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STI/HIV test result disclosure between female sex workers and their primary, non-commercial male partners in two Mexico-US border cities: a prospective study
  1. Heather A Pines1,
  2. Thomas L Patterson2,
  3. Gudelia Rangel3,
  4. Gustavo Martinez4,
  5. Angela R Bazzi5,
  6. Monica D Ulibarri2,
  7. Jennifer L Syvertsen6,
  8. Natasha K Martin7,8,
  9. Steffanie A Strathdee1
  1. 1Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA
  2. 2Department of Psychiatry, University of California, San Diego, La Jolla, USA
  3. 3Department of Population Studies, El Colegio de La Frontera Norte, Tijuana, Baja California, México
  4. 4Federación Mexicana de Asociaciones Privadas (FEMAP), Ciudad Juárez, Chihuahua, México
  5. 5Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
  6. 6Department of Anthropology, The Ohio State University, Columbus, USA
  7. 7School of Social and Community Medicine, University of Bristol, Bristol, UK
  8. 8Social and Mathematical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to Dr Heather A Pines, Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Dr., MC 0507, La Jolla, CA 92093-0507, USA; hpines{at}ucsd.edu

Abstract

Objectives Disclosure of sexually transmitted infections (STI)/HIV diagnoses to sexual partners is not mandated by public health guidelines in Mexico. To assess the feasibility of couples-based STI/HIV testing with facilitated disclosure as a risk-reduction strategy within female sex workers’ (FSW) primary partnerships, we examined STI/HIV test result disclosure patterns between FSWs and their primary, non-commercial male partners in two Mexico–US border cities.

Methods From 2010 to 2013, 335 participants (181 FSWs and 154 primary male partners) were followed for 24 months. At semiannual visits, participants were tested for STIs/HIV and reported on their disclosure of test results from the previous visit. Multilevel logistic regression was used to identify individual-level and partnership-level predictors of cumulative (1) non-disclosure of ≥1 STI test result and (2) non-disclosure of ≥1 HIV test result within couples during follow-up.

Results Eighty-seven percent of participants reported disclosing all STI/HIV test results to their primary partners. Non-disclosure of ≥1 STI test result was more common among participants who reported an STI diagnosis as part of the study (adjusted OR=3.05, 95% CI 1.13 to 8.25), while non-disclosure of ≥1 HIV test result was more common among participants in longer-duration partnerships (AOR=1.15 per year, 95% CI 1.03 to 1.28). Drug use before/during sex within partnerships was associated with non-disclosure of both STI (AOR=5.06, 95% CI 1.64 to 15.62) and HIV (AOR=4.51, 95% CI: 1.32 to 15.39) test results.

Conclusions STI/HIV test result disclosure was highly prevalent within FSWs’ primary partnerships, suggesting couples-based STI/HIV testing with facilitated disclosure may be feasible for these and potentially other high-risk, socially marginalised couples.

  • PREVENTION
  • CHLAMYDIA INFECTION
  • SYPHILIS
  • GONORRHOEA
  • HIV

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