Partner notification in the management of sexually transmitted infections in Nairobi, Kenya

Abstract

Objective: To assess utilization of partner notification as a tool in prevention and control of Sexually transmitted infections in Nairobi City Council clinics. Design: A cross-sectional study carried out between April and September 2000. Setting: Nairobi City Council health clinics were stratified into eight administrative divisions and a total of 16 out of 54 primary health clinics with at least four STIs patients per day were selected. A standard questionnaire was administered to every fourth patient with clinical diagnosis of STIs who gave consent on exist. Sexual partners referred by index cases during the five day period from each clinic were also enrolled into the study. An additional questionnaire was administered to HCP who were managing STIs patients and their sex partners. Results: Of 407 STIs patients recruited between April and September 2000, 20.6% were primary and 2% were secondary referrals giving an average referral rate of 23%. Respondents with multiple sex partners were less likely to refer their partners compared to those who had one partner (17.9% vs 82.1%, p<0.005). Counseling of STI patients on the importance of partner referral was more effective than issuing referral cards alone (72.8% vs 56.8% % p= <0.006). Barriers to partner notification included partners being out of town (44.6%) fear of quarrels and violence from partners (32.5%) and casual partners (15.1%) whose sex partners were unknown. Conclusion: Counseling and understanding of STIs patients on the need to treat all sexual partners is pivotal to the success of partner referral.