title: Surveillance of HIV assisted partner services using routine health information systems in Kenya.
abstract: The utilization of routine health information systems (HIS) for surveillance of assisted partner services (aPS) for HIV in sub-Saharan is sub-optimal, in part due to poor data quality and limited use of information technology. Consequently, little is known about coverage, scope and quality of HIV aPS. Yet, affordable electronic data tools, software and data transmission infrastructure are now widely accessible in sub-Saharan Africa.
  
  
  
  We designed and implemented a cased-based surveillance system using the HIV testing platform in 18 health facilities in Kenya. The components of this system included an electronic HIV Testing and Counseling (HTC) intake form, data transmission on the Global Systems for Mobile Communication (GSM), and data collection using the Open Data Kit (ODK) platform. We defined rates of new HIV diagnoses, and characterized HIV-infected cases. We also determined the proportion of clients who reported testing for HIV because a) they were notified by a sexual partner b) they were notified by a health provider, or c) they were informed of exposure by another other source. Data collection times were evaluated.
  
  
  
  Among 4351 clients, HIV prevalence was 14.2 %, ranging from 4.4-25.4 % across facilities. Regardless of other reasons for testing, only 107 (2.5 %) of all participants reported testing after being notified by a health provider or sexual partner. A similar proportion, 1.8 % (79 of 4351), reported partner notification as the only reason for seeking an HIV test. Among 79 clients who reported HIV partner services as the reason for testing, the majority (78.5 %), were notified by their sexual partners. The majority (52.8 %) of HIV-infected patients initiated their HIV testing, and 57.2 % tested in a Voluntary Counseling and Testing (VCT) site co-located in a health facility. Median time for data capture was 4 min (IQR: 3-15), with a longer duration for HIV-infected participants, and there was no reported data loss.
  
  
  
  aPS surveillance using new technologies is feasible, and could be readily expanded into HIV registries in Kenya and other sub-Saharan countries. Partner services are under-utilized in Kenya but further documentation of coverage and implementation gaps for HIV and aPS services is required.
authors.affiliation: Ministry of Health, Nairobi, Kenya. pcheru@uw.edu.|National AIDS/STI Control Programme (NASCOP), Kenyatta Hospital Grounds, off Hospital Road, Nairobi, Kenya. pcheru@uw.edu.
authors.forename: Peter
authors.initials: P
authors.lastname: Cherutich
authors.affiliation: University of Washington, Seattle, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Golden
authors.affiliation: University of Washington, Seattle, USA.
authors.forename: Bourke
authors.initials: B
authors.lastname: Betz
authors.affiliation: Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Wamuti
authors.affiliation: Ministry of Health, Nairobi, Kenya.
authors.forename: Anne
authors.initials: A
authors.lastname: Ng'ang'a
authors.affiliation: Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Peter
authors.initials: P
authors.lastname: Maingi
authors.affiliation: Ministry of Health, Nairobi, Kenya.
authors.forename: Paul
authors.initials: P
authors.lastname: Macharia
authors.affiliation: Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Betsy
authors.initials: B
authors.lastname: Sambai
authors.affiliation: Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: Felix
authors.initials: F
authors.lastname: Abuna
authors.affiliation: Kenyatta National Hospital, Nairobi, Kenya.
authors.forename: David
authors.initials: D
authors.lastname: Bukusi
authors.affiliation: University of Washington, Seattle, USA.
authors.forename: Mathew
authors.initials: M
authors.lastname: Dunbar
authors.affiliation: University of Washington, Seattle, USA.
authors.forename: Carey
authors.initials: C
authors.lastname: Farquhar
mesh_terms: D000328:Adult; D016358:Contact Tracing / Q000706:statistics & numerical data*; D062665:Epidemiological Monitoring; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D063005:Health Information Systems / Q000706:statistics & numerical data*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D012747:Sexual Partners; D055815:Young Adult
keywords: Assisted partner services; HIV; Health information; Kenya; Open data kit; Surveillance