Regulating sexual bodies or addressing health needs? Men who have sex with men and partner notification

Informed, but uncertain: managing transmission risk and isolation in the 2022 mpox outbreak among gay and bisexual men in Australia

In 2022, a global outbreak of mpox (formerly 'monkeypox') emerged in non-endemic countries, including Australia, predominantly affecting gay, bisexual and other men who have sex with men. Public health advice on transmission and isolation emerged rapidly from different sources, sometimes conflicting and producing uncertainty. Using the concept of 'counterpublic health', which acknowledges the incorporation of official science and experiences of affected communities into embodied practice, this paper investigates how people affected by mpox in Australia managed risk of transmission and navigated self-isolation. In-depth interviews were conducted with 16 people: 13 people diagnosed with mpox and three close contacts. All participants were cisgender gay and bisexual men living in Australia. Participants thought critically about public health advice, often finding it restrictive and unresponsive to the needs of people with mpox. Participants' decisions about reducing mpox risk and isolating often drew on experiences with other infections (i.e. HIV; COVID-19) and were made collaboratively with the people closest to them (e.g. partners, friends, family) to sustain relationships. Future public health responses to infectious disease outbreaks would benefit from identifying more opportunities to formalise and embed mechanisms to obtain feedback from affected communities so as to inform responses.

Anticipated Notification of Sexual Partners following STD Diagnosis among Men Who Have Sex with Men and Transgender Women in Lima, Peru: A Mixed Methods Analysis

BACKGROUND

New strategies to support partner notification (PN) are critical for STD control and require detailed understanding of how specific individual and partnership characteristics guide notification decisions.

METHODS

From 2011 to 2012, 397 MSM and TW recently diagnosed with HIV, syphilis, or another STD completed a survey on anticipated notification of recent sexual partners and associated factors. Qualitative interviews were conducted with a subset of participants to provide further depth to quantitative findings. Prevalence ratios and generalized estimating equation (GEE) models were used to analyze participant- and partner-level factors associated with anticipated PN.

RESULTS

Among all partners reported, 52.5% were described as "Very Likely" or "Somewhat Likely" to be notified. Anticipated notification was more likely for main partners than casual (adjusted Prevalence Ratio [aPR], 95% CI: 0.63, 0.54-0.75) or commercial (aPR, 95% CI: 0.44, 0.31-0.62) partners. Other factors associated with likely notification included perception of the partner as an STD source (aPR, 95% CI: 1.27, 1.10-1.48) and anticipated future sexual contact with the partner (aPR, 95% CI: 1.30, 1.11-1.52). An HIV diagnosis was associated with a lower likelihood of notification than non-HIV STDs (aPR: 0.68, 0.55-0.86). Qualitative discussion of the barriers and incentives to PN reflected a similar differentiation of anticipated notification according to partnership type and type of HIV/STD diagnosis.

DISCUSSION

Detailed attention to how partnership characteristics guide notification outcomes is essential to the development of new PN strategies. By accurately and thoroughly assessing the diversity of partnership interactions among individuals with HIV/STD, new notification techniques can be tailored to partner-specific circumstances.

"Manejar la Situacion": Partner Notification, Partner Management, and Conceptual Frameworks for HIV/STI Control Among MSM in Peru

Previous analyses of partner notification (PN) have addressed individual, interpersonal, social, and structural issues influencing PN outcomes but have paid less attention to the conceptual framework of PN itself. We conducted 18 individual interviews and 8 group discussions, in a two-stage qualitative research process, to explore the meanings and contexts of PN for sexually transmitted infections (STI) among men who have sex with men (MSM) and men who have sex with men and women (MSMW) in Lima, Peru. Participants described PN as the open disclosure of private, potentially stigmatizing information that could strengthen or disrupt a partnership, structured by the tension between concealment and revelation. In addition to informing partners of an STI diagnosis, the act of PN was believed to reveal other potentially stigmatizing information related to sexual identity and practices such as homosexuality, promiscuity, and HIV co-infection. In this context, the potential development of visible, biological STI symptoms represented a risk for disruption of the boundary between secrecy and disclosure that could result in involuntary disclosure of STI status. To address the conflict between concealment and disclosure, participants cited efforts to "manejar la situacion" (manage the situation) by controlling the biological risks of STI exposure without openly disclosing STI status. We use this concept of "managing the situation" as a practical and theoretical framework for comprehensive Partner Management for HIV/STI control systems among MSM in Latin America.

Examining the scope of public health nursing practice in sexually transmitted infection prevention and management: what do nurses do?

AIMS AND OBJECTIVES

To develop a more comprehensive understanding of the scope of public health nursing practice in the prevention and management of sexually transmitted infections and also to examine the public health nursing workforce in sexually transmitted infection care and the range of patient populations served.

BACKGROUND

Sexually transmitted infections are increasing, widespread and remain a significant public health problem throughout the world. Although nurses are taking on expanded roles in sexually transmitted infection care, little is known about the scope of this practice.

DESIGN

A cross-sectional descriptive study took place over 18 months (2009-2010).

METHODS

Three hundred and fourteen eligible nurses completed a 62-item questionnaire.

RESULTS

93·6% of participants were women; 77·5% were baccalaureate prepared and 87·9% underwent continuing education in sexually transmitted infection care. Most spent 50% of their time in direct patient care. Women were the main care recipients (72·9%). Sexually transmitted infection care was one aspect of nurses' multifaceted public health roles accounting for 28% of overall work activities. Not all nurses were working to the full scope of their practice; 77·9% undertook health history assessment, and 79% conducted testing.

CONCLUSION

This study is a comprehensive description of the scope of sexually transmitted infection nursing practice activities. It expands our understanding of sexually transmitted infection nursing practice among nurses working within an expanded scope and provides a baseline for future investigations. This description is situated within nursing competencies and best practices that may be used to develop, implement and evaluate models of sexually transmitted infection service delivery in other locales.

CLINICAL PRACTICE RELEVANCE

Sexually transmitted infection nursing practice needs to be understood and investigated beyond health education and testing practices. The scope of practice is comprehensive and incorporates a full spectrum of care. Public health nurses are a critical entry point into the healthcare system and provide primary and preventative care and healthcare referrals. Models of nursing care need to support nurses working to their full scope, and associated barriers warrant further investigation.