Table 2 Facilitators practiced by participants to support the implementation of VAPN services in terms of ethical implementation and yield, respectively (n = 15)

Ethical Implementation

Developing context-specific and client-centered VAPN policies and guidelines

“With the assistance of our funders CDC, PEPFAR…they have global best practices on what has worked in other countries and settings…we take that and also adopt it and adapt it to our national setting. Eswatini, we have our own culture, where they get evidence from, they also have their own culture.” (community-Eswatini, female, participant 15)

Involving relevant stakeholder groups into VAPN policy development discussions

“…so, when Kenya started developing [a VAPN policy], we ensured that everyone was put together including the human rights organizations.” (national-Kenya, female, participant 11)

Selecting and training specialized counsellors to conduct VAPN

“So, we realize that it's not everyone… PNS [partner notification services] is not for every counsellor. It depends on the age… It depends on the years of experience and the maturity of the counsellor.” (national-Kenya, female, participant 11)

Implementing creative VAPN techniques to ensure confidentiality and anonymity (e.g., developing routine health campaigns with integrated VAPN services)

“…we [healthcare workers] are coming door-to-door. We are having like a health campaign, we will test everybody. We will test maybe for blood sugar, we test maybe for non-communicable diseases but also, we test for HIV. So, when they [HCWs] test that person, he will see like okay, it was just a routine campaign. So, when they find him to be [HIV-] positive, they will record him but actually that person wouldn’t know that he was targeted.” (community-Tanzania, male, participant 1)

Implementing methods to prevent involuntary HIV status disclosure

“… most of the healthcare providers, they are always very careful that when they schedule appointments to make sure that those [medication] appointments are not scheduled on the same time.” (community-Tanzania, male, participant 1)

Rotating rural HCWs to distal healthcare facilities to prevent involuntary HIV status disclosure

“…they [country] were exploring actually moving health workers around. So that the people doing partner services weren’t working in that community, so it would kind of give them one more step of distance which was really potentially helpful for them because they have such small tiny communities.” (global, female, participant 4)

Providing psychological support for HCWs implementing VAPN services

“We always used to have like field investigator meetings you know to…go over what happened because you [HCWs] are dealing with a lot of intense psychological stuff. And you need to talk to somebody who can be that external perspective to say, ‘Oh, we understand what you are dealing with, here is what you need to do about it, we can talk about it again tomorrow’.” (global, female, participant 4)

Enhancing data safety (i.e., using methods to keep medical data safe and confidential)

“…people had signed a confidentiality agreement form which was like an agreement between the provider and the facility which is providing the [VAPN] services. Just to ensure that once it [confidentiality] is broken, somebody should be liable for that.” (community-Malawi, male, participant 2)

Identifying adverse events of VAPN implementation (e.g., hotlines and exit surveys)

“We have hotline numbers that our clients can use to report any, you know, mis-normal [activities] or challenges or anything that they may not have liked [about VAPN] but also even things that they may have liked about our program.” (national-Zimbabwe, female, participant 13)

Yield of VAPN

Sensitizing community members & HCWs to VAPN services

“This [VAPN] information is also out there as pamphlets that can be obtained and there’s posters that are also available at Ministry of Health facilities. (national-Zimbabwe, female, participant 13)

Using digital tools to support uptake of VAPN services

“I know they are piloting it, [an initiative] in Cape Town is using digital [technologies], so using media, to facilitate this [VAPN] process.” (national-South Africa, male, participant 10)

Implementing the Social Network Approach to increase uptake of VAPN services for key populations

“So, you could implement [the] social network [approach] based as one wave. So, you say, okay I have got this one client, and I am going to reach out to just this one wave of partners that they give me and that’s the end of it. Or you can have multiple waves where you keep going contact to contact, and the data really does tell us, the more waves you do, the more you are reaching this kind of harder to reach, historically harder to reach groups that really don’t self-identify or have very low contact with the health system”. (global, female, participant 4)

Conducting VAPN training for HCWs (i.e., peer-based learning)

“…implementing partners were looking like for the people who can do VPN [voluntary partner notification] really well. And when they spot those people… maybe they take a person from Facility A and then they take that person to another facility like to provide hands-on skills to the people in that facility.” (community-Tanzania, male, participant 1)

Integrating and implementing existing HIV testing strategies to support VAPN services (i.e., HIV self-testing, mobile testing, and workplace testing)

“… we did see a number of [studies] using self-testing and showing higher [VAPN] uptake rates.” (global, female, participant 4)

Implementing opt-out VAPN services

“We’ve even moved to what we call the 'opt-out approach to increase the [VAPN] uptake.” (community-Eswatini, female, participant 15)

Motivating rural HCWs to provide VAPN services to their own communities

“[VAPN works better in more rural areas] because relationships might be a bit more personal, so there's more opportunity to talk… also because generally those nurses have a better… a much stronger feeling with their community that they serve, a much stronger bond. So, [nurses] they because they feel much more connected to that area and sometimes even live in there, I think they're more likely to want to help because it indirectly means helping your community.” (national-South Africa, male, participant 10)

Collaborating between communities and healthcare facilities to support linkage to care

“…we had the community linkage approach whereby people who were tested [HIV] positive were also linked to people we call them expert clients.” (community-Tanzania, male, participant 14)