assistants, the questionnaire was administered to participants in a private room to ensure privacy. The interviews commenced after the signing of the informed consent. The questionnaires for service providers were self-administered with minimal support from research assistants, where clarification was needed [see supplementary files].\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eVariables and Measurements\u003c/h2\u003e\n\u003cp\u003eThe independent variables for this study were social demographic information (age, sex, marital status, education level, occupation, disclosure, and duration on ART. The dependent variables are whether the index client elicited at least one sexual partner, the number of sexual contacts elicited, and uptake of HIV testing among sexual partners of index clients.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eData Analysis\u003c/h2\u003e\n\u003cp\u003eData entry was done using Microsoft Excel 365. Data checks and cleaning were done to correct all data entry errors and missing values.\u0026nbsp;\u0026nbsp;Analysis was done using SPSS software version 26. Descriptive analysis was done to summarize important variables in the data. Association between outcome and independent variables such as age, sex, socio-economic status, marital status, and number of sexual partners was done using binary logistic regression. Findings are presented using different tools such as frequency distribution tables, statistical diagrams, and ORs as the measure of effect. P-values equal to or less than 0.05 were considered statistically significant.\u003c/p\u003e\n\u003ch2\u003eEthical Clearance\u003c/h2\u003e\n\u003cp\u003eEthical clearance was sought and obtained from the Institutional Review Board (IRB) of the Muhimbili University of Health and Allied Sciences (MUHAS). Permission to conduct the study was sought from regional, district, and facility-level authorities. After explaining the purpose of the study and data collection methods, informed consent was sought from all participants.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eSociodemographic characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study involved a total of 435 adult clients living with HIV (18-49 years) and 70 staff from the 8 high-volume CTCs in Tanga region. Of the 435 clients from CTC, 287 (66%) were females, and 231 respondents (53.1%) were married. The median age was 32 years (range 18-49 years), while the most common group was 26-35 years (55.6%). Most clients were farmers (33.1%) or engaged in petty trade (26.2%). Table 1 summarizes sociodemographic characteristics of the clients:\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eTable 1. Socio-demographic characteristics of clients living with HIV\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"585\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e18 - 25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e14.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e26 - 35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e55.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026gt;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e30.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e34.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e66.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e53.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eSeparated\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e15.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eSingle\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e23.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eWidowed\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHighest education level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eHigh school\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e3.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eNo formal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e17.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003ePrimary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e203\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e46.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eSecondary education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e27.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eCollege/University\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e5.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eBusiness\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e10.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eFarmer\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e144\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e33.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eGovernment employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e5.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003ePetty trader\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e26.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003ePrivate sector\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e13.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eUnemployed\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e11.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 196px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration on ART\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026lt; 1 Year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e19.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026ge;1 Year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 99px;\"\u003e\n \u003cp\u003e80.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eSociodemographic Characteristics of Index Testing Service Providers\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf the 70 providers, 50 were females (71%), and most of the providers were young, aged 18-25 years (59%), while the smallest group was that aged \u0026gt;35 years (8%). The lowest education level was Primary education (mostly the lay counsellors), while the highest education level was a diploma (31%). Most were trained to a certificate level (47%), and only 52 (74%) providers were trained on index testing services.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eElicitation of Sexual Partners\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e322 (74%) out of the 435 respondents had listed at least one sexual partner, while 113 clients had listed no sexual partners. A total of 403 sexual partners were listed (elicitation ratio 1:1.3), of whom 116 were already known HIV+ and 287 (71%) had unknown HIV status, therefore eligible for testing. Furthermore, the sexual partner elicitation rate among index clients was assessed, where 178 (55%) clients had mentioned only 1 sexual partner (Low Elicitation Rate), and 144 (45%) clients fell in the high elicitation category with \u0026ge;2 sexual partners listed. The highest number of sexual partners listed per respondent was five (5). \u0026nbsp;These findings are summarized in Table 2.\u003cem\u003e\u003cbr\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eTable 2. Elicitation of Sexual Partners of Adult Index Clients\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"583\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDenominator\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(d)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eListed at least 1 Partner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e322\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e435\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e435\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eIndex Elicitation Ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003eLow Elicitation Ratio (1 SP)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e322\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003eHigh Elicitation Ratio (\u0026ge;2 SP)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e144\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e322\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 126px;\"\u003e\n \u003cp\u003eHIV Status of Sexual Partner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003eKnown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e403\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 165px;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e403\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eFactors associated with the elicitation of sexual partners.