Effectiveness and cost-effectiveness of traditional and new partner notification technologies for curable sexually transmitted infections: observational study, systematic reviews and mathematical modelling

Partner notification for sexually transmitted infections and perception of notified partners

“…One example of an innovative action implemented in the United Kingdom was offering telephone consultation with a physician or pharmacist to sexual partners of people with bacterial STIs to expand partner access to the treatment (5) . In this study, the perception of partner tranquility while being notified may be related to the fact that most of these infections are asymptomatic, a factor that does not attenu- hepatitis B, when undetected, lead to serious complications, such as congenital syphilis, pelvic inflammatory disease, infertility and cirrhosis (3) .…”

“…However, despite the national recommendation methods, there is no study in the country showing how partners are notified and what strategies are currently used in health services. Improper notification is one of the main factors associated with the challenge of STI control (4)(5) , especially syphilis, whose non-treatment of partners of infected pregnant women is frequently mentioned as one of the causes of congenital syphilis in the country (6) . In the United States and in Europe, partner notification has become a strategy of HIV prevention, and it is related to the increased search for counseling and testing among sexual partners notified by index patients diagnosed with the virus (1)(2)4) .…”

“…Partner notification actions in case of index patients with syphilis, gonorrhea, chlamydia and HIV in most European countries are priorities and the main responsibility of specialty health providers from reference clinics (2) . Regardless of the partner notification method, during the service to a person diagnosed with an STI, the health professional has to discuss about the importance of partner notification, explaining the information confidentiality process, the possibility of partners being infected and asymptomatic, the risks of reinfection and consequences of non-treatment (5) . Studies indicate the need to review how partners are approached at the primary healthcare level, aiming to implement strategies to encourage contact from sexual partners with STI, in compliance with health service organization logic and the perspective of people involved in this action (6)(7) .…”

The Ballseye programme: a mixed-methods programme of research in traditional sexual health and alternative community settings to improve the sexual health of men in the UK

“…However, the optimal partner notification strategy for people with chlamydial infection is unknown. A recent systematic review of RCTs of partner notification 91 for STIs causing cervicitis and urethritis suggests that expedited partner therapy (EPT), in which the doctor provides the index patient with antibiotics or a prescription to give to their sex partner, 94 is more effective than simple patient referral [verbal advice that the partner(s) should attend] in preventing index reinfection and achieves treatment of a higher proportion of sex partners. However, EPT does not appear to be more effective than enhanced patient referral (simple patient referral supplemented by written advice, longer verbal explanation and/or internet resources) in preventing index reinfection and is not associated with higher numbers of partners treated.…”

“…95 These meet UK prescribing guidance and have shown promise in the specialist setting. 95,96 Furthermore, modelling studies suggest that APT could play an important role in reducing index reinfection and the prevention of costly reproductive health consequences, especially in women, 93,94 by reducing the time to successful partner treatment. 95 Successful control of chlamydia will need effective methods of partner notification, irrespective of the setting in which the infection is diagnosed.…”