CoChat
Sign Up
Cited by 25HIV/AIDS Research and InterventionsHIV, TB, and STIs EpidemiologyHIV, Drug Use, Sexual Risk

Understanding attitudes, barriers and challenges in a small island nation to disease and partner notification for HIV and other sexually transmitted infections: a qualitative study

Open access
Adams, O Peter, Carter, Anne O, Redwood-Campbell, Lynda·2015·BMC Public Health
DOI 10.1186/s12889-015-1794-2PMC PMC4450455
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: In Barbados sexually transmitted infections (STIs) including HIV are not notifiable diseases and there is not a formal partner notification (PN) programme. Objectives were to understand likely attitudes, barriers, and challenges to introducing mandatory disease notification (DN) and partner notification (PN) for HIV and other STIs in a small island state. METHODS: Six key informants identified study participants. Interviews were conducted, recorded, transcribed and analysed for content using standard methods. RESULTS: Participants (16 males, 13 females, median age 59 years) included physicians, nurses, and representatives from governmental, youth, HIV, men's, women's, church, and private sector organisations. The median estimated acceptability by society of HIV/STI DN on a scale of 1 (unacceptable) to 5 (completely acceptable) was 3. Challenges included; maintaining confidentiality in a small island; public perception that confidentiality was poorly maintained; fear and stigma; testing might be deterred; reporting may not occur; enacting legislation would be difficult; and opposition by some opinion leaders. For PN, contract referral was the most acceptable method and provider referral the least. Contract referral unlike provider referral was not "a total suspension of rights" while taking into account that "people need a little gentle pressure sometimes". Extra counselling would be needed to elicit contacts or to get patients to notify partners. Shame, stigma and discrimination in a small society may make PN unacceptable and deter testing. With patient referral procrastination may occur, and partners may react violently and not come in for care. With provider referral patients may have concerns about confidentiality including neighbours becoming suspicious if a home visit is used as the contact method. Successful contact tracing required time and effort. With contract referral people may neither inform contacts nor say that they did not. Strategies to overcome barriers to DN and PN included public education, enacting appropriate legislation to allow DN and PN, good patient counselling and maintaining confidentiality. CONCLUSIONS: There was both concern that mandatory DN and PN would deter testing and recognition of the benefits. Public and practitioner education and enabling legislation would be necessary, and the public needed to be convinced that confidentiality would be maintained.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/s12889-015-1794-2

Cites

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Some health workers prefer simple patient referral because they feel it is the patient's responsibility to inform partners and because it assures the patient's privacy.

    “Some health workers prefer simple patient referral for the reason that they feel it is the patient's responsibility to inform their partners (127) and because it assures the patient's privacy (120, 128-130).”

    From Updated recommendations for the treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum (syphilis) and new recommendations on syphilis testing and partner services (2024) · cites this paper as [130]

    The responsibility rationale is attached to citation 127, so this verdict concerns the privacy rationale. In Results > Provider referral (page unavailable), the paper says maintaining confidentiality is a greater challenge with provider referral than with patient referral. That supports a relative privacy advantage, but not the claim that patient referral assures privacy; the Discussion > Partner notification acceptability and effectiveness also identifies loss of confidentiality as a possible concern with patient referral. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • The most commonly mentioned barrier was individuals' concerns about potential harm or other negative consequences, even despite very little evidence of actual harm.

    “Overall, the most commonly mentioned barrier was individuals' concerns about potential harm or other negative consequences (e.g. fear of relationship break-up, violence, loss of social and financial support) (108, 124, 128-130, 136, 140-144, 146-164), even despite very little evidence of actual harm.”

