Article Text
Abstract
Introduction A detailed understanding of partner notification (PN) practices following STI diagnosis can improve PN strategies. Using data from 2 PN intervention trials in Lima, Peru, we assessed participant- and partner-level factors guiding partner-specific STI notification behaviour, including discordances between anticipated and actual notification.
Methods From 2012–14, newly STI-diagnosed (gonorrhoea, chlamydia, syphilis) men who have sex with men (MSM) and/or with transgender women in Lima reported recent partners’ characteristics, anticipated PN practices, and actual PN outcomes 14 day following STI diagnosis. In this sub-analysis of control-arm participants, GEE Poisson regression analyses assessed factors guiding PN outcomes.
Results Participants (n=150) predominantly identified as homosexual (70%) and moderno (versatile sexual role, 55%); 55% of partners (n=402) were casual. 35% of partners were notified overall, though only 51% of anticipated PN occurred and 26% of notifications were unanticipated. 47% of participants did not notify any partners, while 24% notified all partners. PN was more frequent for main vs. casual (adjusted prevalence ratio [aPR] 0.55, p<0.01; adjusted for anticipated PN) or commercial (aPR 0.29, p<0.05) partners, with a trend toward notifying partners that used condoms (crude PR 1.30, p=0.09). PN frequency did not differ by STI diagnosis. Anticipated PN predicted actual PN (aPR 1.60, p<0.01) imperfectly as 81 (54%) participants’ PN practices did not match anticipated behaviour. Successful notification despite anticipated silence (40 participants, 63 partners) was associated with stable partnerships and perceived community norms supporting PN. Failure of PN despite intent (43 participants, 73 partners) more frequently occurred when oral sex with the partner was exclusively reported, with a trend towards identifying the partner as activo (insertive role).
Conclusion Anticipated PN imperfectly reflects actual PN behaviour. Future interventions to improve notification should acknowledge the differing partnership contexts maintained by MSM.