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Partner notification for HIV and syphilis: effects on sexual behaviors and relationship stability.
Sexually Transmitted Diseases 2003;30(1):75-82.
Kissinger PJ, Niccolai LM, Magnus M, Farley TA, Maher JE, Richardson-Alston
G, Dorst D, Myers L, Peterman TA.
Abstract
BACKGROUND: Partner notification (PN), originally designed for syphilis control,
has been used to control the spread of HIV since 1985. Because HIV infection
is noncurable, the benefit of contact tracing and treatment demonstrated
for the control of syphilis may not apply to HIV. For HIV, PN must facilitate
behavior change that will reduce the spread of the infection. One concern
is that HIV PN can promote the breakup of old partnerships and increase the
acquisition of new partners, thereby spreading HIV infections. GOAL: The
purpose of this study was to determine the effect of partner notification
(PN) on sexual behavior and relationship stability among HIV partnerships,
with use of syphilis partnerships for comparison. STUDY DESIGN: Partnerships
were eligible if the index case was interviewed by a disease intervention
specialist (DIS) for PN and named at least one sex partner. Partnership information
was reported by index cases interviewed at baseline and 3 and 6 months post-PN.
Trends in partnership dissolution and acquisition, sexual abstinence, condom
use, emotional abuse, and physical violence reported by HIV infection and
syphilis index cases were compared. RESULTS: A total of 157 index cases (76
HIV infection and 81 syphilis) reported 220 partnerships (94 HIV and 126
syphilis). The PN process was completed for 32.7% of partnerships and it
was completed more often for partnerships that were classified as main and
cohabiting. After PN, 46.8% of partnerships dissolved, 15.9% of cases acquired
a new partner, and emotional abuse and physical violence decreased significantly.
HIV index cases were somewhat more likely to report using condoms at last
sex act and less likely to acquire a new sex partner after PN compared to
syphilis index cases. There was no difference post-PN between HIV infection
and syphilis partnerships for partnership dissolution, physical violence,
emotional abuse and abstention from sex. CONCLUSION: HIV PN did not appear
to cause greater partnership dissolution, new partner acquisition, or violence
compared with syphilis PN.