Acceptability of Innovative Methods of Anonymous STI Partner Notification Among American Adolescents

Background: Previous studies have explored the acceptability of various methods of partner notification (PN) among American men who have sex with men. These studies have not, however, looked at the acceptability of new methods such as internet-based PN among adolescents in the general population.

Objectives: To describe and compare the acceptability of sending and receiving various methods of anonymous PN for chlamydia among American adolescents.

Methods: An original survey was conducted online. Participants were randomized to hypothetical scenarios in which they were assigned the role of a sender or a recipient of a PN and assigned to a resource-rich setting (where health departments provide chlamydia PN by Disease Intervention Specialists (DIS)) or a resource-poor setting (where only online or self-initiated anonymous options are available). Possible predictors of this acceptability were also measured, including demographic characteristics, sexual history, and projected outcomes of the various methods of PN. Statistical significance was assessed by ordered logistic regression, accounting for within-person clustering.

Results: Three hundred forty-three (343) Americans ages 18-25 years were included. Acceptability differed among the various methods of PN (P<0.0001). For both senders and recipients, DIS phone-based PN was more acceptable than DIS and 3^rd-party email PN (p<.001), which in turn were more acceptable than DIS texts, anonymous e-cards, anonymous texts, or DIS visits. Anonymous letters were fairly acceptable to hypothetical recipients but were unlikely to be used by hypothetical senders. Randomization to a resource-poor versus a resource-rich scenario significantly impacted acceptability. Other predictors of acceptability were explored.

Conclusions: STD programs should continue to offer DIS phone-based partner notification when possible. The development and promotion of email-based partner notification should be explored, both by DIS officers and third-party providers.

Implications for Programs, Policy, and Research: Further research should evaluate acceptability of various methods of PN for other STIs and in clinic-based populations.