The Role of Self-efficacy and Relationship Quality in Partner Notification by Adolescents With Sexually Transmitted Infections

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Abstract
Objective To evaluate the role of self-efficacy, anticipated negative consequences, and relationship quality in patient-initiated sex partner notification following treatment for sexually transmitted infections. Subjects Two hundred forty-one 13- to 20-year-old subjects (83% women; 83% African American) diagnosed with gonorrhea, chlamydia, trichomonas, or nongonococcal urethritis. Subjects were patients at a public sexually transmitted diseases clinic or primary care adolescent clinics. Methods Structured interviews at enrollment and 1 month following treatment. At enrollment, recent sexual partners were identified. Coital frequency, partner-specific sexually transmitted infection notification self-efficacy, anticipated consequences of notification, and relationship quality were measured with multi-item scales. At 1 month, subjects were asked whether partners had been notified and about the timing of notification relative to treatment. Results Subjects reported 279 partners. Of these, 61% of women's partners and 52% of men's partners were notified. Multiple logistic regression adjusted by generalized estimating equations showed that notification was predicted by antecedent notification self-efficacy (adjusted odds ratio, 1.16; 95% confidence interval, 1.03-1.30) and relationship quality (adjusted odds ratio, 1.17; 95% confidence interval, 1.08-1.27). Age, sex, race/ethnicity, prior sexually transmitted infection, coital frequency, and anticipated consequences were not related to partner notification. Conclusions Partner notification is increased among persons with higher levels of self-efficacy and in relationships with stronger affiliative and emotional ties. Self-efficacy and partner communication could be especially amenable to interventions to increase patient-initiated partner notification for curable sexually transmitted infections.