Partner Services in Sexually Transmitted Disease Prevention Programs

Abstract

Background Partner services have been a mainstay of public health sexually transmitted disease (STD) prevention programs for decades. The principal goals are to interrupt transmission and reduce STD morbidity and sequelae. In this paper, we review current literature with the goal of informing STD prevention programs. Methods We searched the literature for systematic reviews. We found nine reviews published between 2005 and 2014 (covering 108 studies). The reviews varied by study inclusion criteria (e.g., study methods, geographic location, infections). We abstracted major conclusions and recommendations from the reviews. Results Conclusions and recommendations were divided into patient referral interventions and provider referral interventions. For patient referral, there was evidence supporting the use of expedited partner therapy and interactive counseling, but not purely didactic instruction. Provider referral through Disease Intervention Specialists was efficacious and particularly well-supported for HIV. For other studies, modeling data and testing outcomes showed that partner notification in general reached high-prevalence populations. Reviews also suggested more focus on using technology and population-level implementation strategies. However, partner services may not be the most efficient means to reach infected persons. Conclusions Partner services programs constitute a large proportion of program STD prevention activities. Value is maximized by balancing a portfolio of patient and provider referral interventions and by blending partner notification interventions with other STD prevention interventions in overall partner services program structure. STD prevention needs program-level research and development to generate this portfolio.

The Number of Interviews Needed to Yield New Syphilis and Human Immunodeficiency Virus Cases Among Partners of People Diagnosed With Syphilis, North Carolina, 2015

“…17511 This demonstrates that during our current epidemic, with high levels of HIV and syphilis coinfection, syphilis case investigation is as efficient as HIV case investigation in identifying newly-diagnosed HIV infection.…”

“…Efficiency has been quantified in many ways, 56 including as the number of treated partners per case interview, 7 likelihood and magnitude of future transmission, 4 and number of infected partners found per case. 89 More recently, calculation of the number of patients needed to interview to identify a new case of disease that is, number needed to interview (NNTI), has been used to assess the efficiency of partner investigation.…”

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

“…Previous systematic reviews and meta-analyses have suggested that EPT (as well as other practical tools to support partner notification efforts) increases the likelihood of notification, thereby also increasing the probability that sexual partners will be encouraged to seek formal HIV/STI counseling and testing [3, 4, 39, 40]. However, none of these outcomes has been fully evaluated in RCTs of MSM sexual partnerships or in developing country settings.…”

Comparison of In-Person Versus Telephone Interviews for Early Syphilis and Human Immunodeficiency Virus Partner Services in King County, Washington (2010–2014)

“…9 Telephone interviews may be more efficient than in-person interviews; however, their relative effectiveness is uncertain. A survey of attendees of STD and community clinics as well as a community based organization about hypothetical PS found that there was no significant difference in favorability of in-clinic notification compared to telephone notification from the perspective of OPs or partners.…”