Effect of Relationship Context and Quality on Healthcare Service Participation

BACKGROUND: The effects of relationship context (e.g. long-term, committed; non-committed, casual) and quality (e.g. perceived as meeting personal needs) on individuals' intentions to engage in healthcare services for sexually transmitted infections (STI) are not well understood. Conceivably, context and quality may influence partner notification, testing, and treatment. This study investigated the influence of these factors on participation in sexual healthcare services. METHODS: Eighty individuals (men, n=40; women, n=40) age 18-40 years attending an urban STI clinic in the mid-western United States participated in individual interviews. The resulting qualitative data were systematically analyzed: broad thematic categories were first identified and in the final stage of analyses a coding framework was applied to all of the data. RESULTS: Relationship context influenced willingness to engage in certain STI healthcare practices. Partner notification was most likely to occur in close, committed partnerships and least likely to occur in casual partnerships (i.e. one night stands) and poor quality relationships (i.e. did not meet personal needs). Surprisingly, in most cases, non-monogamy did not affect participants' intentions to notify their partner. However, established trust between partners was a significant facilitator to the uptake of partner testing and treatment. Moreover, blaming a partner for introducing an STI into the relationship had a major impact on individuals' intentions to participate in certain partner testing and treatment options. DISCUSSION: Our results indicate that both relationship context and relationship quality affect likelihood to participate in certain STI healthcare services and merit further research as well as heightened attention by healthcare providers.