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BMC Public Health. 2019 May 29;19(Suppl 1):606. doi: 10.1186/s12889-019-6813-2.

Using partner notification to address curable sexually transmitted infections in a high HIV prevalence context: a qualitative study about partner notification in Botswana.

Author information

1
GloCal, University of California Global Health Institute, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, USA. awynn@ucsd.edu.
2
Division of Infectious Diseases & Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA. awynn@ucsd.edu.
3
Fielding School of Public Health, Department of Health Policy and Management, University of California Los Angeles, 31-269 CHS, Box 951772, Los Angeles, CA, 90095, USA.
4
Botswana-UPenn Partnership, UB Main Campus, Gaborone, Botswana.
5
David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA.
6
Charles R. Drew University of Medicine and Science, 1731 E 120th St, Los Angeles, CA, 90059, USA.
7
Faculty of Medicine, University of Botswana, Gaborone, Botswana.
8
Liverpool School of Tropical Medicine, Liverpool, UK.
9
Department of Medicine, University of Botswana, Gaborone, Botswana.
10
Wits Reproductive Health and HIV Institute, University of Witwatersrand, Johannesburg, South Africa.
11
Women's Health Research Unit, University of Cape Town, Cape Town, South Africa.

Abstract

BACKGROUND:

Partner notification is an essential component of sexually transmitted infection (STI) management. The process involves identifying exposed sex partner(s), notifying these partner(s) about their exposure to a curable STI, and offering counselling and treatment for the STI as a part of syndromic management or after results from an STI test. When implemented effectively, partner notification services can prevent the index patient from being reinfected with a curable STI from an untreated partner, reduce the community burden of curable STIs, and prevent adverse health outcomes in both the index patient and his or her sex partner(s). However, partner notification and treatment rates are often low. This study seeks to explore experiences and preferences related to partner notification and treatment for curable STIs among pregnant women receiving care in an antenatal clinic with integrated HIV and curable STI testing. Results are intended to inform efforts to improve partner notification and treatment rates in Southern Africa.

METHODS:

We conducted qualitative interviews among women diagnosed with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and/or Trichomonas vaginalis (TV) infection while seeking antenatal care in Gaborone, Botswana. Semi-structured interviews were used to obtain women's knowledge about STIs and their experiences and preferences regarding partner notification.

RESULTS:

Fifteen women agreed to participate in the study. The majority of women had never heard of CT, NG, or TV infections prior to testing. Thirteen out of 15 participants had notified partners about the STI diagnosis. The majority of notified partners received some treatment; however, partner treatment was often delayed. Most women expressed a preference for accompanying partners to the clinic for treatment. Experiences and preferences did not differ by HIV infection status.

CONCLUSIONS:

The integration of STI, HIV, and antenatal care services may have contributed to most women's willingness to notify partners. However, logistical barriers to partner treatment remained. More research is needed to identify effective and appropriate strategies for scaling-up partner notification services in order to improve rates of partners successfully contacted and treated, reduce rates of STI reinfection during pregnancy, and ultimately reduce adverse maternal and infant outcomes attributable to antenatal STIs.

KEYWORDS:

Chlamydia trachomatis; HIV; Neisseria gonorrhoeae; Partner notification; Pregnant women; Sexually transmitted infections; Southern Africa; Treatment; Trichomonas vaginalis

PMID:
31138228
PMCID:
PMC6538557
DOI:
10.1186/s12889-019-6813-2
[Indexed for MEDLINE]
Free PMC Article

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