    From Updated recommendations for the treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum (syphilis) and new recommendations on syphilis testing and partner services (2024) · cites this paper as [130]

    The Results section, “Partner notification barriers and challenges” (page unavailable), identifies fears of violence and loss of economic support as barriers. The paper does not establish that these were the most commonly mentioned barriers or that there was very little evidence of actual harm. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

The citation lists haven’t been fetched yet

References 37 · Cited by 25

Research works printed but not linked: 29

  1. [2]Hogben M McNally T McPheeters M Hutchinson AB The effectiveness of HIV partner counseling and referral services in increasing identification of HIV-positive individuals a systematic review Am J Prev Med 2007 33 2 Suppl S89 100 10.1016/j.amepre.2007.04.015 17675019 · DOI
  2. [3]Ferreira A Young T Mathews C Zunza M Low N Strategies for partner notification for sexually transmitted infections, including HIV Cochrane Database Syst Rev 2013 10 24092529 PMC7138045
  3. [4]Adams DA Gallagher KM Jajosky RA Kriseman J Sharp P Anderson WJ Summary of notifiable diseases - United States, 2011 MMWR 2013 60 53 1 117 23820934
  4. [5]Centers for Disease Control and Prevention CDC guidelines for national human immunodeficiency virus case surveillance, including monitoring for human immunodeficiency virus infection and acquired immunodeficiency syndrome MMWR 1999 48 RR13 1 31 10632297
  5. [6]Valdiserri RO Janssen RS Buehler JW Fleming PL The context of HIV/AIDS surveillance J Acquir Immune Defic Syndr 2000 25 Suppl 2 S97 104 10.1097/00126334-200012152-00003 11256740 · DOI
  6. [7]Nakashima AK Horsley R Frey RL Sweeney PA Weber JT Fleming PL Effect of HIV reporting by name on use of HIV testing in publicly funded counseling and testing programs JAMA 1998 280 16 1421 6 10.1001/jama.280.16.1421 9801002 · DOI
  7. [8]Tesoriero JM Battles HB Heavner K Leung SY Nemeth C Pulver W The effect of name-based reporting and partner notification on HIV testing in New York State Am J Public Health 2008 98 4 728 35 10.2105/AJPH.2006.092742 18356570 PMC2377003 · DOI
  8. [9]Jayaraman GC Preiksaitis JK Larke B Mandatory reporting of HIV infection and opt-out prenatal screening for HIV infection: effect on testing rates CMAJ 2003 168 6 679 82 12642422 PMC154912
  9. [10]Infuso A Hamers F Downs AM Alix J HIV reporting in Western Europe: national systems and first European data Euro Surveillance 2000 5 2 13 7 12631871
  10. [11]Gertig DM Marion SA Schechter MT Estimating the extent of underreporting in AIDS surveillance AIDS 1991 5 10 1157 64 10.1097/00002030-199110000-00001 1786142 · DOI
  11. [12]Konowitz PM Petrossian GA Rose DN The underreporting of disease and physicians’ knowledge of reporting requirements Public Health Rep 1984 99 1 31 5 6422492 PMC1424528
  12. [13]Fox DM From TB to AIDS: value conflicts in reporting disease Hastings Cent Rep 1986 16 6 suppl 11 6 10.2307/3562097 3542898 · DOI
  13. [14]14. Centers for Disease Control and Prevention. Revised guidelines for HIV counseling, testing, and referral and revised recommendations for HIV screening of pregnant women. MMWR 2001;50(RR-19):1-57. http://www.cdc.gov/mmwr/pdf/rr/rr5019.pdf Accessed 26 April 2015. 11718472
  14. [15]Chou R Korthuis PT Huffman LH Smits AK Screening for Human Immunodeficiency Virus in Adolescents and Adults 2005 Rockville (MD) Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services 20722134
  15. [16]Landis SE Schoenbach VJ Weber DJ Mittal M Krishan B Lewis K Results of a randomized trial of partner notification in cases of HIV infection in North Carolina N Engl J Med 1992 326 2 101 6 10.1056/NEJM199201093260205 1445500 · DOI
  16. [17]Macke BA Maher JE Partner notification in the United States: an evidence-based review Am J Prev Med 1999 17 3 230 42 10.1016/S0749-3797(99)00076-8 10987639 · DOI
  17. [18]Apoola A Radcliffe KW Das S Robshaw V Gilleran G Kumari BS Patient preferences for partner notification Sex Transm Infect 2006 82 4 327 9 10.1136/sti.2005.018119 16877586 PMC2564722 · DOI
