"It's not safe for me and what would it achieve?" Acceptability of patient-referral partner notification for sexually transmitted infections to young people, a mixed methods study from Zimbabwe.
"It's not safe for me and what would it achieve?" Acceptability of patient-referral partner notification for sexually transmitted infections to young people, a mixed methods study from Zimbabwe.
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DOI：
10.1080/26410397.2023.2220188
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发表时间：
2023-12
影响因子：
6
通讯作者：
Bernays, Sarah
中科院分区：
文献类型：
--
作者：
Lariat, Joni;Chikwari, Chido Dziva;Dauya, Ethel;Baumu, Valentine T.;Kaisi, Victor;Kafata, Laura;Meza, Esnath;Simms, Victoria;Mackworth-Young, Constance;Rochford, Helena;Machiha, Anna;Bandason, Tsitsi;Francis, Suzanna C.;Ferrand, Rashida A.;Bernays, Sarah
关键词：
性伙伴通知 (PN) 被认为是性传播感染 (STI) 管理不可或缺的一部分。患者转诊是一种常见的 PN 策略，依赖于指示病例通知并鼓励其伴侣接受治疗；然而，它的功效有限。我们进行了一项混合方法研究，以了解年轻人的 PN 经历，特别是患者转诊过程中遇到的风险和挑战。在津巴布韦，所有参加社区性健康和生殖健康服务的被诊断患有性传播感染的年轻人（16-24 岁）都得到了咨询并提供了 PN 条，这使得他们的伴侣能够在该服务中获得免费治疗。记录 PN 滑动吸收和伴侣治疗。在 1807 名年轻人（85.0% 女性）提供 PN 条中，745 名（41.2%）填写了 ≥1 条 PN 条，103 名伴侣（5.7%）返回接受治疗。大多数参与者表示，他们感觉自己没有能力咨询和说服伴侣寻求治疗。 2021 年 6 月至 8 月期间，青年研究人员对 41 名被诊断患有性传播感染的年轻人进行了深入访谈，以探讨他们的 PN 经历。 PN带来了相当大的社会风险，威胁着他们的情感和人身安全。除了少数长期、公开承认的关系之外，参与者并不认为 PN 会取得成功的结果。公共卫生话语将 PN 构建为“正确的做法”，影响参与者采用掩盖 PN 困难及其未满足需求的叙述。需要紧急询问 PN 是否是继续与年轻人一起追求的合适或建设性策略。为了改善预防性传播感染再次感染和进一步传播的效果，我们必须考虑制定更符合年轻人生活经历的替代策略。通俗语言摘要 伴侣通知是一项公共卫生策略，用于追踪性传播感染 (STI) 诊断患者的性伴侣。它的目的是通过治疗确诊者及其性伴侣来中断性传播感染的传播链并防止再次感染。在许多资源有限的环境中，最有效但最常见的合作伙伴通知策略被称为“患者转诊”。这涉及性保健提供者鼓励被诊断的人向他们可能暴露的性伴侣提供“伴侣通知单”并说服他们接受治疗。这项研究旨在更好地了解年轻人在伴侣通知方面的经历，特别是他们在患者转诊过程中面临的风险和挑战。在津巴布韦，所有参加社区性健康和生殖健康服务的被诊断患有性传播感染的年轻人（16-24 岁）都得到了咨询并提供了 PN 条，这使得他们的伴侣能够在该服务中获得免费治疗。作为研究人员接受培训的年轻人采访了 41 名被诊断为性传播感染的年轻人，以探讨他们通知伴侣的经历。只有少数（5.7%）的伴侣参加了接受治疗的服务。大多数参与者认为他们没有准备、技能或资源来说服他们的伴侣寻求治疗。许多人描述了通知伴侣期间和之后的负面经历，包括关系破裂、声誉受损和身体暴力。这些发现表明，我们应该重新考虑伴侣通知是否适合或有效地用于年轻人。我们应该探索不会对年轻人的社会、情感和身体安全与福祉构成风险的替代方法。
Partner notification (PN) is considered integral to the management of sexually transmitted infections (STI). Patient-referral is a common PN strategy and relies on index cases notifying and encouraging their partners to access treatment; however, it has shown limited efficacy. We conducted a mixed methods study to understand young people’s experiences of PN, particularly the risks and challenges encountered during patient-referral. All young people (16–24 years) attending a community-based sexual and reproductive health service in Zimbabwe who were diagnosed with an STI were counselled and offered PN slips, which enabled their partners to access free treatment at the service. PN slip uptake and partner treatment were recorded. Among 1807 young people (85.0% female) offered PN slips, 745 (41.2%) took up ≥1 PN slip and 103 partners (5.7%) returned for treatment. Most participants described feeling ill-equipped to counsel and persuade their partners to seek treatment. Between June and August 2021, youth researchers conducted in-depth interviews with 41 purposively selected young people diagnosed with an STI to explore their experiences of PN. PN posed considerable social risks, threatening their