Abstract
Background:
HIV partner notification is known as one of the methods to increase HIV testing. Evaluating the barriers, facilitators, and recommendations to improve it can lead to the increased uptake of HIV testing, as well as achieving the 95-95-95 UNAIDS targets. Therefore, the present study aimed to evaluate the approaches, barriers, and facilitators of HIV partner notification from different aspects.
Methods:
The barriers and facilitators of HIV partner notification were evaluated. Also, some recommendations were presented to improve the HIV partner notification program in Iran.
Findings:
Based on the results, HIV stigma and discrimination were identified as the most important barriers, and the main facilitator was the support from the spouse or sexual/injection partner and family. Also, the results showed that the HIV partner notification program in Iran was in line with the international guidelines introduced by the World Health Organization. However, it had weaknesses and challenges in various aspects such as the content, the method of implementation, monitoring, and evaluation.
Conclusion:
Overall, this study has shown a critical need to strengthen the HIV partner notification program in Iran. HIV partner notification program can be strengthened by considering the introduced facilitators, from different aspects including content, implementation, monitoring, and evaluation. These measures will ultimately increase HIV testing and thus achieve UNAIDS targets.
Keywords: HIV partner notification, Barriers, Facilitators, Guideline, Iran
Introduction
Despite Iran’s relatively low HIV prevalence, the disease continues to present a significant public health challenge.1-3 HIV partner notification is widely acknowledged as an effective method to enhance HIV testing. This program greatly influences the early detection of new HIV infections, the prevention of transmission, and the provision of optimal treatment and support services.4 Assessing the barriers, facilitators, and recommendations for improvement can help increase HIV testing uptake and contribute to reaching the 95-95-95 UNAIDS targets.5 Nonetheless, despite the program’s importance, challenges such as stigma and discrimination, fears surrounding the disclosure of personal information, and a lack of social and psychological support impede the HIV partner notification process in Iran. These obstacles are especially pronounced among women and vulnerable individuals, as well as those engaging in risky sexual and injection practices, leading many to hesitate in disclosing their status or informing their partners.6,7 Moreover, the shortcomings of current guidelines, along with the necessity to review and update them to better suit Iran’s cultural and social contexts, present further challenges.4 Accordingly, this study seeks to evaluate the approaches, barriers, and facilitators of HIV partner notification from multiple perspectives and dimensions.
Key Findings
The present study analyzed the most important barriers, facilitators, and policy opportunities in the field of HIV partner notification through a systematic review, qualitative research, and analysis of HIV registry data. HIV stigma and discrimination were identified as the most significant barriers. Stigma can lead to social exclusion, patients’ reluctance to seek treatment, and even serious psychological and family harm. The primary facilitator was support from spouses or sexual/injection partners, family, and social networks of PLHIV. Additionally, the results indicated that the HIV partner notification program in Iran aligned with the international guidelines established by the World Health Organization. However, it faced weaknesses and challenges in various aspects, such as content, implementation methods, and monitoring and evaluation. Therefore, it should be revised and implemented more effectively to reduce barriers, enhance facilitators like psychological and social support, and address the needs of vulnerable groups.
Policy Recommendations
1. Increasing Public and Specific Awareness:
The first step toward the success of an HIV partner notification program is to increase public awareness and reduce stigma and discrimination against people living with HIV (PLHIV). Organizing educational campaigns for PLHIV, the general public and specialized courses for healthcare providers, especially those involved in the HIV partner notification program, can enhance the program’s implementation, improve public attitudes, and provide a foundation for the social acceptance of patients. Utilizing media and social networks will be particularly effective in this regard.
2. Maintaining and Enhancing Patient Confidentiality and Rights:
The success of the HIV partner notification program depends on compliance with the confidentiality of patient information and respect for their human dignity. Developing and implementing protocols for maintaining and transferring information, obtaining informed consent, and educating healthcare providers about the importance of confidentiality are essential steps to enhance patients’ trust in the healthcare system.
3. Strengthening psychosocial support:
PLHIV, especially women and vulnerable groups, need easy and free access to psychological and social counseling services. Providing individual and family counseling and support for PLHIV facing problems such as social exclusion, domestic violence, or depression after diagnosis will help boost their morale and increase their motivation to cooperate with health programs.
4. Review and revise guidelines:
Continuous review and updating of guidelines and regulations should be done in light of new scientific and cultural evidence in the country, as well as feedback from patients and experts. To improve the HIV partner notification program in Iran, the participation of PLHIV, their sexual or injection partners, healthcare providers, HIV experts and policymakers in the field of HIV, and also, the general population is necessary. Also, adapting the notification process to the individual and cultural conditions of PLHIV should be a priority.
5. Continuous monitoring and evaluation of programs:
Developing an integrated system for recording, monitoring, and evaluating the implementation of the HIV partner notification program helps to accurately identify strengths and weaknesses and make necessary corrections based on real data. Regular data collection and analysis allow for continuous review and improvement of policies.
6. Active and multi-stakeholder social participation:
The sustainability of this approach relies on the active participation of all stakeholders, including policymakers, healthcare providers, PLHIV, families, NGOs, peers, and the media. Building support networks, gaining the trust of PLHIV and the community, and fostering attitude changes are ways to successfully implement the HIV partner notification program in Iran.
Ethical and Social Considerations
When implementing all proposed policies, it is crucial to adhere to the principles of fairness, equality, and social justice. Preserving human dignity, respecting individuals’ rights to choose and obtaining informed consent in the HIV partner notification process, fully protecting the confidentiality of medical information, and providing special safeguards for vulnerable social and economic groups are essential requirements for this process. Ongoing training and supervision should also ensure professional and ethical behavior by healthcare providers.
Conclusion
Overall, this study demonstrated a critical need to strengthen the HIV partner notification program in Iran. The HIV partner notification program can be enhanced by considering the suggested facilitators from various perspectives, including content, implementation, and monitoring and evaluation. These actions will ultimately boost HIV testing and help achieve UNAIDS targets. To improve the HIV partner notification program in Iran, it is essential to involve people living with HIV, their sexual or injection partners, healthcare service providers, HIV experts, policymakers in the field, and the general population.
Citation: Tavakoli F, Haghdoost AA, Mirzazadeh A, Dehghan M, Gouya MM, Adhami M, et al. HIV partner notification program in Iran: policy brief. Addict Health. 2025;17:1709. doi:10.34172/ahj.1709
Funding Statement
Kerman University of Medical Sciences (Grant number: 401000288) financially supported the project.
Footnotes
Data Availability Statement
Not applicable.
Competing Interests
The authors declare no conflict of interests.
Ethical Approval
Kerman University of Medical Sciences ethically approved (Ethics ID: IR.KMU.REC.1401.181) the project.
References
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