Initial and Subsequent Engagement of Recently Diagnosed Persons Living with HIV in Contact Tracing Interviews Conducted by Public Health Practitioners

Abstract

Contact tracing is effective in disrupting HIV transmission, but may be limited by the reluctance or inability of recently HIV-diagnosed persons (RDPs) to engage collaboratively with public health. Leveraging an ongoing study endeavoring to increase the yield of standard-of-care contact tracing by re-interviewing a subset of RDPs, we assessed RDP engagement during first and second interviews and compared the two. We used Likert scale scores to develop and employ a 35-point index tool, to assess engagement during first interviews (standard of care) and second interviews (executed in a parent study to inform RDPs of clustering in an attempt to identify additional contacts). Cronbach’s Alpha was used to assess the internal consistency of the index, and differences between the index scores of paired (first vs. second) interviews were assessed using paired Student’s t-tests. Between January/2021 and December/2022, first interviews were performed with 120 RDPs, and second interviews with 20 of the 120 RDPs. The index was simple to use and internally consistent (Alpha = 0.93). Higher engagement was observed in first interviews (~ 30/35, soon after diagnosis) and lower engagement in second interviews (~ 22/35, usually several weeks later) (P < 0.01). Using a novel engagement tool, we observed diminished engagement between first and second contact tracing interviews, suggesting the limits of RDPs’ collaboration with public health praxis. The simple, reliable, and informative engagement index we developed and tested may be used in the future to explore interactions between RDPs and public health practitioners.