BackgroundPartner notification (PN) among individuals newly diagnosed with HIV/STI is seen as a vital tool to identify others at risk of infection. However, hardly any data are available on the effectiveness of PN on HIV/STI transmission in the Netherlands. This study aims to fill this gap by assessing current PN practices, case-finding effectiveness, and determinants of being notified among men having sex with men (MSM) in the Netherlands.MethodsNurses from five STI centers participated in a prospective pilot study on PN outcomes (partners being: at risk, notifiable, notified, and tested) for HIV/STI, by completing a newly developed PN registration form (PN database). PN outcomes including case-finding effectiveness (number of newly diagnosed cases in partners/number of partners being tested) for HIV, syphilis, and gonorrhoea were studied among MSM. Furthermore, the national STI database was analyzed to identify determinants of being notified. The number of infections that remained undetected was estimated based on these two databases.ResultsIn total 105 MSM, newly diagnosed with HIV/STI, reported 612 sexual partners at risk of whom 41% were notifiable and 31% were notified. Patient referral was the predominant PN method (90%). The overall case-finding percentage was 36% (HIV: 15-33%, gonorrhoea: 17-50% and syphilis: 4-11%). Case-finding percentages were lower in the national STI database: 21% (5%, 28%, 12%). Persons with one or more sexual partners, known HIV positives, and IDU were more likely to be notified to the STI clinic. Notified clients were more likely to have HIV/STI than unnotified clients (OR 1.7-2.5). Based on these two databases, an estimated 75 to 133 infections remained undetected (HIV: 12–90; gonorrhoea: 28–97; syphilis: 5–12 infections).ConclusionsPartner notification among MSM in the Netherlands is suboptimal; an extensive number of STI/HIV infections remained undetected mainly due to unnotifiable partners. To enhance PN practices, combined and innovative PN interventions such as Internet-based PN will be implemented for hard-to-reach MSM and other risk groups.

Partner notification effectiveness among index clients diagnosed with HIV, syphilis and/or gonorrhoea at sexually transmitted infection (STI) clinics was evaluated between 2010 and 2012. We explored percentages of identifiable, notified and tested partners by sexual preference and gender. Partner notification trends were studied using the national STI database. Men who have sex with men (n = 304), heterosexual men (n = 33) and women (n = 35) reported, respectively, 6.7, 3.8 and 2.3 partners per index. Percentages of identifiable partners differed between groups (men who have sex with men: 46%, heterosexual men: 63%, women: 87%, p < 0.001). The percentage of notified partners (of those identifiable) was lowest for heterosexual men (76%; men who have sex with men: 92%; women: 83%; p < 0.001). STI positivity rates among notified partners were high: 33%-50% depending on sexual preference. Among men who have sex with men, having HIV was associated with not notifying all identifiable partners. Percentages of notified clients at STI clinics increased between 2010 and 2012: from 13% to 19% among men who have sex with men, from 13% to 18% among heterosexual men and from 8% to 11% among women (p < 0.001 for all groups). The percentage of STI/HIV detected through partner notification increased among men who have sex with men (from 22% to 30%) and women (from 25% to 29%; p < 0.001). Unidentifiable partners among men who have sex with men, lower partner notification effectiveness for HIV and the relative large proportion of heterosexual men not notifying their partners appear to be important partner notification challenges.

