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Partner Notification for HIV and Syphilis: Effects on Sexual Behaviors and Relationship Stability

KISSINGER, PATRICIA J. PhD*; NICCOLAI, LINDA M. PhD*†; MAGNUS, MANYA PhD*; FARLEY, THOMAS A. MD, MPH*; MAHER, JULIE E. PhD§¶; RICHARDSON-ALSTON, GWANGI MSW*; DORST, DENNIS; MYERS, LEANN PhD*; PETERMAN, THOMAS A. MD

Sexually Transmitted Diseases: January 2003 - Volume 30 - Issue 1 - p 75-82
Article

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.

A prospective study in New Orleans comparing outcomes of HIV infection and syphilis partner notification found no difference in the rates of partnership dissolution, new partner acquisition, and violence.

From *Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Yale University Department of Epidemiology and Public Health, New Haven, Connecticut; Louisiana Office of Public Health, New Orleans, Louisiana; §Center for Health Research, Kaiser Permanente Northwest, Seattle, Washington; and Centers for Disease Control and Prevention, Atlanta, Georgia

The authors thank the following for their contributions to the study: the Disease Intervention Specialist staff of Jefferson and Marrero Parishes, Gail Collins, Cindy Allo, Melissa Ayoub, Tracey Ford, Tsegaye Assefeya, and Dr. Patricia Morse.

Supported by a grant from the Centers for Disease Control and Prevention, Atlanta.

Reprint requests: Patricia Kissinger, PhD, Tulane University—SPHTM, Department of Epidemiology SL-18, 1440 Canal Street, New Orleans, LA 70112. E-mail: kissing@tulane.edu

Received February 28, 2002,

revised May 8, 2002, and accepted May 13, 2002.

© Copyright 2003 American Sexually Transmitted Diseases Association