Sexual relationships, intimate partner violence and STI partner notification in Cape Town, South Africa: an observational study

Abstract

ObjectivesWe 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).MethodsWe 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.ResultsThe 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.ConclusionsEfforts 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 registrationPACTR201606001682364; Pre-results.

Partner notification and treatment for sexually transmitted infections among pregnant women in Cape Town, South Africa

“…9 In another study at a community-based clinic in South Africa, participants reported notifying only 64% of partners of their STI diagnosis. 10 Among South Africans, fears of intimate partner violence and relationship dissolution have been identified as barriers to partner notification following diagnosis with a STI. 11,12 Others have been conducting research on how best to optimize STI management, including partner notification, in South Africa since the late 1990s.…”

Partner notification and treatment outcomes among South African adolescents and young adults diagnosed with a sexually transmitted infection via laboratory-based screening

“…21 While the optimal method for partner notification is unknown in South Africa and similar settings, the latest South Africa National Strategic Plan for HIV, TB, and STIs outlines the need to assess ideal partner notification methods and focus on key populations, including adolescent girls and young women. 22 This issue is of great importance for young people, who are less likely to notify their partners of STIs compared with older adults, [23][24][25][26] likely contributing to STI recurrence rates of up to 60% among South African youth. 27 The limits of syndromic STI management among youth, 11,[27][28][29][30][31] alongside the current lack but ongoing development of cost-effective, point-of-care diagnostics, 32 support the argument for lower-resourced settings to consider laboratory-based STI screening, and thus appropriate medications for individuals and their sexual partners for the first time.…”

Is HIV index testing and partner notification safe for adolescent girls and young women in low‐ and middle‐income countries?

“…GBV-associated HIV transmission may be compounded over the sexual life course of AGYW [45] as repeated acts of violence perpetrated by more than one partner are commonly reported [46,47]. While cases of IPV linked directly to HIV PN have not been reported following HIV PN among adult women in the literature [48][49][50][51], the risk of IPV following HIV PN may be greater for AGYW and must be monitored.…”