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Objectives Long-term care facilities (LTCFs) may act as a reservoir of ESBL-producing Enterobacterales (ESBL-E) and carbapenemase-producing Enterobacterales (CPE) for hospitals and the general population. In this study, we estimated the prevalence and molecular epidemiology of rectal carriage with ESBL-E and CPE in residents of Dutch LTCFs between March 2018 and December 2018. Methods LTCFs were geographically selected across the country. For each LTCF, a random sample of residents were tested for ESBL-E and CPE in 2018. To identify risk factors for high carriage prevalence and/or individual carriage, characteristics of LTCFs and of a subset of the tested residents were collected. WGS was conducted on isolates from LTCFs with an ESBL-E prevalence of &gt;10% and all CPE isolates to identify institutional clonal transmission. Results A total of 4420 residents of 159 LTCFs were included. The weighted mean ESBL-E prevalence was 8.3% (95% CI: 6.8–10.0) and no CPE were found. In 53 LTCFs (33%), where ESBL-E prevalence was &gt;10%, MLST using WGS (wgMLST) was performed. This included 264 isolates, the majority being Escherichia coli (n = 224) followed by Klebsiella pneumoniae (n = 30). Genetic clusters were identified in more than half (30/53; 57%) of high ESBL-positive LTCFs. Among the E. coli isolates, blaCTX-M-15 (92/224; 41%) and blaCTX-M-27 (40/224; 18%) were the most prevalent ESBL-encoding genes. For K. pneumoniae isolates, the most common was blaCTX-M-15 (23/30; 80%). Conclusions The estimated prevalence of ESBL-E rectal carriage in Dutch LTCFs is 8.3% and resistance is observed mainly in E. coli with predominance of blaCTX-M-15 and blaCTX-M-27. ESBL-E prevalence in LTCFs seems comparable to previously reported prevalence in hospitals and the general population.

Purpose This study investigated the difference of effects between advanced partner notification (APN) and traditional partner notification (TPN). Methods The subjects who had Western bolt test or newly diagnosed with HIV were recruited. All subjects were randomly assigned into experimental and control group, 30 subjects in each group. Advanced Partner Notification was therefore developed based on the self-efficacy concept of Bandura. The process of APN includes advanced interaction model, comprehensive assessment model for partner information, and promoting self-efficacy of partner notification model. In control group, 30 subjects accepted the process of TPN. Results Sixty participants were men who have sex with men and unmarried. The mean age was 28.3 years (SD = 4.64). The results revealed that the index cases of APN were significantly better than the group of TPNM in provided more contactable partner of 107 cases (t = 2.16, p = 0.037), successed notified more partner of 73 cases (t = 2.25, p = 0.029), receiving HIV test more partner of 25 cases (t = 2.05, = 0.046). There were 22 partners whose HIV test were positive in APN group (HIV positive rate was 41.51%) and 7 partners whose HIV test were positive in TPN group (HIV positive rate was 25.0%). The HIV positive partners in APN group were 15 cases (t = 2.64, p = 0.01) more than those in TPN group. In addition, the mean difference in safer sexual knowledge, number of sexual partners, frequency of unsafe sexual behaviours, frequency of safer sexual behaviours, frequency of resource referral numbers, and process evaluation of PN were significantly better than those in TPN group. Conclusion The process of APN is better than the process of TPN in many aspects. The result can improve the quality of current partner notification policy and practise. Background Partner notification (PN) is seen as a vital tool to break HIV/STI transmission chains. In the Netherlands, studies assessing PN effectiveness were lacking. Here, we evaluated effectiveness of current PN practises in STI clinics to provide recommendations to further enhance PN. Methods PN outcomes were collected through a newly developed registration system from index patients with HIV, syphilis, and gonorrhoea visiting five STI centres in 2010-2011. PN outcomes for men who have sex with men (MSM) and heterosexuals included partners: at risk, notifiable, notified, tested and diagnosed with STI/HIV. Results Of all index patients newly diagnosed with HIV/STI (N = 388) for whom PN was indicated, 312 MSM, 35 heterosexual men and 41 women reported respectively 2042, 126 and 82 partners at risk (6.5, 3.6 and 2.0 partners per index). Proportions of notifiable partners differed significantly by sexual preference (MSM: 46%, heterosexual men: 63%, women: 87%, p < 0.001). Proportions of notified partners (of those notifiable) were lowest for heterosexual men (77% versus 92% for MSM and 83% for women, p < 0.001). STI positivity rates among partners were high for all groups: 33%-50%. Partner notifiCation outComes for msm and