A UK audit of HIV partner notification and the testing of children of people living with HIV

OBJECTIVES: HIV partner notification (PN) and testing of children of adults living with HIV (including adult children) are key interventions for diagnosis and linkage to care. We audited UK HIV and sexual health services' policies, procedures and practice relating to PN and testing of children. METHODS: The audit focused on new patients and comprised service-level questions (once per service) and case note reviews (up to 40 patients per service). Data were collected June-July 2025, covering the preceding 12 months. RESULTS: We received responses covering 143 services across the United Kingdom. The case note review included 3297 people ('index patient'), with 0.61 contacts tested per index patient. More than half (59.8%) of contactable contacts were tested, and 15.8% of contacts tested were diagnosed with HIV. Most (79.6%) index patients had a PN plan in place within 4 weeks of diagnosis, 69.2% of index patients had a discussion at diagnosis around contacts' post-exposure prophylaxis need. Notably, 83.1% of services provided or had referral pathways for HIV testing of children. Of 490 children requiring testing, 49.8% had been tested and 16.5% were undergoing testing. Forty-eight children (9.8%) had not been tested, with no documented plan or reason for not testing. CONCLUSION: PN remains highly effective for reaching people with undiagnosed HIV; however, PN performance has declined and falls below national standards. Similarly, persistent gaps in practice mean some children of adults with HIV are not tested. Services must adopt policies and procedures to ensure PN is prioritized, and all children requiring HIV testing are tested.