Partner notification for sexually transmitted infections and perception of notified partners

Abstract

Objective: Learn the perceptions of patients with sexually transmitted infections and sexual partners who are notified of the infection. Method: A descriptive and qualitative study, based on the collective subject discourse technique, was conducted in four healthcare centers of reference in Fortaleza, Ceará, from March to July 2014. The sample comprised 21 subjects (11 index patients and 10 notified partners). Results: The index patients reported complicity, concern about the partner's health and revelation of diagnosis aiming to preserve the relationship. The partners showed antagonistic perceptions: tranquilitybetrayal, fear of death, of incurability and the diagnosis, especially of HIV. The reasons for coming to a healthcare center were: fear of being sick, attenuation of guilt of infection transmission, need for diagnosis, early start of treatment. Conclusion: Fear of losing trust, insecurities when dealing with a sexual infection and being responsible or coresponsible for the transmission were the predominant feelings. Various types of partner notification were reported (verbal, telephone, notification card), according to individual convenience. This study suggests the use of alternative methods of notification and an integrated system of notification.

Difficulties and facilities for notification of sexual partners with sexually transmitted infections

“…Two barriers to successful reporting have been observed in this and other surveys (4)(5) : resistance of index patients to reveal the infection to their contacts due to the fear of the partner's reaction, anger or shame; and absence of alternative methods for the professional to directly contact sexual partners.…”

“…Another facilitating strategy in the field of communication was the use of a communication card offered to the patient to deliver to the partner. A study carried out in Brazil considered the card as a means that allowed the index patient to communicate the partner without offering more information (4) . Advances in the approach of partners by professionals have been recommended in the country with the insertion of new technological tools (electronic, social networks), besides the conventional methods (correspondence, communication card, telephone contact) (13) , following the example of international experiences (12) .…”

“…This intervention is complex because of the demotivation people to reveal their infected status to their sexual partners in the face of subjective issues related to sexuality, prejudice, rejection, or feelings of guilt, shame, and fear of exposing their sexual behaviors (3)(4) . Therefore, it is recommended that professionals be aware of the safety and preference of index patients for the most effective means of communication and the challenges involved in locating partners (2) .…”

“…In Brazil, the Ministry of Health recommends that the approach of partners be performed by health professionals. However, a study showed that the attendance of sexual partners depends only on index patients, what may be associated with the lack of detail in the STI national protocol of the responsibilities of professionals and institutions to ensure the success of this action (4) .…”

“…In this regard, it is considered important to analyze aspects inherent in the notification of partners in the light of the essential competences of health promotion, because it allows an expanded view of how this action is being carried out in health institutions, especially face of the lack of research on this theme in the Brazil (4) . In addition, this study can provide support for developing guidelines to approach partners of STI patients as a way to assist health professionals and services to increase the recruitment of sexual contacts.…”