Table 2.

Barriers and facilitators of HIV partner status notification by key population in low and lower-middle-income countries, 2000–2023

Population type	Notification of sexual partners by people living with HIV		Testing of sexual partners after they have been notified of possible HIV exposure		Linking partners living with HIV to treatment services
	Barriers	Facilitators	Barriers	Facilitators	Barriers	Facilitators
People living with HIV [47, 54–56, 58, 59, 62, 63, 66, 73, 76, 79–82, 88, 91, 92]	1) Fear of Stigma and Discrimination 2) Fear of Violence 3) Fear of Relationship Loss 4) Fear of Breach of Confidentiality 5) Fear of Rejection and Abuse 6) Fear of Negative Repercussions 7) Fear of Loss of Financial Support 8) Lack of HIV Knowledge and Low Risk Perception 9) Social-Ecological Factors 10) Challenges in Communication 11) Time Constraints 12) Lack of Partner Contact Information 13) Lack of Support from Partner 14) Shame and Denial	1) Emotional Factors 2) Moral Duty and Responsibility 3) Assisted Partner Notification	1) Fear of Consequences of a Positive Diagnosis 2) Fear of Stigma and Discrimination 3) Fear of Intimate Partner Violence 4) Fear of Testing Itself 5) Relationship Dissolution and Distance 6) Lack of Trust in Healthcare providers 7) Gender Norms and Inequality 8) Reluctance of Key Populations	1) Increased Access to HIV Testing 2) Assisted Partner Notification 3) Community-Based HIV Testing 4) Health System Factors	1) HIV Stigma 2) Spouse Negligence or Violence	1) Initiating antiretroviral therapy on the Same-day as Testing
People newly diagnosed with HIV [45, 46, 51, 64, 67, 68, 71, 72, 74, 77, 83, 90, 92]	1) Fear of Stigma and Discrimination 2) Fear of Relationship Loss 3) Fear of Negative Repercussions 4) Challenges in Communication 5) Lack of HIV Knowledge and Low Risk Perception 6) Lack of Partner Contact Information 7) Social-Ecological Factors 8) Shame and Denial	1) Emotional Factors 2) Positive Cultural Practices 3) Assisted Partner Notification	1) Fear of Stigma and Discrimination 2) Fear of Intimate Partner Violence 3) Fear of Consequences of a Positive Diagnosis 4) Refusal by Partners 5) Health System Barriers 6) Relationship Dissolution and Distance	1) Increased Access to HIV Testing 2) Community-Based HIV Testing 3) Assisted Partner Notification	1) Loss of retention in care or Migration 2) Inappropriate Services	1) Support from Family, Relatives, and the Social System 2) Positive Patient-Staff Relationship 3) Well-Organized Clinic Procedures 4) Presence of Disease Symptoms
Women living with HIV [42, 87, 93, 95]	1) Fear of Stigma and Discrimination 2) Fear of Relationship Loss 3) Fear of Negative Repercussions 4) Fear of Rejection and Abuse 5) Fear of Breach of Confidentiality 6) Shame and Denial 7) Lack of HIV Knowledge and Low Risk Perception 8) Time Constraints	1) Emotional Factors 2) Moral Duty and Responsibility	NRa	1) HIV Self-Testing	NRa	NRa
Pregnant women [39, 40, 48, 50, 53, 57, 61, 84–86, 89, 94]	1) Fear of Relationship Loss 2) Fear of Violence	1) Emotional Factors 2) Positive Cultural Practices 3) Partner Support 4) Moral Duty and Responsibility 5) HIV Counseling Services 6) Incentives and Facilities	NRa	1) HIV Self-Testing 2) Community-Based HIV Testing 3) Partner Support	1) HIV Stigma 2) Spouse Negligence or Violence,	1) Partner Support
Key populations including gay men and other men who have sex with men, transgender people, sex workers, people in prisons [44, 60]	1) Fear of Stigma and Discrimination 2) Fear of Loss of Financial Support 3) Fear of Rejection and Abuse 4) Fear of Violence 5) Fear of Negative Repercussions 6) Fear of Breach of Confidentiality 7) Fear of Relationship Loss 8) Social-Ecological Factors 9) Challenges in Communication 10) Lack of Support from Partner	1) Assisted Partner Notification 2) Emotional Factors 3) Moral Duty and Responsibility	NRa	1) Assisted Partner Notification 2) Increased Access to HIV Testing 3) Community-Based HIV Testing 4) Health System Factors	NRa	NRa
Sexual partners of people living with HIV or pregnant women [41, 48, 52, 55–57, 61, 70, 75, 78–80, 82]	1) Fear of Stigma and Discrimination 2) Fear of Violence 3) Fear of Negative Repercussions 4) Fear of Relationship Loss 5) Fear of Rejection and Abuse 6) Fear of Breach of Confidentiality 7) Fear of Loss of Financial Support 8) Challenges in Communication 9) Social-Ecological Factors	1) Emotional Factors 2) Assisted Partner Notification 3) Partner Support	1) Fear of Stigma and Discrimination 2) Fear of Consequences of a Positive Diagnosis 3) Fear of Intimate Partner Violence 4) Fear of Testing Itself 5) Refusal by Partners 6) Relationship Dissolution and Distance 7) Gender Norms and Inequality 8) Health System Barriers 9) Reluctance of Key Populations	1) HIV Self-Testing 2) Increased Access to HIV Testing 3) Partner Support 4) Assisted Partner Notification 5) Health System Factors	1) HIV Stigma 2) Spouse Negligence or Violence,	NRa
Health care workers, health advisors, HIV testing and counseling counselors [37, 38, 43, 46, 49, 56, 58–60, 64, 65, 69, 70, 74, 82]	1) Fear of Stigma and Discrimination 2) Fear of Relationship Loss 3) Fear of Violence 4) Fear of Rejection and Abuse 5) Fear of Negative Repercussions 6) Fear of Breach of Confidentiality 7) Fear of Loss of Financial Support 8) Fear of Isolation and Job Loss 9) Challenges in Communication 10) Social-Ecological Factors 11) Lack of Support from Partner 12) Lack of HIV Knowledge and Low Risk Perception 13) Shame and Denial 14) Lack of Partner Contact Information	1) Emotional Factors 2) Assisted Partner Notification	1) Fear of Consequences of a Positive Diagnosis 2) Fear of Stigma and Discrimination 3) Fear of Intimate Partner Violence 4) Fear of Testing Itself 5) Relationship Dissolution and Distance 6) Health System Barriers 7) Gender Norms and Inequality 8) Lack of Trust in Healthcare providers 9) Reluctance of Key Populations	1) Increased Access to HIV Testing 2) Assisted Partner Notification 3) HIV Self-Testing 4) Community-Based HIV Testing 5) Health System Factors 6) Partner Support	1) HIV Stigma 2) Spouse Negligence or Violence 3) Inconsistent and Under-Resourced Training	1) Importance of Peer-Supported Linkages to HIV Care 2) Support from Family, Relatives, and the Social System 3) Conducting Multiple Counseling Sessions 4) Well-Organized Clinic Procedures 5) Presence of Disease Symptoms

^aNot reported