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Lariat J, Chikwari CD, Dauya E, Baumu VT, Kaisi V, Kafata L, Meza E, Simms V, Mackworth-Young C, Rochford H, Machiha A, Bandason T, Francis SC, Ferrand RA, Bernays S. "It's not safe for me and what would it achieve?" Acceptability of patient-referral partner notification for sexually transmitted infections to young people, a mixed methods study from Zimbabwe. Sex Reprod Health Matters 2023; 31:2220188. [PMID: 37565610 PMCID: PMC10424614 DOI: 10.1080/26410397.2023.2220188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Abstract
Partner notification (PN) is considered integral to the management of sexually transmitted infections (STI). Patient-referral is a common PN strategy and relies on index cases notifying and encouraging their partners to access treatment; however, it has shown limited efficacy. We conducted a mixed methods study to understand young people's experiences of PN, particularly the risks and challenges encountered during patient-referral. All young people (16-24 years) attending a community-based sexual and reproductive health service in Zimbabwe who were diagnosed with an STI were counselled and offered PN slips, which enabled their partners to access free treatment at the service. PN slip uptake and partner treatment were recorded. Among 1807 young people (85.0% female) offered PN slips, 745 (41.2%) took up ≥1 PN slip and 103 partners (5.7%) returned for treatment. Most participants described feeling ill-equipped to counsel and persuade their partners to seek treatment. Between June and August 2021, youth researchers conducted in-depth interviews with 41 purposively selected young people diagnosed with an STI to explore their experiences of PN. PN posed considerable social risks, threatening their emotional and physical safety. Except for a minority in long-term, publicly acknowledged relationships, participants did not expect PN would achieve successful outcomes. Public health discourse, which constructs PN as "the right thing to do", influenced participants to adopt narratives that concealed the difficulties of PN and their unmet needs. Urgent interrogation is needed of whether PN is a suitable or constructive strategy to continue pursuing with young people. To improve the outcomes of preventing reinfection and onward transmission of STIs, we must consider developing alternative strategies that better align with young people's lived experiences.Plain language summary Partner notification is a public health strategy used to trace the sexual partners of people who have received a sexually transmitted infection (STI) diagnosis. It aims to interrupt the chains of STI transmission and prevent reinfection by treating both the person diagnosed and their sexual partners. The least effective but most common partner notification strategy used in many resource-limited settings is called "patient referral". This involves a sexual healthcare provider encouraging the person diagnosed to give a "partner notification slip" to their potentially exposed sexual partner/s and persuading them to access treatment. This research sought to better understand young people's experiences of partner notification, particularly the risks and challenges they faced during patient-referral.All young people (16-24 years) attending a community-based sexual and reproductive health service in Zimbabwe who were diagnosed with an STI were counselled and offered PN slips, which enabled their partners to access free treatment at the service. Young people trained as researchers interviewed 41 young people who had received a STI diagnosis to explore their experiences of partner notification.Only a small number (5.7%) of the partners of those who took a slip attended the service for treatment. Most participants felt they did not have the preparation, skills, or resources to persuade their partners to seek treatment. Many described negative experiences during and after partner notification, including relationship breakdown, reputation damage, and physical violence.These findings suggest that we should reconsider if partner notification is suitable or effective for use with young people. We should explore alternative approaches that do not present risks to young people's social, emotional, and physical safety and well-being.
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Affiliation(s)
- Joni Lariat
- Associate Lecturer, School of Public Health, University of Sydney, Sydney, Australia
| | - Chido Dziva Chikwari
- Assistant Professor, THRU Zim, Harare, Zimbabwe; Assistant Professor, London School of Hygiene and Tropical Medicine, London, UK
| | - Ethel Dauya
- Study Coordinator, THRU Zim, Harare, Zimbabwe
| | | | | | | | - Esnath Meza
- Youth Researcher, THRU Zim, Harare, Zimbabwe
| | - Victoria Simms
- Associate Professor. THRU Zim, Harare, Zimbabwe; Associate Professor, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Anna Machiha
- STI Coordinator, Ministry of Health and Child Care, Harare, Zimbabwe
| | | | - Suzanna C. Francis
- Associate Professor, London School of Hygiene and Tropical Medicine, London, UK
| | - Rashida A. Ferrand
- Professor, THRU Zim, Harare, Zimbabwe; Professor, London School of Hygiene and Tropical Medicine, London, UK
| | - Sarah Bernays
- Associate Professor, School of Public Health, University of Sydney, Sydney, Australia; Associate Professor, London School of Hygiene and Tropical Medicine, London, UK
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Shultz JM, Garcia-Vera MP, Santos CG, Sanz J, Bibel G, Schulman C, Bahouth G, Dias Guichot Y, Espinel Z, Rechkemmer A. Disaster complexity and the Santiago de Compostela train derailment. Disaster Health 2017; 3:11-31. [PMID: 28229012 DOI: 10.1080/21665044.2015.1129889] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 05/23/2015] [Accepted: 05/26/2015] [Indexed: 10/22/2022]
Abstract
This disaster complexity case study examines Spain's deadliest train derailment that occurred on July 24, 2013 on the outskirts of Santiago de Compostela, Galicia, Spain. Train derailments are typically survivable. However, in this case, human error was a primary factor as the train driver powered the Alvia train into a left curve at more than twice the posted speed. All 13 cars came off the rails with many of the carriages careening into a concrete barrier lining the curve, leading to exceptional mortality and injury. Among the 224 train occupants, 80 (36%) were killed and all of the remaining 144 (4%) were injured. The official investigative report determined that this crash was completely preventable.
