Sexually transmissible infections, partner notification and intimate relationships: a qualitative study exploring the perspectives of general practitioners and people with a recent chlamydia infection
Jacqueline Coombe
A E , Jane Goller A , Helen Bittleston A , Alaina Vaisey A , Lena Sanci B , Anita Groos C , Jane Tomnay D , Meredith Temple-Smith B and Jane Hocking A
A Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Parkville, Vic. 3053, Australia.
B Department of General Practice, The University of Melbourne, 3rd Floor, 780 Elizabeth Street, Carlton, Vic. 3053, Australia.
C Communicable Diseases Branch, Queensland Department of Health, 15 Butterfield Street, Herston, Qld 4006, Australia.
D Centre for Excellence in Rural Sexual Health, Department of Rural Health, The University of Melbourne, 49 Graham Street, Shepparton, Vic. 3630, Australia.
E Corresponding author. Email: jacqueline.coombe@unimelb.edu.au
Sexual Health 17(6) 503-509 https://doi.org/10.1071/SH20109
Submitted: 19 June 2020 Accepted: 17 October 2020 Published: 13 November 2020
Abstract
Background: Individuals diagnosed with a chlamydia infection are advised to notify their sexual partners from the previous 6 months so that they too can get tested and treated as appropriate. Partner notification is an essential component of chlamydia management, helping to prevent ongoing transmission and repeat infection in the index case. However, partner notification can be challenging, particularly in circumstances where a relationship has ended or transmission has occurred beyond the primary relationship. Methods: In this study we use data from 43 semistructured interviews with general practitioners (GPs) and people with a recent diagnosis of chlamydia. The interviews examined experiences of chlamydia case management in the general practice context. Here, we focus specifically on the effect of a chlamydia infection on intimate relationships in the context of the consultation and beyond.? Results: A chlamydia infection can have significant consequences for intimate relationships. Although GPs reported speaking to their patients about the importance of partner notification and participants with a recent chlamydia infection reported notifying their sexual partners, both would appreciate further support to engage in these conversations. Conclusions: Conversations with patients should go beyond simply informing them of the need to notify their sexual partners from the previous 6 months, and should provide information about why partner notification is important and discuss strategies for informing partners, particularly for those in ongoing relationships. Ensuring GPs have the training and support to engage in these conversations with confidence is vital.
Keywords: chlamydia, general practice, partner notification, relationships.
References
[1] Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, et al Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016. Bull World Health Organ 2019; 97 548–62.| Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016.Crossref | GoogleScholarGoogle Scholar | 31384073PubMed |
[2] Unemo M, Bradshaw CS, Hocking JS, de Vries HJC, Francis SC, Mabey D, et al Sexually transmitted infections: challenges ahead. Lancet Infect Dis 2017; 17 e235–79.
| Sexually transmitted infections: challenges ahead.Crossref | GoogleScholarGoogle Scholar | 28701272PubMed |
[3] Australasian Sexual Health Alliance. Australian STI management guidelines for use in primary care. 2018. Available online at: http://www.sti.guidelines.org.au/ [verified 31 January 2019].
[4] Australian Government Department of Health. Fourth national sexually transmissible infections strategy: 2018–2022. 2018. Available online at: https://www1.health.gov.au/internet/main/publishing.nsf/Content/ohp-bbvs-1//$File/STI-Fourth-Nat-Strategy-2018-22.pdf [verified 7 January 2020].
[5] Yeung A, Temple-Smith M, Fairley C, Hocking J. Narrative review of the barriers and facilitators to chlamydia testing in general practice. Aust J Prim Health 2015; 21 139–47.
| Narrative review of the barriers and facilitators to chlamydia testing in general practice.Crossref | GoogleScholarGoogle Scholar | 25118823PubMed |
[6] Hocking JS, Parker RM, Pavlin N, Fairley CK, Gunn JM. What needs to change to increase chlamydia screening in general practice in Australia? The views of general practitioners. BMC Public Health 2008; 8 425
| What needs to change to increase chlamydia screening in general practice in Australia? The views of general practitioners.Crossref | GoogleScholarGoogle Scholar | 19115998PubMed |
[7] Reddel S, Edmiston N. Contact tracing for STIs new resources and supportive evidence. Aust Fam Physician 2012; 41 128–32.
| 22396926PubMed |
[8] Bilardi JE, Fairley CK, Hopkins CA, Hocking JS, Temple-Smith MJ, Bowden FJ, et al Experiences and outcomes of partner notification among men and women recently diagnosed with chlamydia and their views on innovative resources aimed at improving notification rates. Sex Transm Dis 2010; 37 253–8.
| 20182407PubMed |
[9] Braun V, Clarke V, Terry G. Thematic analysis. In Rohleder P, Lyons AC, editors. Qualitative research in clinical and health psychology. Hampshire (England): Palgrave Macmillan; 2015. pp. 95-113.
[10] Peipert JF. Genital chlamydial infections. N Engl J Med 2003; 349 2424–30.
| Genital chlamydial infections.Crossref | GoogleScholarGoogle Scholar | 14681509PubMed |
[11] Santella AJ, Pollack A, Harrison C, Sawleshwarkar SN, Britt HC, Hillman RJ. Management rates of sexually transmissible infections by Australian general practitioners, 2000–2012. Sex Health 2014; 11 52–7.
| Management rates of sexually transmissible infections by Australian general practitioners, 2000–2012.Crossref | GoogleScholarGoogle Scholar | 24618039PubMed |
[12] Tomnay JE, Pitts MK, Fairley CK. General practitioners’ use of Internet-based patient materials for partner notification. Sex Transm Dis 2007; 34 613–16.
| General practitioners’ use of Internet-based patient materials for partner notification.Crossref | GoogleScholarGoogle Scholar | 17710752PubMed |
[13] Mills N, Daker-White G, Graham A, Campbell R. Population screening for Chlamydia trachomatis infection in the UK: a qualitative study of the experiences of those screened. Fam Pract 2006; 23 550–7.
| Population screening for Chlamydia trachomatis infection in the UK: a qualitative study of the experiences of those screened.Crossref | GoogleScholarGoogle Scholar | 16790452PubMed |
[14] Temple-Smith M, Hopkins C, Fairley C, Tomnay J, Pavlin N, Parker R, et al The right thing to do: patients’ views and experiences of telling partners about chlamydia. Fam Pract 2010; 27 418–23.
| The right thing to do: patients’ views and experiences of telling partners about chlamydia.Crossref | GoogleScholarGoogle Scholar | 20444842PubMed |
[15] Hobbs M, Owen S, Gerber L. Liquid love? Dating apps, sex, relationships and the digital transformation of intimacy. J Sociology 2017; 53 271–84.
| Liquid love? Dating apps, sex, relationships and the digital transformation of intimacy.Crossref | GoogleScholarGoogle Scholar |
