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Woodward C, Bloch S, McInnes-Dean A, Lloyd KC, McLeod J, Saunders J, Flowers P, Estcourt CS, Gibbs J. Digital interventions for STI and HIV partner notification: a scoping review. Sex Transm Infect 2024; 100:242-250. [PMID: 38754986 PMCID: PMC11187395 DOI: 10.1136/sextrans-2023-056097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/21/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Partner notification (PN) is key to the control of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Digital interventions have been used to facilitate PN. A scoping review was conducted to describe the interventions used, user preferences and acceptability of digital PN interventions from patient and partner perspectives. METHODS A systematic literature search was conducted of eight databases for articles published in English, available online with digital PN outcome data. Articles were assessed using the Mixed Methods Appraisal Tool. Quantitative and qualitative data were synthesised and analysed using thematic analysis. RESULTS Twenty-six articles met the eligibility criteria. Articles were heterogeneous in quality and design, with the majority using quantitative methods. Nine articles focused solely on bacterial STIs (five on syphilis; four on chlamydia), one on HIV, two on syphilis and HIV, and 14 included multiple STIs, of which 13 included HIV. There has been a shift over time from digital PN interventions solely focusing on notifying partners, to interventions including elements of partner management, such as facilitation of partner testing and treatment, or sharing of STI test results (between index patients and tested sex partners). Main outcomes measured were number of partners notified (13 articles), partner testing/consultation (eight articles) and treatment (five articles). Relationship type and STI type appeared to affect digital PN preferences for index patients with digital methods preferred for casual rather than established partner types. Generally, partners preferred face-to-face PN. CONCLUSION Digital PN to date mainly focuses on notifying partners rather than comprehensive partner management. Despite an overall preference for face-to-face PN with partners, digital PN could play a useful role in improving outcomes for certain partner types and infections. Further research needs to understand the impact of digital PN interventions on specific PN outcomes, their effectiveness for different infections and include health economic evaluations.
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Affiliation(s)
| | - Sonja Bloch
- Institute for Global Health, University College London, London, UK
| | | | - Karen C Lloyd
- Institute for Global Health, University College London, London, UK
| | - Julie McLeod
- School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - John Saunders
- Institute for Global Health, University College London, London, UK
| | - Paul Flowers
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Claudia S Estcourt
- School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
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Helms YB, Stein ML, Hamdiui N, van der Meer A, Ferreira JA, Crutzen R, Timen A, Kretzschmar MEE. Determinants of Dutch public health professionals' intention to use digital contact tracing support tools: A cross-sectional online questionnaire study. PLOS DIGITAL HEALTH 2024; 3:e0000425. [PMID: 38354119 PMCID: PMC10866487 DOI: 10.1371/journal.pdig.0000425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/02/2023] [Indexed: 02/16/2024]
Abstract
Contact tracing (CT) can be a resource intensive task for public health services. To alleviate their workload and potentially accelerate the CT-process, public health professionals (PHPs) may transfer some tasks in the identification, notification, and monitoring of contacts to cases and their contacts themselves, using 'digital contact tracing support tools' (DCTS-tools). In this study, we aimed to identify determinants of PHPs' intention to use DCTS-tools. Between February and April 2022, we performed a cross-sectional online questionnaire study among PHPs involved in CT for COVID-19 in the Netherlands. We built three random forest models to identify determinants of PHPs' intention to use DCTS-tools for the identification, notification, and monitoring of contacts, respectively. The online questionnaire was completed by 641 PHPs. Most respondents had a positive intention towards using DCTS-tools for the identification (64.5%), notification (58%), and monitoring (55.2%) of contacts. Random forest models were able to correctly predict the intention of 81%, 80%, and 81% of respondents to use DCTS-tools for the identification, notification, and monitoring of contacts, respectively. Top-determinants of having a positive intention are the anticipated effect of DCTS-tools on the feasibility and efficiency of CT (speed, workload, difficulty), the degree to which PHPs anticipated that cases and contacts may find it pleasant and may be willing to participate in CT using DCTS-tools, and the degree to which PHPs anticipated that cases and contacts are sufficiently supported in CT when using DCTS-tools. Most PHPs have a positive intention to involve cases and their contacts in the identification, notification, and monitoring stages of the CT-process through DCTS-tools. The identified top-determinants should be prioritized in the (future) development and implementation of DCTS-tools in public health practice. Citizens' perspectives on the use of DCTS-tools should be investigated in future research.
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Affiliation(s)
- Yannick B. Helms
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Mart L. Stein
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Nora Hamdiui
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Akke van der Meer
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - José A. Ferreira
- Department of Statistics, Informatics and Modelling, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Aura Timen
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mirjam E. E. Kretzschmar
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Kocur W, McLeod J, Bloch SCM, MacDonald JJ, Woodward C, McInnes-Dean A, Gibbs JJ, Saunders JJ, Blandford AA, Estcourt C, Flowers P. Improving digital partner notification for sexually transmitted infections and HIV through a systematic review and application of the Behaviour Change Wheel approach. Sex Health 2024; 21:SH23168. [PMID: 38402852 DOI: 10.1071/sh23168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/30/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Partner notification (PN) is key to controlling sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Digital PN options (e.g. social media, short message service (SMS), emails) are promising in increasing PN behaviour. However, their implementation is often challenging and studies report varied levels of acceptability and uptake of PN, highlighting the need to optimise digital PN interventions. METHODS A systematic review of barriers and facilitators to digital PN interventions for STIs, including HIV, across eight research databases (from 2010 to 2023) identified eight relevant studies, two of which addressed HIV. Data extraction identified 98 barriers and 54 facilitators to the use of digital PN interventions. These were synthesised into 18 key barriers and 17 key facilitators that were each deemed amenable to change. We then used the Behaviour Change Wheel approach, the Acceptability, Practicability, Effectiveness, Affordability, Side-effects and Equity criteria, and multidisciplinary expert input, to systematically develop practical recommendations to optimise digital PN. RESULTS Thirty-two specific recommendations clustered around three themes. Digital PN interventions should: (1) empower and support the index patient by providing a range of notification options, accompanied by clear instructions; (2) integrate into users' existing habits and the digital landscape, meeting contemporary standards and expectations of usability; and (3) address the social context of PN both online and offline through normalising the act of PN, combating STI-related stigma and stressing the altruistic aspects of PN through consistent messaging to service users and the public. CONCLUSIONS Our evidence-based recommendations should be used to optimise existing digital PN interventions and inform the co-production of new ones.
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Affiliation(s)
- Will Kocur
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Julie McLeod
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | | | - Jennifer J MacDonald
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Charlotte Woodward
- Institute for Global Health, University College London, London, England, UK
| | | | - Jo J Gibbs
- Institute for Global Health, University College London, London, England, UK
| | - John J Saunders
- Institute for Global Health, University College London, London, England, UK; and UK Health Security Agency, Colindale, England, UK
| | | | - Claudia Estcourt
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Paul Flowers
- Psychological Science and Health, University of Strathclyde, Glasgow, Scotland, UK
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Baron R, Hamdiui N, Helms YB, Crutzen R, Götz HM, Stein ML. Evaluating the Added Value of Digital Contact Tracing Support Tools for Citizens: Framework Development. JMIR Res Protoc 2023; 12:e44728. [PMID: 38019583 PMCID: PMC10719815 DOI: 10.2196/44728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic revealed that with high infection rates, health services conducting contact tracing (CT) could become overburdened, leading to limited or incomplete CT. Digital CT support (DCTS) tools are designed to mimic traditional CT, by transferring a part of or all the tasks of CT into the hands of citizens. Besides saving time for health services, these tools may help to increase the number of contacts retrieved during the contact identification process, quantity and quality of contact details, and speed of the contact notification process. The added value of DCTS tools for CT is currently unknown. OBJECTIVE To help determine whether DCTS tools could improve the effectiveness of CT, this study aims to develop a framework for the comprehensive assessment of these tools. METHODS A framework containing evaluation topics, research questions, accompanying study designs, and methods was developed based on consultations with CT experts from municipal public health services and national public health authorities, complemented with scientific literature. RESULTS These efforts resulted in a framework aiming to assist with the assessment of the following aspects of CT: speed; comprehensiveness; effectiveness with regard to contact notification; positive case detection; potential workload reduction of public health professionals; demographics related to adoption and reach; and user experiences of public health professionals, index cases, and contacts. CONCLUSIONS This framework provides guidance for researchers and policy makers in designing their own evaluation studies, the findings of which can help determine how and the extent to which DCTS tools should be implemented as a CT strategy for future infectious disease outbreaks.