emotional and physical safety. Except for a minority in long-term, publicly acknowledged relationships, participants did not expect PN would achieve successful outcomes. Public health discourse, which constructs PN as “the right thing to do”, influenced participants to adopt narratives that concealed the difficulties of PN and their unmet needs. Urgent interrogation is needed of whether PN is a suitable or constructive strategy to continue pursuing with young people. To improve the outcomes of preventing reinfection and onward transmission of STIs, we must consider developing alternative strategies that better align with young people’s lived experiences. Plain language summary Partner notification is a public health strategy used to trace the sexual partners of people who have received a sexually transmitted infection (STI) diagnosis. It aims to interrupt the chains of STI transmission and prevent reinfection by treating both the person diagnosed and their sexual partners. The least effective but most common partner notification strategy used in many resource-limited settings is called “patient referral”. This involves a sexual healthcare provider encouraging the person diagnosed to give a “partner notification slip” to their potentially exposed sexual partner/s and persuading them to access treatment. This research sought to better understand young people’s experiences of partner notification, particularly the risks and challenges they faced during patient-referral. All young people (16–24 years) attending a community-based sexual and reproductive health service in Zimbabwe who were diagnosed with an STI were counselled and offered PN slips, which enabled their partners to access free treatment at the service. Young people trained as researchers interviewed 41 young people who had received a STI diagnosis to explore their experiences of partner notification. Only a small number (5.7%) of the partners of those who took a slip attended the service for treatment. Most participants felt they did not have the preparation, skills, or resources to persuade their partners to seek treatment. Many described negative experiences during and after partner notification, including relationship breakdown, reputation damage, and physical violence. These findings suggest that we should reconsider if partner notification is suitable or effective for use with young people. We should explore alternative approaches that do not present risks to young people’s social, emotional, and physical safety and well-being.
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影响因子：
3.4
作者：
Binu W;Marama T;Gerbaba M;Sinaga M
通讯作者：
Sinaga M
DOI：
10.1016/s2352-4642(20)30335-7
发表时间：
2021-03
期刊：
The Lancet. Child & adolescent health
影响因子：
--
作者：
Martin K;Olaru ID;Buwu N;Bandason T;Marks M;Dauya E;Muzangwa J;Mabey D;Dziva Chikwari C;Francis SC;Tembo M;Mavodza C;Simms V;Mackworth-Young CRS;Machiha A;Kranzer K;Ferrand RA
通讯作者：
Ferrand RA
影响因子：
5.4
作者：
Jewkes, R;Vundule, C;Jordaan, E
通讯作者：
Jordaan, E
影响因子：
4.5
作者：
Alam, Nazmul;Chamot, Eric;Kristensen, Sibylle
通讯作者：
Kristensen, Sibylle
影响因子：
1.4
作者：
Chitneni, Pooja;Beksinska, Mags;Kaida, Angela
通讯作者：
Kaida, Angela