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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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Ostermann J, Njau B, van Zwetselaar M, Yamanis T, McClimans L, Mwangi R, Beti M, Hobbie A, Gass SJ, Mtuy T, Thielman N. Mobile Phone-Based Confidential Social Network Referrals for HIV Testing (CONSORT): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e55068. [PMID: 38814692 PMCID: PMC11176874 DOI: 10.2196/55068] [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: 12/01/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Critical to efforts to end the HIV epidemic is the identification of persons living with HIV who have yet to be diagnosed and engaged in care. Expanded HIV testing outreach efforts need to be both efficient and ambitious, targeting the social networks of persons living with HIV and those at above-average risk of undiagnosed HIV infection. The ubiquity of mobile phones across many high HIV prevalence settings has created opportunities to leverage mobile health (mHealth) technologies to engage social networks for HIV testing outreach, prevention, and treatment. OBJECTIVE The purpose of this study is to evaluate the acceptability and efficacy of a novel mHealth intervention, "Confidential Social Network Referrals for HIV Testing (CONSORT)," to nudge at-risk individuals to test for HIV using SMS text messages. METHODS We will conduct the CONSORT study in Moshi, Tanzania, the commercial center and administrative capital of the Kilimanjaro Region in northern Tanzania. After qualitative formative work and pilot testing, we will enroll 400 clients presenting for HIV counseling and testing and 200 persons living with HIV and receiving care at HIV care and treatment centers as "inviters" into a randomized controlled trial. Eligible participants will be aged 18 years or older and live, work, or regularly receive care in Moshi. We will randomize inviters into 1 of 2 study arms. All inviters will be asked to complete a survey of their HIV testing and risk behaviors and to think of social network contacts who would benefit from HIV testing. They will then be asked to whom they would prefer to extend an HIV testing invitation in the form of a physical invitation card. Arm 1 participants will also be given the opportunity to extend CONSORT invitations in the form of automated confidential SMS text messages to any of their social network contacts or "invitees." Arm 2 participants will be offered physical invitation cards alone. The primary outcome will be counselor-documented uptake of HIV testing by invitees within 30 days of inviter enrollment. Secondary outcomes will include the acceptability of CONSORT among inviters, the number of new HIV diagnoses, and the HIV risk of invitees who present for testing. RESULTS Enrollment in the randomized controlled trial is expected to start in September 2024. The findings will be disseminated to stakeholders and published in peer-reviewed journals. CONCLUSIONS If CONSORT is acceptable and effective for increasing the uptake of HIV testing, given the minimal costs of SMS text reminders and the potential for exponential but targeted growth using chain referrals, it may shift current practices for HIV testing programs in the area. TRIAL REGISTRATION ClincalTrials.gov NCT05967208; https://clinicaltrials.gov/study/NCT05967208. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/55068.
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Affiliation(s)
- Jan Ostermann
- Department of Health Services Policy & Management, University of South Carolina, Columbia, SC, United States
| | - Bernard Njau
- Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
| | | | - Thespina Yamanis
- School of International Service, American University, Washington, DC, United States
| | - Leah McClimans
- Department of Philosophy, University of South Carolina, Columbia, SC, United States
| | - Rose Mwangi
- Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
| | - Melkiory Beti
- Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
| | - Amy Hobbie
- Center for Health Policy and Inequalities Research, Duke University, Durham, SC, United States
| | - Salomé-Joelle Gass
- Department of Health Services Policy & Management, University of South Carolina, Columbia, SC, United States
| | - Tara Mtuy
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Nathan Thielman
- Department of Medicine, Duke University School of Medicine, Durham, NC, United States
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Murray C, Rose SB. Improving partner notification for sexually transmitted infections: Interviews with key informants in Aotearoa New Zealand. Int J STD AIDS 2024; 35:397-404. [PMID: 38225809 DOI: 10.1177/09564624241226740] [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: 01/17/2024]
Abstract
BACKGROUND Partner notification is a vital part of sexually transmitted infection (STI) control but evidence suggests that its practice in Aotearoa New Zealand (NZ) is inconsistent. This study sought to explore barriers to partner notification for STIs, identify areas for improvement and draw on lessons learnt from Covid-19. METHODS Semi-structured interviews with key informants working in primary care, sexual health, public health, management, and research were undertaken between December 2021 and March 2022. Interviews were audiorecorded, transcribed, coded, and analysed using thematic analysis. RESULTS The overarching theme was that partner notification for STIs needs to be improved, and must be a more acceptable experience for providers, cases and their contacts. Four themes described how this could be achieved: (i) destigmatise and increase understanding of STIs, (ii) ensure engagement with services is easy and affirming, (iii) prioritise and resource evidence-based services and (iv) develop tools to optimise partner notification. CONCLUSIONS Sexually transmitted infection partner notification in NZ needs prioritisation, resourcing and innovation. The inadequate resourcing of STI management in NZ contrasts with the well-funded response to Covid-19. Without a well-resourced action plan, NZ's high rates of STIs will persist and continue to inequitably impact Māori, Pacific, gay and bisexual men and young people.
