From the Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.
Department of Global Health.
Sex Transm Dis. 2021 Oct 1;48(10):766-772. doi: 10.1097/OLQ.0000000000001430.
Expedited partner treatment (EPT) is effective for preventing sexually transmitted infection recurrence, but concerns about intimate partner violence and missed opportunities for human immunology virus (HIV) testing have limited its use in African settings.
We conducted a pilot prospective evaluation of EPT among adolescent girls and young women (AGYW) accessing HIV preexposure prophylaxis in an implementation project in Kisumu, Kenya. Those with etiologic diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae were treated and given the option of delivering sexually transmitted infection medication and HIV self-test kits to their current sexual partner(s). At enrollment, we assessed their reasons for declining. Three months after they delivered medication and kits to the partner(s), we assessed their reasons for failing to deliver medication and kits to their partner and reported partner's reactions.
Between September 2018 and March 2020, 63 AGYW were enrolled. The majority (59/63 [94%]) accepted EPT, and 50 (79%) of 63 partner HIV self-testing (HIVST). Three quarters (46/59) of those accepting EPT returned for the assessment visit with 41 (89%) of 46 successfully delivering medication to 54 partners, of whom 49 (91%) used it. Seventy percent (35/50) who took partner HIVST kits returned for the assessment, with 80% (28/35) reporting providing kits to 40 partners, of whom 38 (95%) used it. Reported barriers to EPT and partner HIVST uptake among women who declined included anticipated fear that their partner could become angry or violent and loss of relationship.
Both EPT and partner HIVST were acceptable despite noted barriers among Kenyan AGYW with etiologic diagnosis of Chlamydia trachomatis/Neisseria gonorrhoeae and their partners.
性伴侣治疗(EPT)对于预防性传播感染的复发是有效的,但在非洲环境中,由于担心亲密伴侣暴力和错失人类免疫缺陷病毒(HIV)检测机会,其应用受到限制。
我们在肯尼亚基苏木的一个实施项目中,对接受 HIV 暴露前预防的青少年女孩和年轻妇女(AGYW)进行了 EPT 的试点前瞻性评估。那些患有沙眼衣原体和淋病奈瑟菌病因诊断的患者接受了治疗,并可以选择将性传播感染药物和 HIV 自我检测试剂盒交给他们当前的性伴侣。在入组时,我们评估了他们拒绝的原因。在他们将药物和试剂盒交给伴侣 3 个月后,我们评估了他们未能将药物和试剂盒交给伴侣的原因,并报告了伴侣的反应。
2018 年 9 月至 2020 年 3 月,共有 63 名 AGYW 入组。大多数(59/63 [94%])接受了 EPT,63 名中的 50 名(79%)进行了伴侣 HIV 自我检测(HIVST)。接受 EPT 的人中,有四分之三(46/59)返回评估访问,其中 41 人(89%)成功将药物交给 54 名伴侣,其中 49 人(91%)使用了药物。接受伴侣 HIVST 试剂盒的人中,有 70%(35/50)返回评估,其中 80%(28/35)报告向 40 名伴侣提供了试剂盒,其中 38 人(95%)使用了试剂盒。拒绝 EPT 和伴侣 HIVST 接种的妇女报告的障碍包括预期伴侣可能会生气或暴力,以及关系破裂。
尽管肯尼亚接受沙眼衣原体/淋病奈瑟菌病因诊断的 AGYW 及其伴侣存在明显障碍,但 EPT 和伴侣 HIVST 都可以接受。