HIV index testing with partner notification (PN) is the testing strategy with the highest positivity rate. Such a strategy is important at this stage of the HIV epidemic where many countries have reached or are near to reaching the global target of 90% of people living with HIV knowing their status by 2020 and other testing approaches have decreasing positivity rates. While HIV index testing and PN services have the potential to reach adolescent girls and young women (AGYW) aged 15-24 and their sexual partners in need of HIV testing services (HTS), the implementation of PN requires careful consideration to minimize potential social harms for AGYW who may be experiencing violence or stigma, fear violence or stigma, or who may have acquired HIV as a result of violence. Paramount among considerations regarding the roll-out of HIV PN for AGYW is ensuring voluntarism, with informed consent and the explicit right to decline, as expressly stated in the HIV Self-Testing and Partner Notification guidance document published by the World Health Organization (WHO).
YouthPower Learning reviewed the evidence on social harms linked with HIV index testing and PN, including intimate partner violence (IPV) and stigma. Using the lens that a holistic positive youth development approach can help to address the barriers and challenges associated with HIV PN among AGYW, we synthesized the potential risks to AGYW in low- and middle- income countries (LMICs) of HIV PN among this vulnerable population. Eighteen published studies were identified and reviewed spanning three main geographical areas from 1999 to 2018.