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn addition to socio-demographic factors, the study also assessed client/social demographic factors that affected the elicitation of sexual contacts through open-ended questions, which required the respondents to list the factors. The responses were coded into four major factors: infidelity, lack of disclosure, fear of separation, and geographical distance/separation. 296 participants (68%) mentioned disclosure as a major barrier to the elicitation of sexual partners. Separation/geographical distance ranked second with 168 respondents (39%), while fear of separation and infidelity factors were the least mentioned. However, from Table 3, the only statistically significant factor was the number of sexual partners in the past 2 years (with \u003cem\u003eP\u003c/em\u003e-Value \u0026lt;0.001), which revealed that individuals with a larger number of sexual partners are more likely to elicit their partners than those with one partner. Almost 95% of clients with more than 2 partners had listed at least 1 partner with unknown status, while only 50% of those involved with 1 sexual partner in the past two years managed to list at least one sexual partner.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eTable 3. Client/Socio-demographic factors affecting the elicitation of sexual partners\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"638\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026ge; 1 sexual partner elicited\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 107px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal Number\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(Denominator)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;- value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e18 \u0026ndash; 25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e44 (72.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e17 (27.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e0.445\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e26 \u0026ndash; 35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e161 (66.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e81 (33.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e242\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026gt;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e83 (62.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e49 (37.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e132\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e107 (72.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e41 (27.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e0.054\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e181 (63.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e106 (36.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e287\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e159 (68.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e72 (31.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e0.062\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eSeparated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e40 (59.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e27 (40.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e73 (70.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e31 (29.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e16 (48.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e72 (31.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eNo formal education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e54 (72.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e21 (28.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e0.586\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e127 (62.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e76 (37.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e203\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e83 (69.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e37 (30.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e120\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e9 (64.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e5 (35.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eUniversity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e15 (65.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e8 (34.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eBusiness\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e32 (72.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e32 (72.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e0.535\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eFarmer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e98 (68.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e98 (68.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e144\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eGovernment employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e19 (76.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e19 (76.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003ePetty trader\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e74 (64.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e74 (64.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003ePrivate sector\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e34 (58.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e34 (58.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e31 (62.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e31 (62.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of Sexual partners\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eOne\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e100 (49.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e101 (50.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eTwo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e102 (88.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e13 (11.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e115\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eMore than two\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e86 (94.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e5 (5.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration on ART (years)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026lt;1\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e61(73.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e22 (26.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e0.072\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026ge;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e227 (64.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e125 (35.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e352\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInfidelity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e35 (68.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e16 (31.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e0.697\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e253 (65.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e131 (34.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e384\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisclosure\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e202 (68.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e94 (31.