Factors associated with partner referral among patients with sexually transmitted infections in Bangladesh

Understanding the demographic, behavioural and psychosocial factors associated with partner referral for patients with sexually transmitted infections (STIs) is important for designing appropriate intervention strategies. A survey was conducted among STI clients in three government and three non-governmental organization-operated clinics in Dhaka and Chittagong city in Bangladesh. Demographic and psychosocial information was collected using a questionnaire guided by the Attitude-Social Influence-Self Efficacy model. Partner referral data were collected by verification of referral cards when partners appeared at the clinics within one month of interviewing the STI clients. Of the 1339 clients interviewed, 81% accepted partner referral cards but only 32% actually referred their partners; 37% of these referrals were done by clients randomly assigned to a single counselling session vs. 27% by clients not assigned to a counselling session (p < 0.0001). Among psychosocial factors, partner referral intention was best predicted by attitudes and perceived social norms of the STI clients. Actual partner referral was significantly associated with intention to refer partner and attitudes of the index clients. Married clients were significantly more likely to refer their partners, and clients with low income were less likely to refer partners. Intervention programmes must address psychosocial and socio-economic issues to improve partner referral for STIs in Bangladesh.