UCLA

Background: Curable sexually transmitted infections (STIs) including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) are associated with adverse pregnancy outcomes. Partner notification is an important component of STI control as it has been shown to prevent re-infection and reduce infectious burden. However, few studies have examined partner notification among pregnant women in sub-Saharan Africa.

Methods: Between October 2017 and February 2019, we conducted a cohort study of women ≥18 years attending antenatal care in Cape Town, South Africa. Prior to STI screening, participants were asked if they would notify their partner if they were diagnosed with an STI. Women self-collected vulvovaginal swabs at first antenatal visit, during the third trimester and postpartum. Trained staff tested the swabs for CT, NG, and TV using Xpert� assays (Cepheid, USA). At the following visit, STI-infected women were asked if they notified their partner and if their partner sought treatment and was treated. We used logistic regression to evaluate correlates of partner notification and partner notification and treatment.

Results: Among the 242 participants, 234 (97%) reported being willing to notify partners if they tested positive and 189 (78%) thought their partner would be willing to take medication to treat the STI. Of the 73 women who were diagnosed with an STI (30%) and reported having a sex partner, 68 (93%) reported notifying their partner, 47 (64%) reported their partner sought treatment, and 46 (63%) reported their partner took medication to treat the STI. Younger pregnant women (ages 18-31) had over three times the odds of partner notification and treatment (OR=3.82;95%CI=1.34-10.90) compared to older women.

Conclusions: Pregnant women were willing to notify their partners, leading to a high rate of notification. Nearly two-thirds of women who were diagnosed with an STI reported that their partner was treated. Younger maternal age was associated with partner notification and treatment. Future research on interventions to improve partner notification and treatment is needed.