Population-Level Outcomes of Partner Notification Among Gay, Bisexual, and Other Men Who Report Sex With Men Diagnosed With Infectious Syphilis in British Columbia, Canada

Abstract

Background: Syphilis testing, treatment, and partner notification (PN) are centrally coordinated in British Columbia (BC), Canada. Public health (PH) nurses (PHNs) contact almost all syphilis patients and either notify partners of syphilis exposure (PH-initiated PN) or support patients to notify their own partners (patient-initiated PN). In the context of an ongoing syphilis epidemic among gay, bisexual, and other men who report sex with men (gbMSM), we measured population-level yields and compared PN approaches to inform prevention and control efforts.Methods: All gbMSM diagnosed with infectious syphilis in 2016 in BC were included. We calculated indicators of engagement with PN among patients and PN outcomes among notifiable partners using a cascade-of-care framework. χ 2 Tests compared indicators between PN approaches. Results:Of the 759 syphilis diagnoses, 85.4% (648/759) were among gbMSM and 94.7% (614/648) were treated within 30 days of testing (mean [SD], 5.5 [5.2] days). Among patients, 87.7% (568/648) discussed PN with PHNs and 49.5% (281/568) named at least 1 notifiable partner, for a total of 1094 partners (mean [SD], 3.9 [5.5] partners/patient). Compared with PH-initiated PN, patient-initiated PN resulted in a greater proportion of partners notified (70.1% [573/817] vs. 89.8% [211/235]; P = 1.88 Â 10 −9 ), but there was no difference in the proportion of partners tested and/or treated (90.2% [517/573] vs. 86.7% [183/211]; P = 0.203), and diagnosed (12.8% [66/517] vs. 16.4% [30/183]; P > 0.271).Conclusions: Public health-and patient-initiated PN had similarly high yields of partners tested and/or treated, and diagnosed, demonstrating that gbMSM can contribute to syphilis PN when supported by resource-equipped PHNs.

Treatment and Partner Notification Outcomes for Clients Diagnosed With Chlamydia and Gonorrhea Through GetCheckedOnline Compared With Sexually Transmitted Infection Clinics in British Columbia, Canada

“…Hence, our PN outcome results are likely underestimates. For example, we have previously reported higher PN outcomes for syphilis cases in men who have sex with men in BC (higher proportions of partners notified, tested, and/or treated), which reflects STI nurses taking a much more active role in notifying partners and ensuring testing or treatment for syphilis cases 27 . Our study emphasizes the ongoing real-world challenges in PN and ascertainment of PN outcomes for STBBI.…”

“…For example, we have previously reported higher PN outcomes for syphilis cases in men who have sex with men in BC (higher proportions of partners notified, tested, and/or treated), which reflects STI nurses taking a much more active role in notifying partners and ensuring testing or treatment for syphilis cases. 27 Our study emphasizes the ongoing real-world challenges in PN and ascertainment of PN outcomes for STBBI. In addition, a time component was not measured for the outcomes in this analysis restricting us from commenting on differences between GetCheckedOnline and clinic cases pertaining to the time to treatment or engagement in PN.…”

Previous Sexually Transmitted Infections and Partner Services Interviews as Predictors of Subsequent Interview Completion Among Cisgender MSM: Partner Services Fatigue?

“…Moreover, MSM carry a disparate burden of HIV in the United States, comprising two-thirds of incident cases nationally 5 . Concurrent with rising rates of STIs and their concentration among MSM, repeat infections are more common 6,7 and known to be associated with risk of subsequent HIV acquisition 8,9 …”

“…4 Moreover, MSM carry a disparate burden of HIV in the United States, comprising two-thirds of incident cases nationally. 5 Concurrent with rising rates of STIs and their concentration among MSM, repeat infections are more common 6,7 and known to be associated with risk of subsequent HIV acquisition. 8,9 Since the mid-20th century, health departments around the United States have used partner services (PS) to control the spread of HIV and STIs.…”