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Affiliation(s)
- Ruth Baron
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Nora Hamdiui
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Yannick B Helms
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Hannelore M Götz
- Department of Public Health, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Mart L Stein
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
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5
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van der Meer A, Helms YB, Baron R, Crutzen R, Timen A, Kretzschmar MEE, Stein ML, Hamdiui N. Citizen involvement in COVID-19 contact tracing with digital tools: a qualitative study to explore citizens' perspectives and needs. BMC Public Health 2023; 23:1804. [PMID: 37716982 PMCID: PMC10504771 DOI: 10.1186/s12889-023-16664-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 08/30/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Contact tracing (CT) is a key strategy when dealing with outbreaks of infectious diseases such as COVID-19. The scale of the COVID-19 pandemic has often left public health professionals (PHPs), who are responsible for the execution of CT, unable to keep up with the rapid and largescale spread of the virus. To enhance or support its execution, and potentially lower the workload for PHPs, citizens may be more actively involved in CT-tasks that are commonly executed by PHPs (referred to as 'self-led CT'). There is limited insight into citizens' perspectives on and needs for self-led CT for COVID-19. This study aims to explore the perspectives and needs of Dutch citizens on taking more responsibilities in the execution of CT for COVID-19, potentially through the use of digital tools. METHODS An exploratory qualitative study was performed, in which online semi-structured interviews were conducted. Questions were based on the Reasoned Action Approach and Health Belief Model. Interviews were audio-recorded and transcribed verbatim. A thematic analysis was conducted to identify citizens' perspectives and needs to participate in self-led CT. RESULTS We conducted 27 interviews with Dutch citizens. Seven main themes were identified from the interviews: 1) 'Citizens' perspectives on self-led CT are influenced by prior experiences with regular CT', 2) 'Citizens' felt responsibilities and the perceived responsibilities of the PHS in CT shape their perspectives on self-led CT', 3) 'Anticipated impacts of self-led CT on the CT-process', 4) 'Citizens' attitude towards the application of self-led CT depends on their own perceived skills and the willingness and skills of others', 5) 'Shame and social stigma may hamper participation in self-led CT', 6) 'Concerns about privacy and data security: a barrier for self-led CT', and 7) 'Citizens' perspectives and anticipated needs for the implementation and application of self-led CT in practice'. CONCLUSIONS Most interviewees hold a positive attitude towards self-led CT and using digital tools for this purpose. However, their intention for self-led CT may depend on various factors, such as prior experiences with regular CT, and their perceived self-efficacy to participate. Perspectives and needs of citizens should be considered for the future implementation of self-led CT in practice.
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Affiliation(s)
- A van der Meer
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
| | - Y B Helms
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - R Baron
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - R Crutzen
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - A Timen
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M E E Kretzschmar
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - M L Stein
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - N Hamdiui
- National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Barry MP, Thibault CS, Berzkalns A, Spellman DR, Rowlinson E, Barbee LA, Golden MR, Kerani RP. Previous Sexually Transmitted Infections and Partner Services Interviews as Predictors of Subsequent Interview Completion Among Cisgender MSM: Partner Services Fatigue? Sex Transm Dis 2023; 50:506-511. [PMID: 37213183 PMCID: PMC10523844 DOI: 10.1097/olq.0000000000001822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Anecdotal reports suggest that partner services (PS) are less successful among people with repeat sexually transmitted infection (STI) diagnoses and/or previous PS interactions. We examine whether having repeated STI diagnoses and/or PS interactions is associated with PS outcomes among men who have sex with men (MSM). METHODS With STI surveillance and PS data for MSM diagnosed with gonorrhea, chlamydia, and/or syphilis from 2007 to 2018, in King County, WA, we used Poisson regression models to examine the relationships between PS outcomes (e.g., completing a PS interview and providing identifying information for a contact) with (1) number of previous STI case episodes and (2) number of previous PS interviews completed. RESULTS Of the 18,501 MSM STI case patients initiated for interview in the analytic period (2011-2018), 13,232 (72%) completed a PS interview, and 8,030 (43%) had at least 1 prior PS interview. The proportion of initiated cases successfully interviewed declined from 71% among those with no previous PS interview to 66% among those with ≥3 prior interviews. Similarly, the proportion of interviews with ≥1 partner identified declined with greater numbers of previous PS interviews (from 46% [0 interviews] to 35% [≥3 interviews]). In multivariate models, having ≥1 prior PS interview was negatively associated with completing a subsequent interview and providing partner locating information. CONCLUSIONS Having a history of STI PS interviews is associated with less PS engagement among MSM. New approaches to PS should be explored to address the growing epidemic of STIs among MSM.
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Affiliation(s)
- Michael P. Barry
- Department of Epidemiology, University of Washington, Seattle, WA
- HIV/STD Program, Public Health – Seattle and King County, Seattle, WA
| | | | - Anna Berzkalns
- HIV/STD Program, Public Health – Seattle and King County, Seattle, WA
| | - Dawn R. Spellman
- HIV/STD Program, Public Health – Seattle and King County, Seattle, WA
| | - Emily Rowlinson
- Department of Epidemiology, University of Washington, Seattle, WA
| | - Lindley A. Barbee
- HIV/STD Program, Public Health – Seattle and King County, Seattle, WA
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA
| | - Matthew R. Golden
- Department of Epidemiology, University of Washington, Seattle, WA
- HIV/STD Program, Public Health – Seattle and King County, Seattle, WA
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA
| | - Roxanne P. Kerani
- Department of Epidemiology, University of Washington, Seattle, WA
- HIV/STD Program, Public Health – Seattle and King County, Seattle, WA
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA
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7
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Hansman E, Klausner JD. Approach to Managing Sex Partners of People with Sexually Transmitted Infections. Infect Dis Clin North Am 2023; 37:405-426. [PMID: 36931992 DOI: 10.1016/j.idc.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Partner management of sexually transmitted infection (STIs) is essential to identify and treat new cases, prevent reinfection in the index case, interrupt chains of transmission, reduce STI-related morbidity, and target STI screening and treatment interventions. The responsibility for partner notification and treatment falls on the health care provider. Approaches to partner management include patient referral, provider referral, contractual referral, and expedited partner therapy (EPT), with EPT and enhanced partner referral outperforming other methods. This article provides an overview of clinical recommendations regarding partner management, with particular emphasis on EPT, and an update on new and emerging evidence in the field.
