Designing partner-notification programs to maximize client participation: a factorial survey approach

Abstract

Background: Factorial survey methods were used to elicit preferences for partner-notification contact, interviewing, and treatment procedures. Most of the experimental alternatives were not rated as highly as standard practice, although there were differences in ratings in accordance with respondents' roles as infected persons or sex partners of infected persons.

Goal: To report on research that identifies the preferences of clients and potential clients for different features of partner-notification programs.

Study design: A factorial survey was used to investigate which aspects of current and potential partner-notification programs increase the likelihood of cooperation. Six dimensions defined the hypothetical programs: (1) the sex of the client, (2) the ethnicity of the person meeting with the client,(3) the location of the first meeting with the client, (4) the method of collecting data on sex partners, (5) the contact and referral methods for partners, and (6) how infected sex partners receive medical treatment. Respondents (n = 186) were recruited from a county-run STD clinic, a community clinic, and a community-based organization that primarily provided drug treatment. Each respondent evaluated five different vignettes from two different perspectives: (1) as an infected person and (2) as a sex partner of an infected person.

Results: Regression analysis of the responses showed that most experimental approaches to partner notification were negatively evaluated in comparison with evaluations for the conventional program description. There were some differences between the two sets of results, depending on the role of the respondent, suggesting that as sex partners of infected persons, respondents are less concerned about confidentiality at the notification stage but more concerned about it at the treatment stage. Finally, there was no effect of the ethnic or sex match between the disease intervention specialist program staff and the client; this demonstrates that professionalism and training can overcome cultural or ethnic disparities between program staff and clients.