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Affiliation(s)
- Catriona Murray
- Department of Public Health, University of Otago, Wellington, Wellington South, New Zealand
| | - Sally B Rose
- Department of Primary Health Care and General Practice, University of Otago, Wellington, Wellington South, New Zealand
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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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Denman J, Hodson J, Manavi K. Infection Risk in Sexual Contacts of Syphilis: A Systematic Review and Meta-analysis. J Infect 2022; 84:760-769. [PMID: 35447230 DOI: 10.1016/j.jinf.2022.04.024] [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: 02/10/2022] [Accepted: 04/15/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Current guidelines recommend offering epidemiological treatment to asymptomatic contacts of early syphilis. This is on the expectation that up to 60% of sexual contacts of patients with syphilis will be infected. However, the evidence for this figure is sparse. We performed a systematic review and meta-analysis, to estimate the proportion of sexual contacts of syphilis that are infected with syphilis. METHODS Two electronic databases (Medline and Embase) were reviewed in March 2021, to identify studies that reported rates of infection in sexual contacts of syphilis. RESULTS Of 3,051 Embase and 1,828 Medline articles identified, 32 were included in the meta-analysis. In total 36,397 contacts were tested. The proportion of contacts infected varied across the studies, ranging from 10.7% to 97.5%, resulting in considerable heterogeneity (I2=98.5%). Pooling the studies gave an estimated proportion of infected contacts of 32.6% (95% confidence interval: 26.2% - 39.7%). CONCLUSIONS The risk of infection in sexual contacts of syphilis reported in the literature is highly variable, with a pooled estimate of 32.6%. This will help guide decisions regarding epidemiological treatment of sexual contacts of patients with syphilis. These decisions are increasingly important in this era of antibiotic resistance, with increasing emphasis being placed on antimicrobial stewardship.
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Affiliation(s)
- Johanna Denman
- Department of Genitourinary Medicine, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2GW, UK.
| | - James Hodson
- Institute of Translational Medicine and Department of Health Informatics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Kaveh Manavi
- Department of Genitourinary Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Joseph HA, Ingber SZ, Austin C, Westnedge C, Strona FV, Lee L, Shah AB, Roper L, Patel A. An Evaluation of the Text Illness Monitoring (TIM) Platform for COVID-19: Cross-sectional Online Survey of Public Health Users. JMIR Public Health Surveill 2022; 8:e32680. [PMID: 34882572 PMCID: PMC8823610 DOI: 10.2196/32680] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/28/2021] [Accepted: 11/30/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The US public health response to the COVID-19 pandemic has required contact tracing and symptom monitoring at an unprecedented scale. The US Centers for Disease Control and Prevention and several partners created the Text Illness Monitoring (TIM) platform in 2015 to assist US public health jurisdictions with symptom monitoring for potential novel influenza virus outbreaks. Since May 2020, 142 federal, state, and local public health agencies have deployed TIM for COVID-19 symptom monitoring. OBJECTIVE The aim of this study was to evaluate the utility, benefits, and challenges of TIM to help guide decision-making for improvements and expansion to support future public health emergency response efforts. METHODS We conducted a brief online survey of previous and current TIM administrative users (admin users) from November 28 through December 21, 2020. Closed- and open-ended questions inquired about the onboarding process, decision to use TIM, groups monitored with TIM, comparison of TIM to other symptom monitoring systems, technical challenges and satisfaction with TIM, and user support. A total of 1479 admin users were invited to participate. RESULTS A total of 97 admin users from 43 agencies responded to the survey. Most admin users represented the Indian Health Service (35/97, 36%), state health departments (26/97, 27%), and local or county health departments (18/97, 19%), and almost all were current users of TIM (85/94, 90%). Among the 43 agencies represented, 11 (26%) used TIM for monitoring staff exclusively, 13 (30%) monitored community members exclusively, and 19 (44%) monitored both staff and community members. Agencies most frequently used TIM to monitor symptom development in contacts of cases among community members (28/43, 65%), followed by symptom development among staff (27/43, 63%) and among staff contacts of cases (24/43, 56%). Agencies also reported using TIM to monitor patients with COVID-19 for the worsening of symptoms among staff (21/43, 49%) and community members (18/43, 42%). When asked to compare TIM to previous monitoring systems, 78% (40/51) of respondents rated TIM more favorably than their previous monitoring system, 20% (10/51) said there was no difference, and 2% (1/51) rated the previous monitoring system more favorably than TIM. Most respondents found TIM favorable in terms of time burden, staff burden, timeliness of the data, and the ability to monitor large population sizes. TIM compared negatively to other systems in terms of effort to enroll participants (ie, persons TIM monitors) and accuracy of the data. Most respondents (76/85, 89%) reported that they would highly or somewhat recommend TIM to others for symptom monitoring. CONCLUSIONS This evaluation of TIM showed that agencies used TIM for a variety of purposes and rated TIM favorably compared to previously used monitoring systems. We also identified opportunities to improve TIM; for example, enhancing the flexibility of alert deliveries would better meet admin users' varying needs. We also suggest continuous program evaluation practices to assess and respond to implementation gaps.