  18. [19]Hogben M St Lawrence JS Montano DE Kasprzyk D Leichliter JS Phillips WR Physicians’ opinions about partner notification methods: case reporting, patient referral, and provider referral Sex Transm Infect 2004 80 1 30 4 10.1136/sti.2003.004937 14755032 PMC1758392 · DOI
  19. [20]Passin WF Kim AS Hutchinson AB Crepaz N Herbst JH Lyles CM A systematic review of HIV partner counseling and referral services: client and provider attitudes, preferences, practices, and experiences Sex Transm Dis 2006 33 5 320 8 10.1097/01.olq.0000194597.16236.48 16505750 · DOI
  20. [21]Kumar A Waterman I Kumari G Carter AO Prevalence and correlates of HIV serostatus disclosure: a prospective study among HIV-infected postparturient women in Barbados AIDS Patient Care STDS 2006 20 10 724 30 10.1089/apc.2006.20.724 17052142 · DOI
  21. [23]Adams OP Carter AO Prussia P McIntyre G Branch SL Risk behaviour, healthcare access and prevalence of infection with Chlamydia trachomatis and Neisseria gonorrhoeae in a population-based sample of adults in Barbados Sex Transm Infect 2008 84 3 192 4 10.1136/sti.2007.028126 18305122 · DOI
  22. [24]Ministry of Health Barbados HIV surveillance Bulletin 2011 2011 Barbados Ministry of Health
  23. [25]Adams OP Carter AO Feasibility of a population based survey on HIV prevalence in Barbados, and population preference for sample identification method Open AIDS J 2010 4 84 7 10.2174/1874613601004010084 20448809 PMC2864420 · DOI
  24. [26]Kumar A Kilaru KR Forde S Roach TC Changing HIV infection-related mortality rate and causes of death among persons with HIV infection before and after the introduction of highly active antiretroviral therapy: analysis of all HIV-related deaths in Barbados, 1997-2005 J Int Assoc Physicians AIDS Care (Chic) 2006 5 3 109 14 10.1177/1545109706288587 16928879 · DOI
  25. [27]Clark JP Godlee F Jefferson T How to peer review a qualitative manuscript Peer Review in Health Sciences, 2nd ed 2003 London BMJ Books 219 35
  26. [28]Hayter M Confidentiality and the acquired immune deficiency syndrome (AIDS): an analysis of the legal and professional issues J Adv Nurs 1997 25 6 1162 6 10.1046/j.1365-2648.1997.19970251162.x 9181412 · DOI
  27. [29]Doyle TJ Glynn MK Groseclose SL Completeness of notifiable infectious disease reporting in the United States: an analytical literature review Am J Epidemiol 2002 155 9 866 74 10.1093/aje/155.9.866 11978592 · DOI
  28. [30]Centers for Disease Control and Prevention Current trends partner notification for preventing Human Immunodeficiency Virus (HIV) infection -- Colorado, Idaho, South Carolina, Virginia 1988 393 6 3132603
  29. [31]Centers for Disease Control and Prevention Recommendations for partner services programs for HIV infection, syphilis, gonorrhea, and chlamydial infection MMWR early release 2008 57 RR-9 1 83 18987617

Authors
Adams, O. P., Carter, A. O., & Redwood-Campbell, L.
Affiliations
  • University of the West Indies (JM)
  • Queen's University (CA)
  • McMaster University (CA)
Corresponding author
Adams, O Peter
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2015-05-02
Volume
15
Issue
1
Pages
455-455
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/s12889-015-1794-2
PMC
PMC4450455
OpenAlex
W1996376738
Cited by
25
References
37
Citations by year
2026: 2 · 2025: 1 · 2024: 2 · 2023: 1 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 2 · 2017: 3 · 2016: 2
FWCI
1.82
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • McMaster University
  • Public Health Agency
  • Queen's University
Topics
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Social Sciences › General Social Sciences › HIV, TB, and STIs Epidemiology
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords
HIV, sexually transmitted infections, partner notification, disease notification, mandatory reporting, confidentiality, stigma, contact tracing, public acceptance, health care legislation, Barbados, small island states, HIV testing
MeSH terms
Adult, Aged, Barbados, Counseling, Culture, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Referral and Consultation, Sexual Partners, Sexually Transmitted Diseases, HIV Infections, Contact Tracing, Qualitative Research, Social Stigma

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review