(P263) Partner treatment preferences and outcomes at three timepoints among pregnant women treated for Chlamydia trachomatis and Neisseria gonorrhoeae in Botswana

Background:

Partner notification and treatment for sexually transmitted infections (STIs) is critical to prevent reinfection and reduce transmission. However, partner treatment rates are low globally. There is evidence that Expedited Partner Therapy (EPT) results in increased partners treated and decreased reinfection. We assessed partner notification and treatment intent and outcomes among pregnant women in Gaborone, Botswana at three timepoints.

Methods:

The Maduo study was a cluster-controlled trial to evaluate the effect of antenatal CT/NG screening in asymptomatic pregnant women compared to the standard-of-care in Botswana (February 2021-December 2022). The intervention arm received CT/NG testing at first ANC, third trimester, and 6-8 weeks post-delivery. The standard-of-care arm received CT/NG testing at their postnatal visit only. All participants were asked about partner notification preferences. Women who tested positive for CT/NG were given options for partner treatment, including contact slips, in-clinic treatment, and EPT. Partner notification and treatment outcomes were assessed at test-of-cure.

Results:

Among 491 women with a current sex partner at first ANC, 490 (99.8%) reported an intent to notify if they were diagnosed with an STI. This was consistent across third trimester and postnatal visits (99.8% and 99.0% respectively). Of the 52 women testing positive for CT/NG at baseline and returning for test-of-cure, 51 (98.1%) reported notifying their partner and 49 (96.1%) reported successful partner treatment. Similar success was achieved at third trimester and postnatal visits with 5 (100%) and 29 (96.7%) reporting partners treated, respectively. A plurality of participants ( >40%) at all time points preferred for their partner to be treated in-clinic, with few preferring EPT (first ANC: 9.2%; third trimester: 12.3%; postnatal: 12.9%). Among those testing positive, at first ANC 45 (83.3%) chose EPT when offered. Similarly, 5 (83.3%) and 24 (82.8%) participants opted for EPT at third trimester and postnatal visits respectively.



Conclusion:

Self-reported partner notification and treatment success was high in this population. Despite low indicated interest in EPT, the majority of women testing positive ultimately utilized EPT to high success. Partner notification and treatment outcomes did not vary significantly throughout pregnancy and postnatally. Our findings suggest that EPT may be a successful partner treatment strategy to pursue in LMICs.