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Sexual relationships, intimate partner violence and STI partner notification in Cape Town, South Africa: an observational study
  1. Catherine Mathews1,2,
  2. Moira O Kalichman3,
  3. Ria Laubscher4,
  4. Cameron Hutchison1,
  5. Koena Nkoko5,
  6. Mark Lurie6,
  7. Seth C Kalichman3
  1. 1 Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
  2. 2 School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
  3. 3 Department of Psychology, University of Connecticut, Storrs, Connecticut, USA
  4. 4 Biostatistics Unit, South African Medical Research Council, Tygerberg, South Africa
  5. 5 City of Cape Town Health Department, Cape Town, South Africa
  6. 6 Brown University School of Public Health, Providence, Rhode Island, USA
  1. Correspondence to Dr Catherine Mathews, Health Systems Research Unit, South African Medical Research Council, Tygerberg, 7505, South Africa; cathy.mathews{at}mrc.ac.za

Abstract

Objectives We aimed to identify individual and sexual partnership characteristics associated with partner notification (PN) among people with STI. We hypothesised that PN would be less likely in more casual sexual partnerships and in partnerships with intimate partner violence (IPV).

Methods We conducted an observational study among the first 330 patients with STI enrolled in a trial of a behavioural intervention to reduce STI incidence, at a clinic in a poor, Cape Town community. We included 195 index patients (those reporting STI symptoms), and conducted longitudinal analyses using participant-completed questionnaires on the day of diagnosis and 2 weeks later. Using partnership data for five recent sexual partners, we assessed factors associated with reported PN with logistic regressions, adjusting for repeated measurements on the same participant for each partner.

Results The sample included 99 males with 303 partners and 96 females with 158 partners. Males reported perpetrating IPV in 46.2% of partnerships. Females reported being IPV victims in 53.2% of partnerships. Males notified 58.1%, females 75.4% of partners during the 2 weeks following diagnosis. Type of partner was an independent correlate of PN for males and females, with the odds of PN lower in more casual partnerships. For males, reporting physical IPV perpetration in the partnership was an independent correlate of PN. For females, there was no association between IPV victimisation in a partnership and PN.

Conclusions Efforts to decrease the pool of infectious partners need to have a strong focus on the promotion of PN in casual relationships and one-night stands. IPV was not identified as a barrier to PN. In future, we need to investigate the association between IPV with an objective measure of PN success such as partner testing or treatment, or index patient reinfection.

Clinical trial registration PACTR201606001682364; Pre-results.

  • partner notification
  • contact tracing
  • africa

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Handling editor Jackie A Cassell

  • Contributors CM, SCK and MOK conceptualised the study. MOK, SCK, CM, KN and ML contributed to the acquisition of data for the study. RL and CH performed the statistical analyses. CM drafted the manuscript. All authors contributed to revising it and approved the final version.

  • Funding This research was supported by a grant from the National Institute of Health under award number R01HD074560. This research was also supported by funding from the South African Medical Research Council.

  • Competing interests None declared.

  • Ethics approval The study was approved by the Ethics Committee of the South African Medical Research Council (EC018-10/2013) and the University of Connecticut Institutional Review Board (H12-340).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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