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Affiliation(s)
- Emily Hansman
- David Geffen School of Medicine University of California Los Angeles, Los Angeles, CA, USA.
| | - Jeffrey D Klausner
- University of Southern California Keck School of Medicine, 1845 North Soto Street, Health Sciences Campus, Los Angeles, CA 90032, USA
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8
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Da Costas Dias B, Kufa T, Kularatne RS. Factors associated with partner notification intentions among symptomatic sexually transmitted infection service attendees in South Africa. S Afr Med J 2023; 113:91-97. [PMID: 36757077 DOI: 10.7196/samj.2023.v113i2.16510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND In South Africa (SA), a client-initiated partner notification (PN) approach is implemented for the management of sexual partners of patients presenting with sexually transmitted infections (STIs) or STI syndromes. OBJECTIVES To explore the demographic, sexual behavioural and clinical characteristics associated with PN intentions among symptomatic STI service attendees at sentinel primary healthcare facilities in three SA provinces. METHODS We analysed cross-sectional data obtained from 1 293 adults enrolled into STI aetiological surveillance during 2019 - 2020 in Gauteng, KwaZulu-Natal and Western Cape provinces. Self-reported sexual practices, PN intentions and clinical data were collected using nurse-administrated questionnaires. We assessed gender-stratified factors associated with the index case's willingness to notify their sexual partners of their STI syndrome diagnosis. Univariable and multivariable Poisson regression models with robust error variance were used to determine factors associated with gender-stratified PN intentions. RESULTS The enrolled participants comprised 887 male (68.6%) and 406 female (31.4%) STI clients. Self-reported PN intentions were higher among women than men (83.5% v. 64.4%; p<0.001). Multivariable analyses revealed that casual sex partnerships during the preceding 3-month period and enrolment at the KwaZulu-Natal site were independent barriers to PN intent among male participants. For females, enrolment at the Gauteng site was independently associated with lower PN intentions, while presenting with genital ulcer syndrome was a motivator towards PN intent. The primary reasons cited for non-disclosure across both genders were casual sexual encounters, followed by geographically distant partnerships and fear of disclosure. CONCLUSION We show that demographic and behavioural characteristics, as well as relationship dynamics, may influence the PN intentions of STI service attendees in SA. Alternative PN strategies should be considered, based on the reported barriers, to increase overall STI notification, strengthen partner management and ultimately reduce STI incidence.
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Affiliation(s)
- B Da Costas Dias
- Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa.
| | - T Kufa
- Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - R S Kularatne
- Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa; Department of Clinical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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9
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Mokgatle M, Madiba S, Hlongwane N. Differences in Sexual Behavior and Partner Notification for Sexually Transmitted Infections Between the Out of School Youth and University Students in a Peri-Urban District in South Africa-A Cross-Sectional Survey. Front Public Health 2022; 10:793702. [PMID: 35812474 PMCID: PMC9257014 DOI: 10.3389/fpubh.2022.793702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
The increase in sexually transmitted infections (STIs) in young people is a public health concern. Among those in university and out of school, different contextual factors contribute to their risky sexual behavior and increased susceptibility to STIs and HIV. There are limited comparative studies examining risky sexual behavior and partner notification (PN) between these two groups, particularly in South Africa. We investigated sexual behaviors, self-reported STI diagnosis, health seeking behavior, and preferred PN methods of university students and out of school youth. A descriptive cross-sectional survey was used using convenient sampling to select 917 students across five health sciences universities and through periodic sampling 699 out of school youth were selected from two main local shopping centers in South Africa. Descriptive statistics, bivariate and multivariable logistic analysis were performed using Stata IC version 14. More university students (71.7%) than out of school youth were in casual relationships (28.3%), with half of out of school youth being in steady relations (50.2%). Moreover, university students (65.7%) used a condom in the past 6 months compared to their counterparts (34.3%). Of the 124 youth who were diagnosed with STI in the past 12 months, majority (n = 106, 85%) were out of school youth. The probability of notifying a partner about a STI infection was 82% among university students compared to their counterparts (p = >0.05). The odds of notifying a partner was 1.79 times more for those having multiple sexual partners than those who had only one partner. Both groups preferred a face-to-face STI disclosure with partner; however, more university students (67%) preferred SMS notification than PN referral slips as compared to out of school youth (42%). Both the university students and the out of school youth engaged in risky sexual behaviors. Both groups preferred face-to-face and clinic SMS partner notifications, even though university students were in the majority. There is a need for developing health promotion scripts on disclosing STIs to sexual partners to empower the majority of the youth who prefer face-to-face PN over the prescribed methods.
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Affiliation(s)
- Mathildah Mokgatle
- Department of Biostatistics, School of Public Health, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
- School of Transdisciplinary Research and Graduate Studies, College of Graduate Studies, University of South Africa (UNISA), Pretoria, South Africa
| | - Sphiwe Madiba
- Department of Environmental and Occupational Health, School of Public Health, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
| | - Naomi Hlongwane
- School of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Ga-Rankuwa, South Africa
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Davis C, Wright SS, Babcock M, Kingdon E, Broussard D, Oyervides O, Carr D. Lessons Learned From a Centers for Disease Control and Prevention Virtual Partner Services Technical Assistance Pilot Project to Respond to a Local Syphilis Outbreak. Sex Transm Dis 2022; 49:166-168. [PMID: 34475354 DOI: 10.1097/olq.0000000000001547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT A virtual partner services technical assistance (TA) project was piloted with the Minnesota Department of Health to address an ongoing syphilis outbreak. The TA reduced the health department's disease intervention specialist workload, achieved partner services outcomes comparable with in-person methods, and identified lessons learned to replicate with other jurisdictions.
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Affiliation(s)
- Cassandra Davis
- From the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Atlanta, GA
| | - Shauntā S Wright
- From the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Atlanta, GA
| | - Marcie Babcock
- Minnesota Department of Health, STD, HIV and TB Section, St Paul, MN
| | - Elisabeth Kingdon
- Minnesota Department of Health, STD, HIV and TB Section, St Paul, MN
| | - Dawn Broussard
- From the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Atlanta, GA
| | - Otilio Oyervides
- From the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Atlanta, GA
| | - Deborah Carr
- From the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Atlanta, GA
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Parkes-Ratanshi R, Mbazira Kimeze J, Nakku-Joloba E, Hamill MM, Namawejje M, Kiragga A, Kayogoza Byamugisha J, Rompalo A, Gaydos C, Manabe YC. Low male partner attendance after syphilis screening in pregnant women leads to worse birth outcomes: the Syphilis Treatment of Partners (STOP) randomised control trial. Sex Health 2021; 17:214-222. [PMID: 32527365 DOI: 10.1071/sh19092] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/09/2019] [Indexed: 11/23/2022]
Abstract
Background Maternal syphilis causes poor birth outcomes, including congenital syphilis. Testing and treatment of partners prevents reinfection, but strategies to improve partner attendance are failing. The aim of this study was to determine the effectiveness of three partner notification strategies. METHODS Pregnant women with a positive point-of-care treponemal test at three antenatal clinics (ANCs) in Kampala, Uganda, were randomised 1:1:1 to receive either notification slips (NS; standard of care), NS and a text messages (SMS) or NS and telephone calls. The primary outcome was the proportion of partners who attended the ANC and were treated for syphilis. RESULTS Between 2015 and 2016, 17130 pregnant women were screened; 601 (3.5%) had a positive treponemal result, and 442 were enrolled in the study. Only 81 of 442 partners (18.3%; 23/152 (15.1%), 31/144 (21.5%) and 27/146 (18.5%) in the NS only, NS + SMS and NS + telephone call groups respectively) attended an ANC for follow-up; there were no significant differences between the groups. Twelve per cent of women attended the ANC with their male partner, and this proportion increased over time. Partner non-treatment was independently associated with adverse birth outcomes (odds ratio 2.75; 95% confidence interval 2.36-3.21; P < 0.001). CONCLUSIONS Only 18.3% of partners of pregnant women who tested positive for syphilis received treatment. Female partners of non-attendant men had worse birth outcomes. Encouraging men to accompany women to the ANC and testing both may address the urgent need to treat partners of pregnant women in sub-Saharan Africa to reduce poor fetal outcomes.
