Low Partner Testing in High HIV Prevalence Setting in Freetown, Sierra Leone: A Retrospective Study

Abstract Objective: Our study aimed at assessing partner testing and HIV prevalence among individuals tested at an urban tertiary hospital in Sierra Leone. Results: Of the 3808 clients tested for HIV at Connaught Hospital in Freetown from January to December 2017, 2048(53.8%) were females. Median age was 31 (IQR 24 – 42) years and 2104 (55.3%) were single. While 3014(79.1%) had Provider Initiated Testing and Counselling (PITC), 794 (20.9%) had Client Initiated Testing and Counselling (CITC). HIV test was positive in 925 (24.3%) {CI 22.9 – 25.6, P= 0.00} clients. Of the 17 (0.4%) partners tested for HIV, 9 (52.9%) were positive. PITC yielded more HIV positive cases (760, 25.2%) than CITC (165, 20.8%). Partner testing (CI: 1.45 – 10.20, P=0.007), female sex (CI: 1.32 – 1.80, P=0.000) and PITC (CI: 1.08 – 1.61, p=0.006) were associated with a positive HIV diagnosis. With demonstrated high HIV prevalence and low partner testing, we recommend for stakeholders in the HIV response to address the address the challenges of disclosure and adopt new HIV testing approaches.