Acquired Skills in Sexually Transmitted Disease Prevention: Partner Services and Tailoring Interventions to Populations

Abstract

Data from the past decade and a half revealed that many people, at least in the United States and Western Europe, have used the internet as a means to seek and acquire sex partners, both for short-term and potentially long-term relationships. Early survey research and 1 meta-analysis of men who have sex with men (MSM) suggested that those who sought sex partners on the internet engaged in riskier behaviors (eg, multiple sex partners) than those who did not. 1,2 One later 2006 -2008 clinic-based survey has shown fewer differences between internet users and non-users in risky behaviors and infection rates, although this clinic-based survey has limited generalizability. 3 Intervention services have also been distributed through the same medium, including one of the major components of sexually transmitted disease (STD) prevention programs: partner services. In this editorial, we address a study in which an STD clinic implemented and evaluated the effects of an online partner notification program. 4 The results have led us to write about the role of the intervention, as well as the role of the clinic.If people can find partners online, many of them should be able to either put a disease intervention specialist (DIS) in touch with those partners through the same medium or send an online notification message themselves. In fact, DIS have used email and other electronic methods 5 to contact partners of persons infected with syphilis or HIV, whether the infection occurred with a partner met over the internet. 6,7 However capable DIS may be, there are insufficient numbers of them to provide partner services to all infected people, and, in the current fiscal climate, that fact is not likely to change soon. With the index patient as the alternative medium through which partner services can be offered, it makes sense to explore how the internet might contribute to partner services intervention.With a few exceptions, 2,8 the majority of the literature on online sex partner seeking has either focused on MSM or found that MSM make up a disproportionate fraction of people seeking sex on the internet. A substantial proportion of this subset of MSM has relatively large numbers of partners and poor-quality contact information for them. Consequently, initial efforts to establish internet partner notification programs focused upon MSM. While internet sexuality information services first adopted this approach when it created inSPOT, a website dedicated to facilitating internet partner notification, it now aims to be inclusive of all audiences, regardless of sexual orientation. 9 In this issue, Rietmeijer et al. describe the promotion of inSPOT and uptake of its services among STD clinic clients, a predominantly heterosexual population in Denver. 4 Promotion of inSPOT was achieved through 4 activities that were "feasible in the 'real-world' setting [given] the resource constraints of a typical STD clinic": (1) distribution of cards advertising inSPOT to index cases, (2) clinic posters and flyers, (3) a link to inSPOT on the STD clinic ...

Expedited Partner Therapy (EPT) increases the frequency of partner notification among MSM in Lima, Peru: a pilot randomized controlled trial

“…The majority of research on EPT has been conducted with heterosexual partnerships in the USA and Western Europe, with little attention paid to how the delivery of patient-delivered partner therapy might differ within the interpersonal dynamics of male and/or transgender female sexual partnerships in developing country settings [29–32]. Social, cultural, and structural differences in how same-sex sexual partnerships are defined, how norms of gender and sexuality influence power dynamics and communication patterns within these partnerships, and how access to healthcare services affects HIV/STI testing and treatment outcomes are all critical issues to address prior to the large-scale introduction and global dissemination of EPT and other partner-based HIV and STI prevention interventions [33–38].…”