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Affiliation(s)
- Rosalind Parkes-Ratanshi
- Infectious Diseases Institute, Makerere University College of Health Sciences, PO Box 22418, Kampala, Uganda; and Institute of Public Health, University of Cambridge, Forvie Site, Cambridge CB2 0SR, UK; and Corresponding author.
| | - Joshua Mbazira Kimeze
- Infectious Diseases Institute, Makerere University College of Health Sciences, PO Box 22418, Kampala, Uganda
| | - Edith Nakku-Joloba
- School of Public Health, Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda
| | - Matthew M Hamill
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Room 8031, Baltimore, MD 21287, USA
| | - Mariam Namawejje
- Infectious Diseases Institute, Makerere University College of Health Sciences, PO Box 22418, Kampala, Uganda
| | - Agnes Kiragga
- Infectious Diseases Institute, Makerere University College of Health Sciences, PO Box 22418, Kampala, Uganda
| | | | - Anne Rompalo
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Room 8031, Baltimore, MD 21287, USA
| | - Charlotte Gaydos
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Room 8031, Baltimore, MD 21287, USA
| | - Yukari C Manabe
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Room 8031, Baltimore, MD 21287, USA
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12
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Hansman E, Wynn A, Moshashane N, Ramontshonyana K, Mompe A, Mussa A, Ryan R, Ramogola-Masire D, Klausner JD, Morroni C. Experiences and preferences with sexually transmitted infection care and partner notification in Gaborone, Botswana. Int J STD AIDS 2021; 32:1250-1256. [PMID: 34304619 DOI: 10.1177/09564624211033231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Partner notification and treatment are essential to sexually transmitted infection (STI) management. However, in low- and middle-income countries, half of partners do not receive treatment. A mixed methods study was conducted to explore experiences and preferences around partner notification and treatment in patients seeking STI care in Gaborone, Botswana. Thirty participants were administered a quantitative survey, followed by a semi-structured interview on partner notification, treatment, and expedited partner therapy (EPT). Among the 30 participants, 77% were female with a median age of 28 years (IQR = 24-36), 87% notified their partner, and 45% of partners requiring treatment received treatment. Partners who received a contact slip were more likely to have been treated than those who did not (75% vs. 25%). Contact slips were identified as facilitators of notification and treatment, while asymptomatic partners and limited clinic resources were identified as barriers to treatment. Few participants expressed a preference for EPT and concerns included preference for medical supervision, a belief their partner would refuse, and an inability to explain the treatment. Despite successful notification, partner treatment was modest within this population. Information for partners, provider counseling, and improved access to services may increase partner treatment. Education on STIs and treatment options may improve EPT acceptability.
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Affiliation(s)
- Emily Hansman
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Adriane Wynn
- Division of Infectious Diseases and Global Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Neo Moshashane
- 292006Botswana-UPenn Partnership, Gaborone, Botswana.,Botswana Sexual & Reproductive Health Initiative, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Kehumile Ramontshonyana
- 292006Botswana-UPenn Partnership, Gaborone, Botswana.,Botswana Sexual & Reproductive Health Initiative, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Atlang Mompe
- 292006Botswana-UPenn Partnership, Gaborone, Botswana
| | - Aamirah Mussa
- Botswana Sexual & Reproductive Health Initiative, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Rebecca Ryan
- Botswana Sexual & Reproductive Health Initiative, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | | | - Jeffrey D Klausner
- Department of Preventive Medicine, University of Southern California, CA, USA
| | - Chelsea Morroni
- Botswana Sexual & Reproductive Health Initiative, Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.,9655Liverpool School of Tropical Medicine, Liverpool, UK
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13
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Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021; 70:1-187. [PMID: 34292926 PMCID: PMC8344968 DOI: 10.15585/mmwr.rr7004a1] [Citation(s) in RCA: 737] [Impact Index Per Article: 245.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
These guidelines for the treatment of persons who have or are at risk for
sexually transmitted infections (STIs) were updated by CDC after consultation
with professionals knowledgeable in the field of STIs who met in Atlanta,
Georgia, June 11–14, 2019. The information in this report updates the
2015 guidelines. These guidelines discuss 1) updated recommendations for
treatment of Neisseria gonorrhoeae, Chlamydia trachomatis,
and Trichomonas vaginalis; 2) addition of
metronidazole to the recommended treatment regimen for pelvic inflammatory
disease; 3) alternative treatment options for bacterial vaginosis; 4) management
of Mycoplasma genitalium; 5) human papillomavirus vaccine
recommendations and counseling messages; 6) expanded risk factors for syphilis
testing among pregnant women; 7) one-time testing for hepatitis C infection; 8)
evaluation of men who have sex with men after sexual assault; and 9) two-step
testing for serologic diagnosis of genital herpes simplex virus. Physicians and
other health care providers can use these guidelines to assist in prevention and
treatment of STIs.
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14
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Mokgatle MM, Madiba S, Cele L. A Comparative Analysis of Risky Sexual Behaviors, Self-Reported Sexually Transmitted Infections, Knowledge of Symptoms and Partner Notification Practices among Male and Female University Students in Pretoria, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115660. [PMID: 34070603 PMCID: PMC8198344 DOI: 10.3390/ijerph18115660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 11/18/2022]
Abstract
The surge of sexually transmitted infections (STIs) among young people is of public health importance, and the notification and treatment of sex partners after the diagnosis of an STI is a public health approach to prevent and reduce further transmissions. There are limited studies that investigate partner notification among young people in general, and university students in South Africa in particular. We investigated self-reported STIs and partner notification practice, intentions, and preferences among university students. We also assessed their STI knowledge and risky sexual behaviour in relation to STIs. The study was a descriptive cross-sectional survey that used multistage sampling to select 918 students across the five schools of a health sciences university in South Africa. Descriptive statistics and bivariate logistic analysis were performed using Stata IC version 16. More males (54.1%) than females were currently in a sexual relationship (47.3%), more males reported multiple sexual partners (n = 114, 46%), engaged in transactional sex (n = 13, 5.3%), and had one-night stands (n = 68, 28.1%) in the past 12 months (p = 0.001). Moreover, half (55.9%) had poor knowledge of STIs with an overall mean knowledge score of 2.9 ± 2.0, and the majority (85.8%) perceived themselves to be at low risk of acquiring STIs. The odds of intentions to disclose an STI infection to a sexual partner and delivering a partner notification slip to ex-sexual partners were not statistically significant (p = 0.95; p = 0.10), with the likelihood of disclosure being 1.3 times for female students compared to males. Female students were 1.5 times as likely to prefer a doctor to send an SMS notification to their sexual partners (p = 0.02) compared to their male counterparts, while the preference of an SMS notification was 41% (p = 0.03) among female students. Students engaged in risky behaviours but had a low perception of the risks of acquiring STIs. Although they had preferences of different methods of partner notification, both male and female students preferred SMS partner notifications from a doctor, even though women were in the majority. Health care providers should put in place interventions so that young people can safely inform their partners about STIs.
