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Individual and partnership factors associated with anticipated versus actual partner notification following STI diagnosis among men who have sex with men and/or with transgender women in Lima, Peru

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Factors Associated with Partner Notification Following STI Diagnosis among Men Who Have Sex with Men and/or with Transgender Women in Lima, Peru

 

Introduction:

- Partner notification (PN) focuses public health efforts on high risk sexual partnerships to interrupt transmission.

- Factors affecting PN: structural (testing center availability), biological (STI diagnosis), individual (personal values, healthcare mistrust), and partnership (type, future sexual contact).

- Previous studies have used anticipated PN or report a retrospective overall PN rate, which is limited by social desirability bias or misses partner-specific information.

- We evaluated factors guiding PN following STI diagnosis, including what drives discordances between anticipated and actual PN.

 

Methods:

Study Design

-        A secondary analysis from 2 parallel PN intervention trials for MSM with newly diagnosed STIs from 2012 – 14 in Lima

Eligibility criteria

-       ≤ 18 years old;

-       Assigned male sex at birth; and

-       Sex with a male or male-to-female transgender partner in the previous 12 months

Data Collection

-       Participants reported their three most recent partners’ characteristics, anticipated PN practices, and then reported actual PN outcomes 14-days following STI diagnosis.

Data Analysis

-       Main outcome: Self-reported notification for each recent partner at 14-day follow-up

-       Secondary outcome: “PN discordance” – reported notification events that did not align with the participant’s anticipated behavior

-       In this analysis of control-arm participants, GEE analyses assessed factors guiding anticipated and actual PN outcomes.

 

Results:

-       35% of partners were notified, though only 51% of anticipated PN occurred and 26% of actual PN events were unanticipated.

-       47% of participants did not notify any partners; 24% notified all of their partners; and 29% notified only certain partners.

-       PN was more common with: stable partners (vs casual or commercial); PN intention; participants perceiving PN as a peer norm; and following condom-protected intercourse (trend levels).

 

Conclusions:

-       To our knowledge, no previous study of MSM has tracked partner-specific anticipated versus actual notification

-       Differences in partnership type, perceptions of transmission risk given the sexual acts performed, and perceived social norms result in distinct patterns of PN among MSM.

-       Anticipated notification is only an imperfect predictor of actual notification; existing communication patterns and risk perceptions can more powerfully influence notification behavior than simple intention.

-       Knowledge of partnership contexts and community standards are critical for tailoring future PN interventions for MSM in Latin America.

 

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