Receptivity of referral letters and partner notification practices for sexually transmitted infections among a population of men who have sex with men in South Africa: A qualitative study

Abstract

Although an effective public health strategy to control transmission of sexually transmitted infection (STI) and promote linkage to care exists, little is known about the receptivity of patient referral letters and partner notification (PN) among men who have sex with men (MSM). A qualitative study was conducted involving MSM enrolled in a clinical trial. Individual exit interviews were done with purposefully sampled participants (n = 23) at month 12 from baseline. The study was conducted at a research institute located in a poorly resourced community in Gauteng Province, South Africa. The themes that emerged from the data during thematic content analysis were reaction to STI diagnosis on receiving a referral letter, receptivity of the referral letter and partner notification, STI treatment and usefulness of a referral letter, experiences of accessing healthcare services, nurses’ attitudes towards the MSM, and the MSM’s recommendations for improving health services. The findings suggest that the MSM were receptive to referral letters, which they believed allowed for earlier and easier access to treatment and provided the opportunity to embrace safer sexual practices. Nevertheless, many felt it was challenging to inform their sexual partners due to some being in casual or multiple sexual relationships. Some reported experiencing discrimination from nurses while seeking treatment. This study anticipated that it would be of importance to policymakers when designing and implementing policies on patient referral letters and partner notifications.