Research

Relationship Dynamics and Experiences of Expedited Partner Therapy Among Adolescent Girls and Young Women in Johannesburg, South Africa

Rebecca Howett | 2024

Research Area(s): Infectious Diseases, Public Health Practice

Background: Adolescent girls and young women (AGYW) are disproportionately impacted by sexually transmitted infections (STIs). We evaluated associations between relationship dynamics and expedited partner therapy (EPT) acceptance and delivery, and delivery experiences, among AGYW diagnosed with an STI and participating in a prospective cohort study (ARISE). Setting: Participants attending a research clinic in Johannesburg, South Africa, were enrolled between February 2022 and December 2023. Methods: Cisgender AGYW (aged 18-25) diagnosed with an STI at enrollment, were provided STI treatment, completed the HEAlthy Relationship Assessment Tool (HEART, an index developed for PrEP that measures relationship dynamics across three domains – traditional values, partner support, and partner abuse and control), and were offered EPT or partner notification slips (standard of care). We used modified Poisson regression to assess associations between HEART domain scores and initial EPT acceptance and delivery, and characterized EPT delivery experiences. Results: Among 305 participants enrolled, 257 reported a primary partner and returned for the first follow-up visit. Prevalence of EPT acceptance (244/257, 95%) and delivery (232/244, 95%) were high. In relationships characterized by high partner abuse and control, there was a lower likelihood of EPT acceptance (89% among participants with a high score in this domain versus 97% among those with a low score; PR 0.91 [95% CI 0.84, 0.99]). Other domains were not associated with EPT acceptance or delivery. Some participants reported angry (19/232, 8%) or violent (1/232, <1%) partner responses. Conclusion: Initial EPT acceptance and delivery were high. Participants who indicated partner abuse and control were less likely to accept EPT. Intimate partner violence was reported infrequently. The HEART index helped guide EPT conversations and may have applicability beyond PrEP.