Objectives A detailed understanding of intentions and practices related to partner notification (PN) following STI diagnosis can improve control strategies. We assessed participant-level and partner-level factors guiding notification behaviour among men who have sex with men and/or with transgender women (MSM-TW) in Lima, Peru, including discordances between anticipated and actual notification.
Methods Men newly diagnosed with gonorrhoea, chlamydia and/or syphilis between 2012 and 2014 reported recent partners’ characteristics, anticipated PN practices, and actual PN outcomes following diagnosis. Generalised estimating equation 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. Among all sexual partners, 35% were notified of the STI diagnosis, though only 51% of predicted PN occurred and 26% of actual notifications were unanticipated. 47% of participants notified no partners, while 24% notified all partners. PN was more common with stable versus casual (adjusted prevalence ratio (aPR), 95% CI: 0.53, 0.39 to 0.73) or commercial (aPR, 95% CI: 0.38, 0.12 to 1.21) partners, and among participants who perceived PN as normative among their peers (aPR, 95% CI: 1.96, 1.37 to 2.82). A trend towards greater notification following condom-protected intercourse was observed (aPR, 95% CI: 1.33, 0.98 to 1.81). PN frequency did not differ by type of STI diagnosed.
Anticipated notification predicted actual notification (aPR, 95% CI: 1.67, 1.19 to 2.33) only imperfectly: 81 (54%) participants’ PN practices did not match their anticipated behaviour. Successful notification despite anticipated silence (40 participants, 63 partners) was associated with stable partnerships and a normative perception of PN. Non-notification despite intention (43 participants, 73 partners) frequently occurred among participants reporting exclusively oral sex with the partner or with partners identified as activo (insertive role).
Conclusions Anticipated notification imperfectly reflects actual PN behaviour. Future interventions to improve PN among MSM-TW in Peru need to acknowledge partnership contexts.
- partner notification
- latin america
- menwho have sex with men
- sexually transmitted diseases
- public health
- sexual partners
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Handling editor Jackie A Cassell
Contributors JLC, ERS and HMB: conceptualised the analysis. JLC, ERS, JR, MVV, JS and JRL: assisted with study design and implemented the study procedures including data collection. HMB and ERS: conducted the statistical analysis. HMB, JLC, ERS, JEL and MG: interpreted the results. HMB: drafted the manuscript. All authors: edited and approved the final version of the manuscript.
Funding This research was supported by the National Institutes of Health grants R25 MH087222 (South American Program in HIV Prevention Research; PI: J. Clark), K23 MH 084611 (PI: J. Clark), K23 AI 110532 (PI: J. Lake) and R21 MH 092322 (PI: T. Coates). This work was supported in part by the Doris Duke Charitable Foundation through a grant supporting the Doris Duke International Clinical Research Fellows Program at the University of California, San Francisco.
Competing interests None declared.
Patient consent Obtained.
Ethics approval The study procedures were approved by the UCLA Office for Human Research Participant Protection (for ClinicalTrials.gov NCT01720654: IRB11-003095; for ClinicalTrials.gov NCT01720641: IRB 11-003105), the Asociacion Civil Impacta Comite de Bioetica (for ClinicalTrials.govNCT01720654: Certificate 0053-2012-CE; for ClinicalTrials.govNCT01720641: 0052-2012-CE), and the US Naval Medical Research Unit-6 (for ClinicalTrials.gov NCT01720654: Protocol HRPP NAMRU6.2012.0033), and registered with the Peruvian Instituto Nacional de Salud. Written informed consent was obtained from all study participants.
Provenance and peer review Not commissioned; externally peer reviewed.
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