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Affiliation(s)
- Mathildah Mpata Mokgatle
- Department of Biostatistics, School of Public Health, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa;
- Correspondence:
| | - Sphiwe Madiba
- Department of Environmental and Occupational Health, School of Public Health, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa;
| | - Lindiwe Cele
- Department of Biostatistics, School of Public Health, Sefako Makgatho Health Sciences University, Ga-Rankuwa 0208, South Africa;
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15
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Wall KM, Nyombayire J, Parker R, Ingabire R, Bizimana J, Mukamuyango J, Mazzei A, Price MA, Unyuzimana MA, Tichacek A, Allen S, Karita E. Developing and validating a risk algorithm to diagnose Neisseria gonorrhoeae and Chlamydia trachomatis in symptomatic Rwandan women. BMC Infect Dis 2021; 21:392. [PMID: 33910514 PMCID: PMC8080377 DOI: 10.1186/s12879-021-06073-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/06/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Algorithms that bridge the gap between syndromic sexually transmitted infection (STI) management and treatment based in realistic diagnostic options and local epidemiology are urgently needed across Africa. Our objective was to develop and validate a risk algorithm for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) diagnosis among symptomatic Rwandan women and to compare risk algorithm performance to the current Rwandan National Criteria for NG/CT diagnosis. METHODS The risk algorithm was derived in a cohort (n = 468) comprised of symptomatic women in Kigali who sought free screening and treatment for sexually transmitted infections and vaginal dysbioses at our research site. We used logistic regression to derive a risk algorithm for prediction of NG/CT infection. Ten-fold cross-validation internally validated the risk algorithm. We applied the risk algorithm to an external validation cohort also comprised of symptomatic Rwandan women (n = 305). Measures of calibration, discrimination, and screening performance of our risk algorithm compared to the current Rwandan National Criteria are presented. RESULTS The prevalence of NG/CT in the derivation cohort was 34.6%. The risk algorithm included: age < =25, having no/primary education, not having full-time employment, using condoms only sometimes, not reporting genital itching, testing negative for vaginal candida, and testing positive for bacterial vaginosis. The model was well calibrated (Hosmer-Lemeshow p = 0.831). Higher risk scores were significantly associated with increased prevalence of NG/CT infection (p < 0.001). Using a cut-point score of > = 5, the risk algorithm had a sensitivity of 81%, specificity of 54%, positive predictive value (PPV) of 48%, and negative predictive value (NPV) of 85%. Internal and external validation showed similar predictive ability of the risk algorithm, which outperformed the Rwandan National Criteria. Applying the Rwandan National Criteria cutoff of > = 2 (the current cutoff) to our derivation cohort had a sensitivity of 26%, specificity of 89%, PPV of 55%, and NPV of 69%. CONCLUSIONS These data support use of a locally relevant, evidence-based risk algorithm to significantly reduce the number of untreated NG/CT cases in symptomatic Rwandan women. The risk algorithm could be a cost-effective way to target treatment to those at highest NG/CT risk. The algorithm could also aid in sexually transmitted infection risk and prevention communication between providers and clients.
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Affiliation(s)
- Kristin M Wall
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health and Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA.
| | - Julien Nyombayire
- Projet San Francisco, Rwanda Zambia HIV Research Group, Kigali, Rwanda
| | - Rachel Parker
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health and Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Rosine Ingabire
- Projet San Francisco, Rwanda Zambia HIV Research Group, Kigali, Rwanda
| | - Jean Bizimana
- Projet San Francisco, Rwanda Zambia HIV Research Group, Kigali, Rwanda
| | | | - Amelia Mazzei
- Projet San Francisco, Rwanda Zambia HIV Research Group, Kigali, Rwanda
| | - Matt A Price
- IAVI, NY, NY, University of California San Francisco, San Francisco, CA, 94115, USA
| | | | - Amanda Tichacek
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health and Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Susan Allen
- Rwanda Zambia HIV Research Group, Department of Pathology & Laboratory Medicine, School of Medicine and Hubert Department of Global Health and Department of Epidemiology, Rollins School of Public Health, Laney Graduate School, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Etienne Karita
- Projet San Francisco, Rwanda Zambia HIV Research Group, Kigali, Rwanda
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16
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Mokgatle MM, Madiba S. Risky sexual behaviour amidst predicament of acceptable sexually transmitted infection partner notification modalities: A cross-sectional survey amongst minibus taxi drivers in Gauteng Province, South Africa. S Afr Fam Pract (2004) 2020; 62:e1-e6. [PMID: 33314943 PMCID: PMC8378141 DOI: 10.4102/safp.v62i1.5165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/27/2020] [Accepted: 10/16/2020] [Indexed: 11/15/2022] Open
Abstract
Background Sexually transmitted infection patient-initiated partner notification (PN) approach has been implemented over a decade in South Africa, however, use and update by patients has been limited. This study assessed the perceived use of patient-initiated PN by using referral slips and measured the level of acceptability of provider-initiated PN by using short message service (SMS) to the personal mobile phones of sexual partners. Methods A formative evaluation approach using a quantitative survey amongst 722 minibus taxi drivers in nine major taxi ranks in Tshwane Municipality, Gauteng Province. STATA IC version 13 was used for data analyses. Results The mean age of the participants was 37.2 years (59%) were single, 59.5% had multiple sexual partners, 52.2% did not use a condom during the last sexual act, 42.8% reported inconsistent use of condoms and 65% tested for HIV in the past 12 months. The majority (98.2%) understood the importance of PN, but 51% would prefer telling a sexual partner face to face. Perceived easiness of delivering a PN slip was 69.1%, and 93% would use a PN slip received from a partner. Acceptability of provider-initiated PN by using an SMS was 62.7% and about a third (32.5%) were not in favour of provider-initiated PN by SMS. Twenty four point 7 percent (24.7%) preferred patient-initiated PN and 24.3% preferred provider-initiated PN. Conclusion Preferred patient-initiated and provider-initiated PN was almost equal, hence, the provider-initiated PN should be augmented to support the current patient-initiated PN to increase the overall STI notification.
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Affiliation(s)
- Mathildah M Mokgatle
- Department of Biostatistics, School of Public Health, Sefako Makgatho Health Sciences University, Pretoria.
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17
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Rosenbaum JE, Jennings J, Ellen JM, Borkovic LM, Scott JA, Wylie C, Rompalo A. Giving syphilis and gonorrhea to friends: using in-person friendship networks to find additional cases of gonorrhea and syphilis. BMC Public Health 2020; 20:1526. [PMID: 33081743 PMCID: PMC7575333 DOI: 10.1186/s12889-020-09589-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 09/22/2020] [Indexed: 11/25/2022] Open
Abstract
Background Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking “friendship,” so this study asked people diagnosed with syphilis and gonorrhea to identify their friends. Methods Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n = 331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis. Results Eliciting respondents’ in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio = 2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR = 1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR = 1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR = 0.98, 95% CI (0.62, 1.53)). Conclusions Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.
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Affiliation(s)
- Janet E Rosenbaum
- Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY, USA.
| | - Jacky Jennings
- Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Jonathan M Ellen
- Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Laurel M Borkovic
- Department of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Jo-Ann Scott
- Department of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Charleen Wylie
- Department of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Anne Rompalo
- Department of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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18
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Individual and Social Network Factors Associated with High Self-efficacy of Communicating about Men's Health Issues with Peers among Black MSM in an Urban Setting. J Urban Health 2020; 97:668-678. [PMID: 32740700 PMCID: PMC7560668 DOI: 10.1007/s11524-020-00458-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Black men who have sex with men (BMSM) bear a disproportionate burden of HIV in the USA. BMSM face stigma, discrimination and barriers to health care access, and utilization. Peers (male or female) may assist BMSM in navigating their health issues by engaging in communication to support in their health care needs. Individuals with high self-efficacy of communicating about men's health issues with peers can be trained as community popular opinion leaders (CPOLs) to change peer behaviors by promoting risk reduction communication. We examined the characteristics associated with high self-efficacy of communicating with peers about men's health issues among 256 BMSM from a behavioral HIV intervention conducted in Baltimore, Maryland. In the multivariate logistic model, gay identity (AOR: 2.10, 95% CI: 1.15,3.83), involvement in the house and ballroom community (AOR: 2.50, 95% CI: 1.14,5.49), larger number of network members who are living with HIV (AOR: 6.34, 95% CI: 1.48,27.11), and larger number of network members who would loan them money (AOR: 1.46, 95% CI: 1.05,2.03) were statistically significantly associated with high self-efficacy of communicating with peers about men's health issues. We also found that having depressive symptoms (AOR: 0.43, 95% CI: 0.24, 0.77) was negatively associated with high self-efficacy of communicating with peers about men's health issues. Findings from the current study can inform future studies to identify better CPOLs who are able to communicate effectively with peers about men's health issues for BMSM.
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19
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Rosenbaum JE, Jennings J, Ellen J, Borkovic L, Scott JA, Wylie C, Rompalo A. Giving syphilis and gonorrhea to friends: Using in-person friendship networks to find additional cases of gonorrhea and syphilis. RESEARCH SQUARE 2020:rs.3.rs-22332. [PMID: 32793894 PMCID: PMC7402068 DOI: 10.21203/rs.3.rs-22332/v2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking "friendship," so this study asked people diagnosed with syphilis and gonorrhea to identify their friends. Methods Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n=331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis. Results Eliciting respondents' in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio=2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR=1.31,95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR=1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR=0.98, 95% CI (0.62, 1.53)). Conclusions Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.
