Barriers to and facilitators of online partner notification and management for people with STIs in the UK: qualitative findings from the SEQUENCE digital research programme

Introduction

UK sexual health services are shifting online. Uptake of online partner notification and management (OPNM) for sexually transmitted infections (STIs) is low. There is a lack of evidence to guide its development and deployment. This study explored the acceptability of, and barriers and facilitators to, OPNM to inform the optimisation of an eSexual Health Clinic (eSHC).

Methods

We conducted semi-structured qualitative interviews (n=25) with UK sexual health service users recruited from clinics and the community (10/2021–01/2023). Interviews explored experiences of partner notification (PN), barriers to and facilitators of OPNM, and involved a walk-through of an OPNM prototype pathway (Figure 1) using fictional personas/scenarios. We analysed transcripts using thematic analysis.

Results

Participants were diverse in terms of gender, sexual identity, and disability. Most found OPNM acceptable and described using some online PN methods themselves (e.g., texting). Facilitators included: perception of OPNM as more convenient and less embarrassing than face-to-face/telephone PN; perception of its suitability for use with casual partners; provision of multiple tools for both identifiable and anonymous PN; and facilitation of online partner testing/treatment. Barriers included: perception of OPNM as impersonal and preferences for telling/being told in a more personal way, especially in ongoing relationships; security and privacy concerns; and distrust of online notifications.

Discussion

OPNM appears acceptable, but acceptability varied depending on relationship type and communication preferences. In developing an eSHC, consideration should be given to incorporating multiple options for communicating with partners that allow users to identify themselves or remain anonymous, and providing messaging that is personalisable to the relationship and context. Pairing PN with accessible online STI testing/information and treatment, where appropriate, may motivate index patients to engage in PN and efficiently link partners into online management. Building trust with users is key and may be facilitated through NHS branding and security/privacy assurances.