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e296\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e86 (61.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e53 (38.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFear of Separation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e54 (70.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e124 (34.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e0.422\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e234 (65.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e23 (29.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e358\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSeparation/Geographical Distance\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e113 (67.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e55 (32.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e168\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e0.712\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 105px;\"\u003e\n \u003cp\u003e175 (65.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e92 (34.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e267\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eUnivariable and Multivariable Analyses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUnivariable and multivariable analyses were used to determine the factors significantly associated with index testing uptake. In univariable analysis, the number of sexual partners was found to have a significant association with the uptake of the index test, whereby those participants with two or more sexual partners had higher odds of mentioning their sexual partners compared to those with one sexual partner. In multivariable analysis, the number of sexual partners and disclosure of HIV+ status were found to be the factors significantly associated with uptake of Index testing. Having more than two sexual partners (aOR\u003csub\u003e\u0026nbsp;=\u003c/sub\u003e 23.04), having two sexual partners (aOR\u003csub\u003e\u0026nbsp;=\u003c/sub\u003e 9.53), and lack of disclosure (aOR\u003csub\u003e\u0026nbsp;\u003c/sub\u003e= 2.22) were significantly associated with increased odds of listing sexual partners for HIV testing. The results are summarized in Table 5\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eTable 5: Analysis of factors associated with elicitation of at least one SP\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"597\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnivariate analysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 210px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMultivariate analysis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eF (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ecOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP -value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eaOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP - value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eAge group (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 18 \u0026ndash; 25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.79 \u0026ndash; 2.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e0.54 \u0026ndash; 3.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0.454\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 26 - 35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.75 \u0026ndash; 1.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.479\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e0.35 \u0026ndash; 1.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0.179\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026gt;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e148\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.99 \u0026ndash; 2.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e0.62 \u0026ndash; 1.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0.796\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Separated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.38 \u0026ndash; 1.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e0.49 \u0026ndash; 2.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0.884\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Single\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e1.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.64 \u0026ndash; 1.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.803\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e0.33 \u0026ndash; 1.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0.363\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.20 \u0026ndash; 0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e0.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e0.31 \u0026ndash; 3.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0.982\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Married\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eNumber of sexual partners\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; More than two\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e17.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e6.77 \u0026ndash; 44.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e23.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e8.65 - 61.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Two\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e115\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e7.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e4.18 \u0026ndash; 15.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e9.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e4.86 \u0026ndash; 18.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt; 0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; One\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eDisclosure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Not disclosed\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.50 \u0026ndash; 1.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.191\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e2.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e1.17 \u0026ndash; 4.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.015\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Disclosed to SP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e283\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003eDuration on ART (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026lt; 1\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e3.88\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e1.12 \u0026ndash; 13.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.033\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e3.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e0.69 \u0026ndash; 16.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0.133\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; 1 - 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e340\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003e2.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e0.82 \u0026ndash; 8.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e1.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e0.64 \u0026ndash; 7.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e0.527\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 138px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026gt;2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 47px;\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 51px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"9\" valign=\"top\" style=\"width: 547px;\"\u003e\n \u003cp\u003eKey: cOR: crude odds ratio, aOR: adjusted odds ratio, Ref: Reference group, SP: Sexual partner, F: frequency\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eUptake of HIV testing among sexual partners of index clients\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOn further analysis of testing coverage among elicited partners, of the 287 sexual partners eligible for testing (those who had unknown HIV status), 159 contacts were reached and tested for HIV (55.4%). The index testing positive yield was as high as 34%, as 54/159 sexual contacts tested HIV positive.