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Affiliation(s)
- James M Shultz
- Center for Disaster & Extreme Event Preparedness (DEEP Center), University of Miami Miller School of Medicine , Miami, FL, USA
| | - Maria Paz Garcia-Vera
- Universidad Complutense de Madrid, Psychosocial Team, Military Disaster Relief Unit, Spanish Ministry of Defense , Madrid, Spain
| | - Clara Gesteira Santos
- Department of Personality, Assessment, and Clinical Psychology, Universidad Complutense de Madrid , Madrid, Spain
| | - Jesús Sanz
- Department of Personality, Assessment, and Clinical Psychology, Universidad Complutense de Madrid , Madrid, Spain
| | - George Bibel
- Department of Mechanical Engineering, College of Engineering and Mines, University of North Dakota , Grand Forks, ND, USA
| | - Carl Schulman
- William Lehman Injury Research Center, Surgical Residency Program, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine , Miami, FL, USA
| | | | - Yasmin Dias Guichot
- WalkSafe Program, KiDZ Neuroscience Center, The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine , Miami, FL, USA
| | - Zelde Espinel
- Department of Psychiatry and Behavioral Health, University of Miami Miller School of Medicine and Jackson Memorial Hospital , Miami, FL, USA
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Généreux M, Petit G, Maltais D, Roy M, Simard R, Boivin S, Shultz JM, Pinsonneault L. The public health response during and after the Lac-Mégantic train derailment tragedy: a case study. Disaster Health 2015; 2:113-120. [PMID: 28229006 DOI: 10.1080/21665044.2014.1103123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 10/01/2015] [Indexed: 10/22/2022]
Abstract
On July 6th 2013, a train derailment occurred in the small town of Lac-Mégantic, Quebec, Canada, causing a major human and environmental disaster. In this case study, we comprehensively describe and analyze actions taken by the Public Health Department of the Eastern Townships, in close collaboration with community-based organizations, during both the impact phase emergency response and the post-impact recovery operations that continued for months. Due to the complexity of the event, public health actions needed to be broadly diversified. Preventive measures targeted chemical, physical, biological, and psychosocial hazards in the short-, medium- and long-term. Our analyses yielded valuable lessons that will improve and inform our response to future events while serving as a basis for developing a conceptual framework for public health emergency preparedness.
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Affiliation(s)
- Mélissa Généreux
- Public Health Department; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre; Sherbrooke, Québec, Canada; University Institute for Primary Health Care & Social Services; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre; Sherbrooke, Québec, Canada; Department of Community Health Sciences; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, Québec, Canada
| | - Geneviève Petit
- Public Health Department; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre; Sherbrooke, Québec, Canada; Department of Community Health Sciences; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, Québec, Canada
| | - Danielle Maltais
- University Institute for Primary Health Care & Social Services; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre; Sherbrooke, Québec, Canada; Department of Human and Social Sciences; Education Unit in Social Work; Université du Québec à Chicoutimi; Chicoutimi, Quebec, Canada
| | - Mathieu Roy
- University Institute for Primary Health Care & Social Services; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre; Sherbrooke, Québec, Canada; Department of Family Medicine and Emergency Medicine; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, Québec, Canada
| | - Robert Simard
- Public Health Department; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre ; Sherbrooke, Québec, Canada
| | - Sonia Boivin
- Public Health Department; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre ; Sherbrooke, Québec, Canada
| | - James M Shultz
- Center for Disaster & Extreme Event Preparedness (DEEP Center); University of Miami Miller School of Medicine ; Miami, FL USA
| | - Linda Pinsonneault
- Public Health Department; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre; Sherbrooke, Québec, Canada; University Institute for Primary Health Care & Social Services; Eastern Townships Integrated University Centre for Health & Social Services - Sherbrooke Hospital University Centre; Sherbrooke, Québec, Canada; Department of Community Health Sciences; Faculty of Medicine and Health Sciences; Université de Sherbrooke; Sherbrooke, Québec, Canada
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