Sex Partner Presentation and Sexual Health Behaviors Among Shanghai STD Clinic Clients

Background: Because infection with bacterial STIs can facilitate transmission of HIV, and given the high incidence of Neisseria gonorrhoeae infection in China, together with high levels of antibiotic resistance,  prevention and control of STIs in China is of particular importance. Along with primary prevention practices, partner notification is an important strategy for controlling the spread of gonorrhea. We aimed to identify predictors of partner presentation and condom use among a sample of individuals with laboratory diagnosed gonorrhea infections.

Methods:  During two periods—from 2004-2005 and 2008-2011—epidemiologic and demographic data were collected from a cross-sectional sample of symptomatic male patients who tested positive for gonorrhea at the Shanghai Skin Disease and STD Hospital. Partners who subsequently presented and consented to participate were also included. Logistic regression models with a generalized estimating equation link were used to identify predictors of partner presentation and condom use among this population.

Results:  567 index male clients were interviewed and provided information on 765 female partners. Of these, 107 female partners were subsequently brought to treatment, resulting in a brought-to-treatment index of 0.19. Men who had non-temporary partnerships (P<0.001), engaged in intercourse with the partner in the preceding week (P<0.001), and had experienced symptoms for more than three days (P=0.01) were more likely to bring their partner to treatment. Characterizing the relationship as non-temporary (P<0.001), being under 35 (P<0.001), and age at sexual debut (p=0.04) were positively associated with “ever” using condoms as compared to never.

Conclusions:  Relationship type, recentness of sexual contact, and duration of symptoms were strongly predictive of bringing a partner to treatment in a Shanghai STI hospital. Further, identification of the apparent association of condom use with stable versus temporary relationships, and among younger versus older age groups, can help tailor education campaigns to the audiences most in need among this population.