Abstract
Patient-delivered partner therapy (PDPT) is the practice of providing patients diagnosed with a bacterial sexually transmitted infection (STI) medication to give directly to their partner for treatment without requiring the partner to participate in diagnostic testing and counseling. Despite a growing body of evidence in support of PDPT, literature is limited to date on the influence of perceived risk of intimate partner violence (IPV) on PDPT use. We analyzed mixed-method data from 196 quantitative surveys (61% male, M age = 31.2, 92% Black or African-American) and 25 qualitative interviews to better understand the barriers and facilitators associated with PDPT delivery for patients attending a Midwestern, publicly funded STI clinic in the U.S. Nearly a third of surveyed patients (29; 34% of women, 26% of men) expressed worry about IPV when delivering PDPT. Patients had concerns about infidelity worry, embarrassment, and anxiety (referred to as IWEA hereafter) associated with partner notification and PDPT delivery. We found IWEA was highly correlated with IPV concerns in a fully adjusted logistic regression model. Women had 2.43 (95% CI = 1.09–5.42) times greater odds of worrying about IPV than men; other significant factors associated with IPV worry included higher condom use, no prior STI diagnosis, and being uninsured (as compared to having Medicare/Medicaid insurance). Encouraging communication between healthcare providers and their patients about the potential for IPV could facilitate patient triaging that results in the consideration of alternative partner referral mechanisms for patients or partners at risk of harm and better outcomes for patients and their partners.
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Acknowledgements
Funding support was provided from the National Institute of Mental Health (R01-MH089129; PI: Weinhardt; K01-MH099956; PI: Walsh) and the National Institute on Drug Abuse (R01-DA036466; MPIs: Parsons and Grov), which supported several authors of this study. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Additional funding support came from the Public Health Doctoral Student Award (PI: John) from the Dean’s Office in the Zilber School of Public Health at the University of Wisconsin-Milwaukee. This award provided funding for a large portion of the direct research costs associated with this study. We would like to thank the additional contributors of this study. First and foremost, we want to thank the many clinic patients who participated in this study; this research would not have been possible without their valuable contributions. Thank you to Katie Mosack, who provided valuable feedback on the qualitative methods of this study and earlier revisions of this manuscript. Thank you to Ron Cisler, who provided conceptual feedback when this study was in its infancy. We would also like to thank the Undergraduate Research Assistants who helped with recruiting study participants and data collection, including Katelyn Dallman, Amie Emrys, Ratka Galijot, and Steven Lovejoy, in alphabetical order. Finally, we want to thank the entire City of Milwaukee Health Department staff, who helped provide an atmosphere supportive of research and data collection within their clinic space, especially Paul Hunter, Irmine Reitl, and Otilio Oyervides.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
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John, S.A., Walsh, J.L., Cho, Y.I. et al. Perceived Risk of Intimate Partner Violence Among STI Clinic Patients: Implications for Partner Notification and Patient-Delivered Partner Therapy. Arch Sex Behav 47, 481–492 (2018). https://doi.org/10.1007/s10508-017-1051-0
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DOI: https://doi.org/10.1007/s10508-017-1051-0