Going beyond ‘regular and casual': Development of a classification of sexual partner types to enhance partner notification for STIs

Claudia S. Estcourt*, Paul Flowers, Jackie A. Cassell, Maria Pothoulaki, Gabriele Vojt, Fiona Mapp, Melvina Woode-Owusu, Nicola Low, John Saunders, Merle Symonds, Alison Howarth, Sonali Wayal, Rak Nandwani, Susie Brice, Alex Comer, Anne M. Johnson, Catherine H. Mercer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)
40 Downloads (Pure)

Abstract

Objectives: To develop a classification of sexual partner types for use in partner notification (PN) for STIs.

Methods: A four-step process: (1) an iterative synthesis of five sources of evidence: scoping review of social and health sciences literature on partner types; analysis of relationship types in dating apps; systematic review of PN intervention content; and review of PN guidelines; qualitative interviews with public, patients and health professionals to generate an initial comprehensive classification; (2) multidisciplinary clinical expert consultation to revise the classification; (3) piloting of the revised classification in sexual health clinics during a randomised controlled trial of PN; (4) application of the Theoretical Domains Framework (TDF) to identify index patients’ willingness to engage in PN for each partner type.

Results: Five main partner types emerged from the evidence synthesis and consultation: ‘established partner’, ‘new partner’, ‘occasional partner’, ‘one-off partner’ and ‘sex worker’. The types differed across several dimensions, including likely perceptions of sexual exclusivity, likelihood of sex reoccurring between index patient and sex partner. Sexual health professionals found the classification easy to operationalise. During the trial, they assigned all 3288 partners described by 2223 index patients to a category. The TDF analysis suggested that the partner types might be associated with different risks of STI reinfection, onward transmission and index patients’ engagement with PN.

Conclusions: We developed an evidence-informed, useable classification of five sexual partner types to underpin PN practice and other STI prevention interventions. Analysis of biomedical, psychological and social factors that distinguish different partner types shows how each could warrant a tailored PN approach. This classification could facilitate the use of partner-centred outcomes. Additional studies are needed to determine the utility of the classification to improve measurement of the impact of PN strategies and help focus resources.

Original languageEnglish
Pages (from-to)108-114
Number of pages7
JournalSexually Transmitted Infections
Volume98
Issue number2
Early online date29 Apr 2021
DOIs
Publication statusPublished - 17 Feb 2022

Bibliographical note

Funding Information: This work presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (reference number RP-PG-0614–20009).

Open Access: This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

Publisher Copyright: © Author(s) (or their employer(s)) 2022. Published by BMJ.

Citation: Estcourt CS, Flowers P, Cassell JA, et al. Going beyond ‘regular and casual’: development of a classification of sexual partner types to enhance partner notification for STIs. Sexually Transmitted Infections 2022;98:108-114.

DOI: http://dx.doi.org/10.1136/sextrans-2020-054846

Keywords

  • HIV
  • chlamydia infections
  • contact tracing
  • gonorrhea
  • sexual health

Fingerprint

Dive into the research topics of 'Going beyond ‘regular and casual': Development of a classification of sexual partner types to enhance partner notification for STIs'. Together they form a unique fingerprint.

Cite this