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20
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Rosenbaum JE, Jennings J, Ellen J, Borkovic L, Scott JA, Wylie C, Rompalo A. Giving syphilis and gonorrhea to friends: Using in-person friendship networks to find additional cases of gonorrhea and syphilis. RESEARCH SQUARE 2020:rs.3.rs-22332. [PMID: 36575756 PMCID: PMC9793830 DOI: 10.21203/rs.3.rs-22332/v4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking "friendship," so this study asked people diagnosed with syphilis and gonorrhea to identify their friends. METHODS Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n=331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis. RESULTS Eliciting respondents' in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio=2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR=1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR=1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR=0.98, 95% CI (0.62, 1.53)). CONCLUSIONS Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.
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21
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Iturrieta-Guaita NG, Temple-Smith MJ, Tomnay J. Using electronic communication technologies for improving syphilis partner notification in Chile: healthcare providers' perspectives - a qualitative case study. Sex Health 2020; 16:377-382. [PMID: 31234960 DOI: 10.1071/sh19007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 03/27/2019] [Indexed: 11/23/2022]
Abstract
Background Partner notification (PN) in Australia has been studied and improved in recent decades. International researchers have highlighted the use of electronic communication technologies to assist PN (Internet partner notification or IPN). Using the Australian experience as an example, the aim of this study is to explore clinicians' perspectives on the use of specialised websites, such as Let them know, to facilitate PN in the Chilean context. METHODS Semi-structured interviews were conducted with healthcare providers (HCPs) in 14 primary health care centres and six sexual health units located at two regional Health Services, as well as with key informants from different backgrounds. Interviews were transcribed verbatim and QSR International's NVivo 11 PRO Software was used for cross-case thematic analysis, which followed an inductive approach. Selected quotes were translated from Spanish to English. Codes and themes were reviewed by the research team. RESULTS Most participants were unaware of IPN and demonstrated interest. Many agreed this could be a feasible strategy considering the high use of mobile technologies and the Internet in Chile. Participants' primary concerns around this approach were confidentiality, privacy and efficacy, given the local cultural context. The use of a counsellor to offer professional support and guidance was identified as essential to strengthen PN in Chile. CONCLUSION The use of IPN could be an alternative PN strategy for Chile. However, the involvement of local staff and further research to explore patients' perceptions and preferences will be essential in tailoring interventions.
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Affiliation(s)
- Nicole G Iturrieta-Guaita
- Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Vic. 3053, Australia; and Escuela de Obstetricia y Puericultura, Universidad de Valparaíso, La Troya esquina El Convento S/N, San Felipe, Chile; and Corresponding author.
| | - Meredith J Temple-Smith
- Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Vic. 3053, Australia
| | - Jane Tomnay
- Centre for Excellence in Rural Sexual Health (CERSH), Department of Rural Health, The University of Melbourne, 49 Graham Street, Shepparton, Vic. 3630, Australia
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22
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Yan X, Li Y, Su H, Xing Y, Zhang B, Lu Z, Jia Z. Protect MSM from HIV and other sexually transmitted diseases by providing mobile health services of partner notification: protocol for a pragmatic stepped wedge cluster randomized controlled trial. BMC Public Health 2020; 20:1107. [PMID: 32664934 PMCID: PMC7362655 DOI: 10.1186/s12889-020-09162-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/22/2020] [Indexed: 11/30/2022] Open
Abstract
Background Recently, more and more men who have sex with men (MSM) look for casual partners through online dating platforms in China. However, most are unable to know their partners’ HIV and other sexually transmitted diseases (STD) statuses, leading to the rapid increase in HIV infection among Chinese MSM. Effective partner notification is urgently needed to increase the risk awareness of MSM and prevent HIV and other STDs transmission. However, the traditional intervention mainly targets to the HIV-positive MSM and the effect is not promising. Our study aims to provide Internet-based partner notification, along with a series of health services for HIV-negative MSM to protect them from HIV and other STDs. Methods A pragmatic stepped wedge cluster randomized controlled trial design is used to evaluate the effectiveness of a new intervention paradigm, which aims to reduce HIV and other STDs incidences among MSM in China. Through integrating a mobile health (mHealth) service application (app) to the current HIV and other STDs prevention and control methods, the new paradigm provides partner notification of HIV, syphilis, hepatitis B, and hepatitis C statuses. A total of 6172 MSM in 16 districts of Beijing, China will be recruited and randomized to sequentially receive partner notification intervention through the app at 6-month intervals. The primary outcomes are HIV incidence and the additional cost of the intervention. The secondary outcomes include incidences of syphilis, hepatitis B, and hepatitis C, disease transmission social networks, testing adherence, knowledge of HIV and STDs control, health self-responsibility awareness, changes of high risk behaviors and other related outcomes. The generalized linear mixed models (GLMM) will be used to analyze the differences of outcomes in the control period and in the intervention period. Discussion We expect that the HIV incidence will be significantly lower and the secondary outcomes will also be improved with providing health service of partner notification through mhealth intervention. The feasible and affordable public health intervention paradigm will have implications for HIV and STDs prevention and control among MSM and other key populations. Trial registration ClinicalTrials.gov, NCT04349748. Registered on 16 April 2020.
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Affiliation(s)
- Xiangyu Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Yongjie Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Hexuan Su
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,Medical Informatics Center, Peking University, Beijing, China
| | - Yi Xing
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Bo Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China
| | - Zuhong Lu
- State Key Laboratory for Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Zhongwei Jia
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China. .,National Institute on Drug Dependence, Peking University, 38 Xueyuan Rd, Haidian District, Beijing, 100191, China. .,Center for Drug Abuse Control and Prevention, National Institute of Health Data Science, Peking University, Beijing, China. .,Center for Technology and Policy Research on Infectious Disease Prevention and Control, Global Health Research Institute, Peking University, Beijing, China.
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23
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Mathews C, Lombard C, Kalichman M, Dewing S, Banas E, Dumile S, Mdlikiva A, Mdlikiva T, Jennings KA, Daniels J, Berteler M, Kalichman SC. Effects of enhanced STI partner notification counselling and provider-assisted partner services on partner referral and the incidence of STI diagnosis in Cape Town, South Africa: randomised controlled trial. Sex Transm Infect 2020; 97:38-44. [PMID: 32482641 PMCID: PMC7841487 DOI: 10.1136/sextrans-2020-054499] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/18/2020] [Accepted: 05/02/2020] [Indexed: 11/16/2022] Open
Abstract
Objectives We investigated the effects of an enhanced partner notification (PN) counselling intervention with the offer of provider-assisted referral among people diagnosed with STI in a Cape Town public clinic. Methods Participants were adults diagnosed with STI at a community clinic. After the standard STI consultation, participants were randomly allocated in a 1:1:1 ratio to (1) ‘HE’: 20 min health education; (2) ‘RR’: 45 min risk reduction skills counselling; or (3) ‘ePN’: 45 min enhanced partner notification communication skills counselling and the offer of provider-assisted referral. The primary outcome was the incidence of repeat STI diagnoses during the 12 months after recruitment, and the secondary outcome was participants’ reports 2 weeks after diagnosis of notifying recent partners. Incidence rate ratios (IRRs) were used to compare the incidence rates between arms using a Poisson regression model. Results The sample included 1050 participants, 350 per group, diagnosed with STI between June 2014 and August 2017. We reviewed 1048 (99%) participant records, and identified 136 repeat STI diagnoses in the ePN arm, 138 in the RR arm and 141 in the HE arm. There was no difference in the annual incidence of STI diagnosis between the ePN and HE arms (IRR: 1.0; 95% CI 0.7 to 1.3), or between the RR and HE arms (IRR: 0.9; 95% CI 0.7 to 1.2). There was a greater chance of a partner being notified in the ePN condition compared with the HE condition, 64.3% compared with 53.8%, but no difference between the RR and HE arms. Conclusions PN counselling and education with provider-assisted services has the potential to change the behaviour of people diagnosed with STIs, increasing the number of partners they notify by more than 10%. However, these changes in behaviour did not lead to a reduction of repeat STI diagnoses. Trial registration number PACTR201606001682364.