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Affiliation(s)
- Heather A Joseph
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Chamblee, GA, United States
| | - Susan Z Ingber
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Chelsea Austin
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Caroline Westnedge
- Federal Civilian Division, General Dynamics Information Technology, Atlanta, GA, United States
| | - F V Strona
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Leslie Lee
- Office of the Director, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Ami B Shah
- Federal Civilian Division, General Dynamics Information Technology, Atlanta, GA, United States
| | - Lauren Roper
- Office of the Director, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Anita Patel
- Office of the Director, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Abstract
BACKGROUND Reducing transmission depends on the percentage of infected partners treated; if many are missed, impact on transmission will be low. Traditional partner services metrics evaluate the number of partners found and treated. We estimated the proportion of partners of syphilis patients not locatable for intervention. METHODS We reviewed records of early syphilis cases (primary, secondary, early latent) reported in 2015 to 2017 in 7 jurisdictions (Florida, Louisiana, Michigan, North Carolina, Virginia, New York City, and San Francisco). Among interviewed syphilis patients, we determined the proportion who reported named partners (with locating information), reported unnamed partners (no locating information), and did not report partners. For patients with no reported partners, we estimated their range of unreported partners to be between one and the average number of partners for patients who reported partners. RESULTS Among 29,719 syphilis patients, 23,613 (80%) were interviewed and 18,581 (63%) reported 84,224 sex partners (average, 4.5; 20,853 [25%] named and 63,371 [75%] unnamed). An estimated 11,138 to 54,521 partners were unreported. Thus, 74,509 to 117,892 (of 95,362-138,745) partners were not reached by partner services (78%-85%). Among interviewed patients, 71% reported ≥1 unnamed partner or reported no partners; this proportion was higher for men who reported sex with men (75%) compared with men who reported sex with women only (65%) and women (44%). CONCLUSIONS Approximately 80% of sex partners were either unnamed or unreported. Partner services may be less successful at interrupting transmission in networks for men who reported sex with men where a higher proportion of partners are unnamed or unreported.
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Okpara KS, Hecht J, Wohlfeiler D, Prior M, Klausner JD. A Patient-Initiated Digital COVID-19 Contact Notification Tool (TellYourContacts): Evaluation Study. JMIR Form Res 2021; 5:e23843. [PMID: 33621189 PMCID: PMC7939055 DOI: 10.2196/23843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/29/2021] [Accepted: 02/10/2021] [Indexed: 11/20/2022] Open
Abstract
Background Contact notification is a method used to control the spread of infectious disease. In this process, a patient who tests positive for an infectious disease and public health officials work to identify the patient’s close contacts, notify them of their risk of possible exposure to the disease, and provide resources to facilitate the decreased spreading of disease. Contact notification can be done physically in person, via phone call, or digitally through the use of media such as SMS text messages and email. When alerts are made through the latter, it is called digital contact notification. Objective For this study, we aim to perform a preliminary evaluation of the use of the TellYourContacts website, a digital contact notification tool for COVID-19 that can be used confidentially and anonymously. We will gather information about the number of website users and message senders, the types of messages sent, and the geographic distribution of senders. Methods Patients who chose to get tested for COVID-19 and subsequently tested positive for the disease were alerted of their positive results through Curative Inc (a COVID-19 testing laboratory) and Healthvana (a results disclosure app). Included in the notification was a link to the TellYourContacts website and a message encouraging the person who tested positive for COVID-19 to use the website to alert their close contacts of exposure risk. Over the course of three months, from May 18, 2020, to August 17, 2020, we used Google Analytics and Microsoft Excel to record data on the number of website users and message senders, types of messages sent, and geographic distribution of the senders. Results Over the course of three months, 9130 users accessed the website and 1474 unique senders sent a total of 1957 messages, which included 1820 (93%) SMS text messages and 137 (7%) emails. Users sent messages from 40 US states, with the majority of US senders residing in California (49%). Conclusions We set out to determine if individuals who test positive for COVID-19 will use the TellYourContacts website to notify their close contacts of COVID-19 exposure risk. Our findings reveal that, during the observation period, each unique sender sent an average of 1.33 messages. The TellYourContacts website offers an additional method that individuals can and will use to notify their close contacts about a recent COVID-19 diagnosis.