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFacility/programmatic factors associated with contact tracing\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo further understand challenges in reaching elicited contacts, health care providers were interviewed during data collection. Common reasons for not reaching elicited sexual partners include wrong address/locator provided, unreachable phone numbers, long geographical distance from the facility, and clients\u0026apos; unavailability due to travel. Figure 1 summarizes challenges in contact tracing.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eFrom our findings, 322 clients (74%) out of the 435 clients agreed to index testing services and listed at least one sexual partner (SP), while 113 clients did not list sexual partners. Three hundred and twenty-two (322) clients listed 403 sexual partners, hence an elicitation ratio of 1:1.3. The number of sexual partners listed by a single index client ranged from one to five. The index testing acceptance rate was higher than found in studies done in Dar es Salaam (56%) (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) and Njombe (60%) (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) in Tanzania. But studies in Lesotho and Malawi showed that comparable acceptance rates ranging from 75%-89%(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Similar elicitation ratios were observed in these studies (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Fear of stigma, discrimination, and rejection by the partner were associated with lower elicitation rates (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Also, women and married clients, regardless of gender, were less likely to elicit their sexual partners, especially the casual ones (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Other studies have reported higher elicitation rates (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e), indicating a difference in context and partner notification approaches. Creating trust, supporting newly diagnosed clients with counselling, and offering different options for partner notifications have been shown to improve elicitation ratios (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eHigh HIV positivity rates (yield) are the hallmarks of the index testing services. Among the tested eligible partners, 34% tested positive. Similar high positivity rates have been observed in various studies. A positivity rate of 12\u0026ndash;86% has been noted in a systematic review including ten studies from eight countries(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Comparable positivity rates were observed in Kenya and Zimbabwe(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Higher positivity rates, ranging from 52 to 64% were noted in Njombe (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e), Kilimanjaro (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e), Malawi (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) and Cameroon (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). High positivity rates underscore the effectiveness of index testing in reaching previously undiagnosed PLHIV and linking them to care.\u003c/p\u003e\u003cp\u003eHaving\u0026thinsp;\u0026ge;\u0026thinsp;2 sexual partners and non-disclosure of HIV status were significantly associated with elicitation of sexual partners. Studies in Nigeria and Ethiopia have indicated that HIV status disclosure is associated with the uptake of index testing services, including elicitation (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) in contrast to our study findings. Multiple sexual partners may indicate non-committed relationships; hence, ease of eliciting the casual partners without a fear of separation or IPV.\u003c/p\u003e\u003cp\u003eAge, sex, marital status, duration on ART, and fear of separation or intimate partner violence (IPV) were not associated with elicitation of sexual partners. In contrast with our findings, demographic factors have been linked with the elicitation of sexual partners. A study in Dar es salaam showed that women were 13% less likely to name SP compared to men, and married clients were likely to list their SP beyond their spouses. Also, fear of IPV was associated with lower elicitation rates (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Similarly, in Njombe, women were less likely to elicit partners compared to men (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Fear of support loss and IPV have been linked with lower elicitation and uptake of index testing services (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAmong elicited partners, of the 287 sexual partners eligible for testing (those who had unknown HIV status), 159 were reached and tested for HIV (55.4%). Almost half of the elicited contacts were not reached for counselling and HIV testing. During interviews with health providers offering index testing services; wrong address/locator, unreachable phone numbers, geographical distance, and travel accounted for 72% of the mentioned reasons. Study in Njombe had similar findings, where 36.8% were far from the facility due to travel or residence (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). In Malawi, 17% of elicited partners had no locator information. Partners with no locator information were more likely to be short-term/casual (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Similarly, in Kenya, challenges of elicitation and contacting sexual partners included wrong locators and phone numbers (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). This calls for a client-centered approach to index testing, where sexual contacts residing far from the facility can be tested where they currently reside, and results are shared with the index facility. Although fear of violence from partners accounted for 15% of the reasons for not reaching/contacting, no actual incident of IPV was reported. This may be attributed to the national index testing guideline, which requires screening for IPV and other red flags before sexual partners are contacted. Concerns for social harms and adverse events following HIV partner notification have been raised in the literature, but few have been reported. No index client reported a perceived risk of IPV from a listed sexual partner (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). A randomized trial in Keya did not observe any association between IPV and index testing (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). Similar findings were observed in Malawi (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cb\u003eStudy Limitations and Mitigation\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe study had a few limitations. Non-random methods were used during sampling and recruitment of participants. Index clients were conveniently selected as they attend their regular clinics and were recruited for the study; this may limit the generalizability of the study findings. Recall bias is another limitation, as clients may forget to list all sexual partners and whether they were reached and provided with HIV testing services. To minimize this, we triangulated the provided information with the recorded data in the Index and HIV testing registers. Finally, some clients may limit the elicitation of their casual sexual partners for fear of being judged promiscuous and irresponsible. Our interviewers were trained to use a non-judgmental approach during the interview, and participants were assured of privacy and protection of information provided. We did not collect any personal identifying information\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study highlights the high acceptability and effectiveness of index testing as a modality to reach undiagnosed people living with HIV. About 74% of the recruited participants listed at least one sexual partner, indicating high acceptability of the intervention. Among elicited contacts tested, 34% were HIV+, cementing the effectiveness of the intervention. This reinforces existing evidence in the literature on the index testing effectiveness. This calls for the continuation of this intervention and scale-up to all facilities offering HIV testing and care services.