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Affiliation(s)
- Catherine Mathews
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa .,School of Public Health and Family Medicine, University of Cape Town, Rondebosch, South Africa
| | - Carl Lombard
- Biostatistics Unit, South Africa Medical Research Council, Tygerberg, South Africa
| | - Moira Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Sarah Dewing
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Ellen Banas
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa.,Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Sekelwa Dumile
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Amanda Mdlikiva
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Thembinkosi Mdlikiva
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Karen Ann Jennings
- City Health Department of Cape Town Municipality, Cape Town, South Africa
| | - Johann Daniels
- City Health Department of Cape Town Municipality, Cape Town, South Africa
| | - Marcel Berteler
- City of Cape Town IS&T Department, City of Cape Town, Cape Town, Western Cape, South Africa
| | - Seth C Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
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24
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Chitneni P, Beksinska M, Dietrich JJ, Jaggernath M, Closson K, Smith P, Lewis DA, Matthews LT, Smit J, Ndung’u T, Brockman M, Gray G, Kaida A. Partner notification and treatment outcomes among South African adolescents and young adults diagnosed with a sexually transmitted infection via laboratory-based screening. Int J STD AIDS 2020; 31:627-636. [PMID: 32403988 PMCID: PMC7357572 DOI: 10.1177/0956462420915395] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Partner notification and treatment are essential components of sexually transmitted infection (STI) management, but little is known about such practices among adolescents and young adults. Using data from a prospective cohort study (AYAZAZI) of youth aged 16-24 years in Durban, South Africa, we assessed the STI care cascade across participant diagnosis, STI treatment, partner notification, and partner treatment; index recurrent STI and associated factors; and reasons for not notifying partner of STI. Participants completed laboratory-based STI screening (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis) at enrollment and at 12 months. Of the 37/216 participants with STI (17%), 27/37 (73%) were women and 10/37 (27%) were men. Median age was 19 years (IQR: 18-20). Of the participants with STI, 23/37 (62%) completed a Treatment and Partner Tracing Survey within 6 months of diagnosis. All survey participants reported completing STI treatment (100%), 17/23 (74%) notified a partner, and 6/23 (35%) reported partner treatment. Overall, 4/23 (11%) participants had 12-month recurrent C. trachomatis infection, with no association with partner notification or treatment. Stigma and lack of STI knowledge were reasons for not notifying partner of STI. STI partner notification and treatment is a challenge among youth. Novel strategies are needed to overcome barriers along the STI care cascade.
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Affiliation(s)
- Pooja Chitneni
- Brigham and Women’s Hospital and Massachusetts General Hospital combined Infectious Diseases Fellowship, Boston, MA, USA
| | - Mags Beksinska
- Maternal Adolescent and Child Health (MatCH) Research Unit (MRU), University of the Witwatersrand, Faculty of Health Sciences, Durban, South Africa
| | - Janan J. Dietrich
- Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
| | - Manjeetha Jaggernath
- Maternal Adolescent and Child Health (MatCH) Research Unit (MRU), University of the Witwatersrand, Faculty of Health Sciences, Durban, South Africa
| | - Kalysha Closson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Patricia Smith
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - David A. Lewis
- Westmead Clinical School, Faculty of Medicine and Health & Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
- Division of Medical Virology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Lynn T. Matthews
- University of Alabama at Birmingham: Division of Infectious Diseases, Birmingham, AL, USA
| | - Jenni Smit
- Maternal Adolescent and Child Health (MatCH) Research Unit (MRU), University of the Witwatersrand, Faculty of Health Sciences, Durban, South Africa
| | - Thumbi Ndung’u
- HIV Pathogenesis Programme and Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa
- Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
- Max Planck Institute for Infection Biology, Berlin, Germany
| | - Mark Brockman
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Glenda Gray
- Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, South Africa
- South African Medical Research Council, Cape Town, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
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25
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Yan X, Lu Z, Zhang B, Li Y, Tang W, Zhang L, Jia Z. Protecting Men Who Have Sex With Men From HIV Infection With an mHealth App for Partner Notification: Observational Study. JMIR Mhealth Uhealth 2020; 8:e14457. [PMID: 32130147 PMCID: PMC7057823 DOI: 10.2196/14457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 11/22/2019] [Accepted: 11/29/2019] [Indexed: 12/01/2022] Open
Abstract
Background Traditional partner notification methods have been implemented for HIV-infected patients, as well as HIV treatment, in order to identify people at risk of HIV infection, especially men who have sex with men (MSM), since they are more likely to have casual sex partners. These traditional methods have some limitations. Objective Our study focused on developing an mHealth app to improve partner notification in practice for MSM; the study then focused on evaluating the effects of the app. Methods We developed an mHealth app with different modules using Java and HTML5 and tested it in an MSM community to prevent HIV transmission. The HIV incidence stratified by different follow-up periods were calculated. Poisson regression and social networks were used to estimate the risk ratios and to identify the connection among MSM, respectively. Results In addition to the partner notification module, which is the kernel of the app, we developed a test result self-query module to enable MSM to get their approved test results in a timely manner, a prompt and warning module to alert users to protect themselves from high-risk conditions, and a health education module to teach users more skills regarding HIV/AIDS prevention. Over a 1-year duration, a total of 3186 MSM used the app, of which 678 had at least two HIV test results since becoming app users; they were included in the final analysis. Among 678 users, a total of 6473 self-queries and 623 partner notifications were recorded, which identified 180 social networks of MSM app users. Those who used the partner notification function were more likely to have self-queries (P<.001). The 678 MSM app users covered 296.47 person-years and contributed to 20 HIV seroconversions; the cumulative HIV infection incidence was estimated as 6.75 per 100 person-years (95% CI 4.38-10.01). We found that the longer the app was used, the lower the HIV incidence (>5 months vs ≤5 months: 2.22 per 100 person-years vs 6.99 per 100 person-years; risk ratio 0.32, 95% CI 0.12- 0.87). Conclusions The app developed in this study is consistent with the World Health Organization’s sensitivity and confidentiality recommendations; it has the potential to reduce the risk of HIV infection among MSM.
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Affiliation(s)
- Xiangyu Yan
- School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, Beijing, China
| | - Zuhong Lu
- Biomedical Engineering, Southeast University, Jiangsu Province, China
| | - Bo Zhang
- School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, Beijing, China
| | - Yongjie Li
- School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, Beijing, China
| | - Wenjun Tang
- School of Public Health, Peking University, Beijing, China.,National Institute on Drug Dependence, Peking University, Beijing, China
| | - Lingling Zhang
- College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA, United States
| | - Zhongwei Jia
- National Institute on Drug Dependence, Peking University, Beijing, China
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26
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Lessard D, Aslan A, Zeggagh J, Morel S, Michels D, Lebouché B. Acceptability of a digital patient notification and linkage-to-care tool for French PrEPers (WeFLASH ©): Key stakeholders' perspectives. Int J STD AIDS 2019; 30:1397-1407. [PMID: 31757193 DOI: 10.1177/0956462419878043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to describe stakeholders’ perspectives on the acceptability of WeFLASH© (AADISS, Paris, France), a digital smartphone sexually transmitted infection (STI) patient notification (PN) tool to be launched among French HIV pre-exposure prophylaxis users (PrEPers). In Paris, Lyon, and Nice, we conducted 2-hour focus group discussions with PrEPers (n = 21) and community mediators (n = 10), and one-on-one interviews with PrEP-prescribing physicians (n = 5) and HIV/STI management decision-makers (n = 4). Recordings were transcribed. The analysis focused on perceived benefits and risks. Concerning benefits, participants mentioned that WeFLASH© could provide: improved PN and STI screening, by refining the notification of anonymous partners; customized linkage-to-care, by providing users with tailored information on care; and transferable epidemiological data, by filling a need for real-time data. Participants anticipated risks for: privacy and confidentiality and suggested specific security settings to protect users’ identity; sexual behavior and suggested game-like functions to improve the integration of the tool in sexual contexts; and fairness and emphasized the importance of making WeFLASH© accessible to all men who have sex with men. WeFLASH© could facilitate PN for an increasing proportion of anonymous partners met online, and empower users, including notified partners, on questions of confidentiality and consent, access to STI prevention and screening services, and access to data.
