Anticipated Notification of Sexual Partners following STD Diagnosis among Men Who Have Sex with Men and Transgender Women in Lima, Peru: A Mixed Methods Analysis.
BACKGROUND
New strategies to support partner notification (PN) are critical for STD control and require detailed understanding of how specific individual and partnership characteristics guide notification decisions.


METHODS
From 2011 to 2012, 397 MSM and TW recently diagnosed with HIV, syphilis, or another STD completed a survey on anticipated notification of recent sexual partners and associated factors. Qualitative interviews were conducted with a subset of participants to provide further depth to quantitative findings. Prevalence ratios and generalized estimating equation (GEE) models were used to analyze participant- and partner-level factors associated with anticipated PN.


RESULTS
Among all partners reported, 52.5% were described as "Very Likely" or "Somewhat Likely" to be notified. Anticipated notification was more likely for main partners than casual (adjusted Prevalence Ratio [aPR], 95% CI: 0.63, 0.54-0.75) or commercial (aPR, 95% CI: 0.44, 0.31-0.62) partners. Other factors associated with likely notification included perception of the partner as an STD source (aPR, 95% CI: 1.27, 1.10-1.48) and anticipated future sexual contact with the partner (aPR, 95% CI: 1.30, 1.11-1.52). An HIV diagnosis was associated with a lower likelihood of notification than non-HIV STDs (aPR: 0.68, 0.55-0.86). Qualitative discussion of the barriers and incentives to PN reflected a similar differentiation of anticipated notification according to partnership type and type of HIV/STD diagnosis.


CONCLUSIONS
Detailed attention to how partnership characteristics guide notification outcomes is essential to the development of new PN strategies. By accurately and thoroughly assessing the diversity of partnership interactions among individuals with HIV/STD, new notification techniques can be tailored to partner-specific circumstances.
UCLA Geffen School of Medicine, Department of Medicine, Division of Infectious Diseases, Los Angeles, CA, United States of America.
Jesse L
JL
Clark
Columbia University Mailman School of Public Health, New York, NY, United States of America.
Amaya G
AG
Perez-Brumer
UCLA Geffen School of Medicine, Department of Medicine, Division of Infectious Diseases, Los Angeles, CA, United States of America.
Eddy R
ER
Segura
Asociacion Civil Impacta Salud y Educacion, Lima, Peru.
Hector J
HJ
Salvatierra
Asociacion Civil Impacta Salud y Educacion, Lima, Peru.
Jorge
J
Sanchez
Asociacion Civil Impacta Salud y Educacion, Lima, Peru.
Javier R
JR
Lama
D000328:Adult; D016358:Contact Tracing / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009042:Motivation; D010568:Peru / Q000453:epidemiology; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D063106:Transgender Persons / Q000706:statistics & numerical data*
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