Chitneni Pooja, Owembabazi Moran, Kanini Eunice, Kansiime Rosemary, Muyindike Winnie R, Psaros Christina, Haberer Jessica E, Matthews Lynn T
Division of Global Health Equity and General Internal Medicine, Brigham and Women's Hospital, Boston, MA, United States.
Harvard Medical School, Boston, MA, United States.
Front Reprod Health. 2025 Jul 7;7:1564836. doi: 10.3389/frph.2025.1564836. eCollection 2025.
Comprehensive STI care requires not only patient treatment but STI partner notification (PN) and evaluation to prevent ongoing STI transmission and reinfection. In rural, southwestern Uganda, we explored healthcare practitioners' views on three STI PN models that focused on task-shifting to non-physician practitioners to inform the development of a novel STI PN services delivery system.
From September to November 2023, we conducted individual in-depth interviews with 32 participants from 4 categories (8 participants from each category): patients with a self-reported history of having an STI in Uganda, healthcare workers (physicians, nurses, and community health workers), pharmacists, and healthcare administrators (Ministry of Health officials and regional referral hospital administrators). Interviews explored participants' views on a nursing-based, pharmacy-based, and community-based STI PN models as well as healthcare system tools and needs to facilitate PN. We used inductive and deductive approaches to generate a codebook guided by the Consolidated Framework for Implementation Research in a thematic analysis.
Ten female and twenty-two male participants participated in individual in-depth interviews. The median age of the patient and healthcare practitioner participants was 32 and 34 years, respectively. We found that (1) the nursing model was overall supported as nurses (though with one participant noting dissatisfaction with nurses), (2) pharmacies are well-positioned to engage in STI PN as they are early points of contact for patients, incentivized monetarily by PN and patient-delivered partner medication, and have the potential to physically restructure to create private spaces and increase counseling training, (3) the community-based model should center on village health teams and focus on advocacy and education.
Given the high STI incidence globally and in sub-Saharan Africa, exploring innovative STI care models that resonate with patients and healthcare practitioners will be important. Future work includes a Delphi method to refine these models for testing.
全面的性传播感染（STI）护理不仅需要对患者进行治疗，还需要进行性传播感染伴侣通知（PN）和评估，以防止性传播感染的持续传播和再次感染。在乌干达西南部农村地区，我们探讨了医疗从业者对三种性传播感染伴侣通知模式的看法，这些模式侧重于将任务转移给非医师从业者，以推动新型性传播感染伴侣通知服务提供系统的开发。
2023年9月至11月，我们对来自4个类别的32名参与者进行了个人深入访谈（每个类别8名参与者）：有自我报告的乌干达性传播感染病史的患者、医护人员（医生、护士和社区卫生工作者）、药剂师以及医疗管理人员（卫生部官员和地区转诊医院管理人员）。访谈探讨了参与者对基于护理、基于药房和基于社区的性传播感染伴侣通知模式的看法，以及促进伴侣通知的医疗系统工具和需求。我们采用归纳和演绎方法，在主题分析中生成了一个由实施研究综合框架指导的编码手册。
10名女性和22名男性参与者参加了个人深入访谈。患者和医护人员参与者的年龄中位数分别为32岁和34岁。我们发现：（1）护理模式总体上得到支持，因为护士（尽管有一名参与者对护士表示不满）；（2）药房有能力参与性传播感染伴侣通知，因为它们是患者的早期接触点，通过伴侣通知和患者提供的伴侣药物获得经济激励，并且有可能进行实体改造以创建私人空间并增加咨询培训；（3）基于社区的模式应以村卫生团队为中心，侧重于宣传和教育。
鉴于全球和撒哈拉以南非洲地区性传播感染的高发病率，探索与患者和医疗从业者产生共鸣的创新性性传播感染护理模式将很重要。未来的工作包括采用德尔菲法完善这些模式以进行测试。