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Affiliation(s)
- David Lessard
- Centre of Health Outcomes Research, Research Institute of the McGill University Health Centre, Montreal, Canada.,Chronic and Viral Illness Service, McGill University Health Centre, Montreal, Canada
| | | | | | - Stéphane Morel
- AIDES, Pantin, France.,Community-Based Research Laboratory, Coalition Plus, Pantin, France
| | - David Michels
- AIDES, Pantin, France.,Community-Based Research Laboratory, Coalition Plus, Pantin, France
| | - Bertrand Lebouché
- Centre of Health Outcomes Research, Research Institute of the McGill University Health Centre, Montreal, Canada.,Chronic and Viral Illness Service, McGill University Health Centre, Montreal, Canada.,CIHR/SPOR Mentorship Chair in Innovative Clinical Trials, Research Institute of the McGill University Health Centre, Montreal, Canada.,Department of Family Medicine, McGill University, Montreal, Canada
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27
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Wynn A, Moucheraud C, Moshashane N, Offorjebe OA, Ramogola-Masire D, Klausner JD, Morroni C. Using partner notification to address curable sexually transmitted infections in a high HIV prevalence context: a qualitative study about partner notification in Botswana. BMC Public Health 2019; 19:606. [PMID: 31138228 PMCID: PMC6538557 DOI: 10.1186/s12889-019-6813-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partner notification is an essential component of sexually transmitted infection (STI) management. The process involves identifying exposed sex partner(s), notifying these partner(s) about their exposure to a curable STI, and offering counselling and treatment for the STI as a part of syndromic management or after results from an STI test. When implemented effectively, partner notification services can prevent the index patient from being reinfected with a curable STI from an untreated partner, reduce the community burden of curable STIs, and prevent adverse health outcomes in both the index patient and his or her sex partner(s). However, partner notification and treatment rates are often low. This study seeks to explore experiences and preferences related to partner notification and treatment for curable STIs among pregnant women receiving care in an antenatal clinic with integrated HIV and curable STI testing. Results are intended to inform efforts to improve partner notification and treatment rates in Southern Africa. METHODS We conducted qualitative interviews among women diagnosed with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and/or Trichomonas vaginalis (TV) infection while seeking antenatal care in Gaborone, Botswana. Semi-structured interviews were used to obtain women's knowledge about STIs and their experiences and preferences regarding partner notification. RESULTS Fifteen women agreed to participate in the study. The majority of women had never heard of CT, NG, or TV infections prior to testing. Thirteen out of 15 participants had notified partners about the STI diagnosis. The majority of notified partners received some treatment; however, partner treatment was often delayed. Most women expressed a preference for accompanying partners to the clinic for treatment. Experiences and preferences did not differ by HIV infection status. CONCLUSIONS The integration of STI, HIV, and antenatal care services may have contributed to most women's willingness to notify partners. However, logistical barriers to partner treatment remained. More research is needed to identify effective and appropriate strategies for scaling-up partner notification services in order to improve rates of partners successfully contacted and treated, reduce rates of STI reinfection during pregnancy, and ultimately reduce adverse maternal and infant outcomes attributable to antenatal STIs.
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Affiliation(s)
- Adriane Wynn
- GloCal, University of California Global Health Institute, 550 16th Street, 3rd Floor, San Francisco, CA 94158 USA
- Division of Infectious Diseases & Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093 USA
| | - Corrina Moucheraud
- Fielding School of Public Health, Department of Health Policy and Management, University of California Los Angeles, 31-269 CHS, Box 951772, Los Angeles, CA 90095 USA
| | - Neo Moshashane
- Botswana-UPenn Partnership, UB Main Campus, Gaborone, Botswana
| | - Ogechukwu Agatha Offorjebe
- David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095 USA
- Charles R. Drew University of Medicine and Science, 1731 E 120th St, Los Angeles, CA 90059 USA
| | | | - Jeffrey D. Klausner
- David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095 USA
| | - Chelsea Morroni
- Botswana-UPenn Partnership, UB Main Campus, Gaborone, Botswana
- Liverpool School of Tropical Medicine, Liverpool, UK
- Department of Medicine, University of Botswana, Gaborone, Botswana
- Wits Reproductive Health and HIV Institute, University of Witwatersrand, Johannesburg, South Africa
- Women’s Health Research Unit, University of Cape Town, Cape Town, South Africa
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28
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Sender and Receiver Acceptability and Usability of an Online Partner Notification Tool for Sexually Transmitted Infection in the Netherlands. Sex Transm Dis 2019; 45:354-357. [PMID: 29642233 DOI: 10.1097/olq.0000000000000738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Users (index patients with a verified sexually transmitted infection and notified partners) rated the health care provider-initiated Internet-based partner notification application Suggestatest.nl acceptable and usable. Both groups were less positive about Suggestatest.nl to notify/get notified of HIV than other sexually transmitted infection. An anonymous notification was perceived less acceptable.
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29
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Tomnay JE, Hulme-Chambers A, Bilardi J, Fairley CK, Huffam S, Chen MY. A Qualitative Study of Means to Improve Partner Notification After an HIV Diagnosis Among Men Who Have Sex with Men in Australia. AIDS Patient Care STDS 2017; 31:269-274. [PMID: 28605227 DOI: 10.1089/apc.2017.0080] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Improved partner notification (PN) after HIV diagnosis could help control HIV among men who have sex with men (MSM). However, there is little evidence exploring what this experience is like for Australian MSM and how achievable it is in the era of the Internet and smartphones. Fifteen of 39 invited MSM recently diagnosed with HIV undertook a semistructured interview about PN. Interviews were thematically analyzed using a combined deductive/inductive approach. Three main themes arose: fear of PN and HIV disclosure, partners' unexpected reactions, and the need for more patient support. MSM found PN difficult and uncomfortable and described fear about potential repercussions of PN; however, they felt it was the right thing to do. Regular partners were more likely to be notified, and in person, because of the availability of contact information but more notably because of a sense of moral responsibility. Men commonly had few contact details for casual partners and preferred PN strategies that allowed them to remain anonymous, largely reflecting the reasons for and ways in which they met casual partners: online or through apps and predominantly for once-off, anonymous sex. Most described unexpected positive responses from partners who were contacted personally by the men. Our study also showed that participants required professional support to carry out PN, especially with casual partners, as well as support around understanding the implications of and treatments relating to being HIV positive. PN could be improved by offering more options that allow the index patient to remain anonymous, particularly when notifying casual partners.
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Affiliation(s)
- Jane E. Tomnay
- Centre for Excellence in Rural Sexual Health, Department of Rural Health, The University of Melbourne, Melbourne, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Alana Hulme-Chambers
- Centre for Excellence in Rural Sexual Health, Department of Rural Health, The University of Melbourne, Melbourne, Australia
| | - Jade Bilardi
- Central Clinical School, Monash University, Melbourne, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Australia
| | - Christopher K. Fairley
- Central Clinical School, Monash University, Melbourne, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Sarah Huffam
- Central Clinical School, Monash University, Melbourne, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Marcus Y. Chen
- Central Clinical School, Monash University, Melbourne, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
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