Factors Associated with Partner Notification Following STI Diagnosis among Men Who Have Sex with Men and/or with Transgender Women in Lima, Peru
- 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.
- A secondary analysis from 2 parallel PN intervention trials for MSM with newly diagnosed STIs from 2012 – 14 in Lima
- ≤ 18 years old;
- Assigned male sex at birth; and
- Sex with a male or male-to-female transgender partner in the previous 12 months
- Participants reported their three most recent partners’ characteristics, anticipated PN practices, and then reported actual PN outcomes 14-days following STI diagnosis.
- 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.
- 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).
- 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.