Leading with HOPE: A Clinical Communication Campaign to Promote Partner HIV Testing in Assisted Partner Notification and Antenatal Care Programs in Uganda

Abstract

Among heterosexual couples in sub-Saharan Africa, fears of relationship dissolution and inability to bear healthy children following an HIV-positive result remain barriers to HIV testing. Recently expanded availability of pre-exposure prophylaxis (PrEP) affords a critical opportunity to promote HIV testing with reassuring communication that highlights use for relationship preservation and healthy childbearing. We aimed to develop a theoretically-grounded communication intervention to promote partner HIV testing within assisted partner notification (APN) and antenatal care (ANC) programs in Uganda. Through an 18-month iterative co-creation process, we developed the HOPE Clinical Communication Campaign (HOPE-CCC) in collaboration with a project advisory board (PAB) of health workers and the Ugandan Ministry of Health (MoH). We designed gain-framed, patient-facing materials (brochures, poster, invitation cards, self-test kit stickers) that frame PrEP as a family-centered benefit of HIV testing. Multiple cycles of PAB field-testing and feedback informed revisions to enhance relevance and easy integration into clinical workflow. Fifteen qualitative interviews with diverse clients and partners confirmed the relevance and demand for the messaging, supported the acceptability of materials, and guided the development of an accompanying patient-centered counseling strategy (Hear-Offer-Plan-Evaluate). MoH collaboration ensured alignment with national policies and potential for scalability across Ugandan HIV testing settings. HOPE-CCC is well-positioned for further evaluation of its acceptability, feasibility and impact on partner testing in APN and ANC programs. Highlighting the availability of PrEP and its benefits in relationship preservation and healthy childbearing has potential to enhance the effectiveness of HIV testing promotion strategies for heterosexual couples.