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Clearance\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Muhimbili University of Health and Allied Sciences Institutional Review Board (Ref. IRB#: MUHAS-REC-06-2020-284). This study adhered to ethical guidelines outlined in the Declaration of Helsinki. Informed consent was obtained from participants, and confidentiality was maintained throughout the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo specific fund was received for this study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ Contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFG oversaw data collection and initial analysis. FG and AK finalized the analysis and developed the first draft. BM, SM, AM and RM reviewed the draft and provided inputs. RM provided the final review and approval. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMy sincere appreciation to my supervisor Prof. \u0026nbsp;Rose Mpembeni for the guidance and support during my entire research work. Special gratitude CIHEB Tanzania and its leadership for supporting me during my studies. My sincere thanks to Dr Jonathan Budenu, Regional Medical Officer for Tanga region, all District Medical Officers and District AIDS Control Coordinators across the five councils of Tanga for supporting me during this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eUNAIDS. The urgency of now: AIDS at a crossroads [Internet]. UNAIDS; 2024 [cited 2025 Mar 20]. Available from: https://www.unaids.org/en/resources/documents/2024/global-aids-update-2024\u003c/li\u003e\n\u003cli\u003eTACAIDS. Tanzania HIV Impact Survey 2022-2023 (THIS 2022-2023) [Internet]. Dar es salaam: National Bureau of Statistics; 2024 Sep [cited 2024 Mar 20]. Available from: http://www.nbs.go.tz\u003c/li\u003e\n\u003cli\u003eThinkShout. UNAIDS Issues New Fast-Track Strategy to End AIDS by 2030 - EGPAF [Internet]. Elizabeth Glaser Pediatric AIDS Foundation. 2014 [cited 2025 May 11]. Available from: https://pedaids.org/2014/11/20/unaids-issues-new-fast-track-strategy-to-end-aids-by-2030/\u003c/li\u003e\n\u003cli\u003eKennedy CE, Fonner VA, Sweat MD, Okero FA, Baggaley R, O\u0026rsquo;Reilly KR. Provider-Initiated HIV Testing and Counseling in Low- and Middle-Income Countries: A Systematic Review. AIDS Behav. 2013 Jun;17(5):1571\u0026ndash;90. \u003c/li\u003e\n\u003cli\u003eBrown LB, Miller WC, Kamanga G, Nyirenda N, Mmodzi P, Pettifor A, et al. HIV partner notification is effective and feasible in sub-Saharan Africa: Opportunities for HIV treatment and prevention. J Acquir Immune Defic Syndr 1999. 2011 Apr 15;56(5):437. \u003c/li\u003e\n\u003cli\u003eJubilee M, Park FJ, Chipango K, Pule K, Machinda A, Taruberekera N. HIV index testing to improve HIV positivity rate and linkage to care and treatment of sexual partners, adolescents and children of PLHIV in Lesotho. PloS One. 2019;14(3):e0212762. \u003c/li\u003e\n\u003cli\u003eNACP. National Accelerated Action Plan on HIV Testing Services 2019-2020. Dodoma: NACP; 2018. \u003c/li\u003e\n\u003cli\u003eHelleringer S, Kohler HP, Frimpong JA, Mkandawire J. Increasing uptake of HIV testing and counseling among the poorest in sub-Saharan countries through home-based service provision. J Acquir Immune Defic Syndr 1999. 2009 Jun 1;51(2):185\u0026ndash;93. \u003c/li\u003e\n\u003cli\u003eMwango LK, Stafford KA, Blanco NC, Lavoie MC, Mujansi M, Nyirongo N, et al. 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Recruiting male partners for couple HIV testing and counselling in Malawi\u0026rsquo;s option B+ programme: an unblinded randomised controlled trial. Lancet HIV. 2015 Nov;2(11):e483\u0026ndash;91. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"HIV Testing, Sexual Partners, Index testing, partner notification services, PLHIV","lastPublishedDoi":"10.21203/rs.3.rs-7180477/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7180477/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIdentifying people living with HIV (PLHIV) is recognized as an important and challenging goal of the UNAIDS 95-95-95. 87% of PLHIV worldwide and 83% in Tanzania are unaware of their HIV status. HIV index testing (also called partner notification services) involves elicitation of sexual partners and biological children, tracing and offering an HIV test, and linkage to care. Index testing has been proven to be a safe and effective intervention in Sub-Saharan Africa. We sought to determine factors affecting the uptake of HIV testing among sexual partners through the index client modality among adults in Tanga Region\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethodology\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA quantitative cross-sectional study was carried out across 8 high-volume CTCs in Tanga region. We recruited 435 participants enrolled in CTC from January 2018 to August 2020 using convenient sampling, we also purposefully selected 70 health providers. Data was collected using questionnaires and analysed descriptively using SPSS.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf the 435 participants, 55.6% were aged 26-35 years, 66% were female, 59.3% were farmers or petty traders, and 80.9% were on ART for one year or more. About 74% listed at least one sexual partner with an elicitation ratio of 1:1.3.159 out of 287 contacts with unknown HIV status were reached and tested (55.4%), 54 were HIV+ (34%). Having multiple sexual partners (aOR\u003csub\u003e =\u003c/sub\u003e 23.04) and non-disclosure (aOR\u003csub\u003e \u003c/sub\u003e= 2.22) were significantly associated with increased odds of listing sexual partners. Leading challenges in contact tracing include a wrong address (20%), unreachable phone numbers (19%), long distances from facilities (7%), and clients’ travel (16%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIndex testing is an acceptable and effective intervention to reach previously PLHIV. Support and scale-up of this intervention to all facilities offering HIV testing and care services is warranted. Addressing identified challenges will further improve the intervention’s effectiveness.\u003c/p\u003e","manuscriptTitle":"Factors Associated with Uptake of Hiv Index Testing Among Plhiv and Their Sexual Partners in Tanga Region, Tanzania. A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-03 06:37:17","doi":"10.21203/rs.3.rs-7180477/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"252533847011984466144982931433739698506","date":"2025-08-27T13:13:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"102182179837327838969646038898395351546","date":"2025-08-27T04:35:51+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-26T09:06:46+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-20T09:31:23+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-29T06:30:45+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-27T12:57:49+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2025-07-27T09:50:10+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"bcc93b7a-3003-40f2-856c-185703a37830","owner":[],"postedDate":"September 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-09-03T06:37:17+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-03 06:37:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7180477","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7180477","identity":"rs-7180477","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}