Sexually acquired infections: do lay experiences of partner notification challenge practice?

Aim. This paper is a report of a study to explore experiences of partner notification for syphilis from the perspectives of gay, bisexual and other men who have sex with men. Background. Partner notification is the 'cornerstone' of the prevention and control of sexually acquired infections. As a health strategy, it has been in use for over six decades and is employed across all continents. Its success relies almost entirely on the voluntary response of index patients in disclosing details of their sexual partners and sexual practices and the voluntary response of sexual partners who have been traced. However, internationally, few studies have explicitly explored lay experiences of partner notification. Method. A purposive sample of 40 gay, bisexual and other men who have sex with men was recruited from two genitourinary clinics in the Greater Dublin area of Ireland and a variety of gay social venues. Semi-structured interviews were carried out between December 2002 and February 2004. Findings. Men's perspectives on partner notification featured three interweaving stages: on tracing sexual partners, on informing partners and on attending clinics. Participants were in favour of partner notification, but did not find it easy to comply with the demands it made on their relationships. Compliance was difficult not only because of the problem of physically tracing casual and anonymous partners, but also because of the challenge of actually notifying partners. The main incentive for contacts to attend clinics was concern for their own health and that of others. Barriers to attending were fear of being exposed to the stigma of being gay and/or having a sexually acquired infection. Conclusion. There is a need to develop evidence-based methods, which are grounded in the lay experience, to support index patients in ` breaking bad news' and for continued efforts to de-stigmatize sexually acquired infections and homosexuality in the view of the general public.