Patient and Partner Perspectives on Patient-Delivered Partner Screening: Acceptability, Benefits, and Barriers

Abstract

The study examined willingness to engage in patient-delivered partner screening (PDPS) and preferences for expedited partner services (EPS). Forty urban U.S. sexually transmitted infection (STI) clinic patients participated in individual mixed-methods interviews exploring EPS preferences and PDPS willingness. Most participants selected PDPS and PDPT together and uptake varied by patient–partner relationship closeness. For PDPS, several potentially important barriers and benefits were identified. Perceived benefits included improved sexual health for patients and their sexual partner(s) as well as convenience, privacy, and the potential to enhance trust between sexual partners. Perceived barriers included concerns about PDPS processes (e.g., time it would take to receive the result, risk of sample contamination), the accuracy of results, STI stigma and associated blame, lack of trust for a sexual partner, and the packaging/appearance of the screening kit. PDPS affords benefits and may overcome treatment barriers in some situations; however, it shares common PDPT barriers and has its own unique challenges. There are also concerns regarding how the offer of PDPS may interact with PDPT utilization.

Sexually Transmitted Infection Related Stigma and Shame Among African American Male Youth: Implications for Testing Practices, Partner Notification, and Treatment

“…Through this investigation, we noted a significant trend: higher median (IQR) stigma and shame scores among participants who had never been tested for STI [stigma = 15 (9-17); shame = 17 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)], average stigma and shame scores among those who were tested and received a negative result [stigma = 11 (7)(8)(9)(10)(11)(12)(13)(14)(15); shame = 14.5 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)], and the lowest scores among those who tested and received a positive result for an STI [stigma = 8 (5-15); shame = 11 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)]. …”

“…The median and interquartile range (IQR) of the STIrelated stigma scale was 12 (7)(8)(9)(10)(11)(12)(13)(14)(15); median (IQR) of the STIrelated shame scale was 15 (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Good global model-data fit was obtained with five items in the stigma dimension and six items in the shame dimension [v 2 (43) = 92.06, p £ 0.01; comparative fit index (CFI) = 0.97; root mean square error of approximation (RMSEA) = 0.10; weighted root mean square residual (WRMR) = 0.72]; 25 all factor loadings were strong in magnitude (see Table 1).…”

“…12 Our findings similarly showed stigma to be more associated than shame was with testing practices. This may be because stigma involves the (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) 14.5 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) 11 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) Test for trend a p £ 0.05; b p £ 0.01. IQR, interquartile range.…”

“…Between June and July of 2010, participants were recruited in an area of San Francisco with high rates of poverty, crime, and unemployment, 20 as well as the highest gonorrhea rate and the second highest chlamydia rate for adolescents (ages [14][15][16][17][18][19][20] in the city. 21 Eligibility criteria included self-identifying as an African American male resident of San Francisco, 15-24 years of age.…”

“…12,14 Other investigators have noted a relationship between STI-related stigma and shame and prolonged care-seeking intervals 15,16 and reduced likelihood of discussing STIs with partners or health service workers. 13,[17][18][19] There has been limited research however, on the effect of STI-related stigma and shame on African American men, their STI testing practices, and the association between STI-related stigma and shame and partner treatment in this population.…”