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Affiliation(s)
- Kelechi S Okpara
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.,Charles R Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Jennifer Hecht
- Building Healthy Online Communities, San Francisco, CA, United States.,San Francisco AIDS Foundation, San Francisco, CA, United States
| | - Dan Wohlfeiler
- Building Healthy Online Communities, San Francisco, CA, United States
| | - Matthew Prior
- National Coalition of STD Directors, Washington, DC, United States
| | - Jeffrey D Klausner
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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Cavalcante EGF, Galvão MTG, Lima ICVD, Almeida PCD. Strategies for notifying sexual partners of people with sexually transmitted infections: a randomized clinical trial. Rev Esc Enferm USP 2020; 54:e03648. [PMID: 33295528 DOI: 10.1590/s1980-220x2019010103648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 02/06/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To compare the effectiveness of verbal communication and communication by card in getting sexual partners of people with sexually transmitted infections to attend a health service and the factors associated with the success of these types of communication. METHOD Clinical, controlled, and randomized study, whose intervention was offering a reporting card for index patients to hand to their sexual partners. RESULTS The sample was 189 index patients, 94 of whom were in the control group, and verbally invited their sexual partners to receive care, and 95 were allocated to the intervention group, and took their partner's reporting card to their partners as a way to invite them to receive care. The percentage of partners invited by card who came to the service was 52.6%, in contrast with 43.6% among partners who were invited verbally, but no significant statistical difference was found (p=0.215). The factors associated with failure to convince partners to come to the service were: not living with the partner (p=0.0001); not having a steady partner (p=0.0001); having casual partners (p=0.028); and using condoms with a steady partner (p=0.045). The infection type did not influence the studied partners' visits to the service. CONCLUSION Given the failure to achieve effectiveness when applying the reporting by card, the authors recommend another card model containing information for partners to be used in combination with other methods. Brazilian Clinical Trials Registry: RBR-7jp5mr.
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Affiliation(s)
| | | | | | - Paulo César de Almeida
- Universidade Estadual do Ceará, Programa de Pós-Graduação Cuidados Clínicos em Enfermagem e Saúde, Fortaleza, CE, Brasil
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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: 4] [Impact Index Per Article: 1.0] [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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Webster R, Moore MS, Bocour A, Johnson N, Winters A. Health Department Efforts to Increase Hepatitis C RNA Testing Among People Appearing Out of Care: Comparison of Outreach Approaches, New York City, 2017. Public Health Rep 2020; 135:823-830. [PMID: 32886566 DOI: 10.1177/0033354920952068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Hepatitis C virus (HCV) infection is a serious health problem in New York City. Although curative treatments are available, many people are out of care. The New York City Department of Health and Mental Hygiene (DOHMH) used surveillance data and various outreach methods to attempt to link to care people diagnosed with HCV infection from 2010 through 2015. METHODS We randomly assigned people out of care (ie, no HCV test >6 months after first report) to 4 outreach groups: no outreach (control group); letter only; letter and telephone call; and letter, text message, and telephone call. Three months after outreach ended, we analyzed surveillance data to identify people with a subsequent HCV RNA or genotype test suggesting linkage to care. RESULTS Of 2626 selected people, 199 (7.6%) had a subsequent HCV test. People in all 3 outreach groups had higher odds of a subsequent test than people in the control group (letter only: adjusted odds ratio [aOR] = 1.81 [95% CI, 1.18-2.91]; letter and telephone: aOR = 3.11 [95% CI, 1.67-5.79]; letter, text, and telephone: aOR = 3.17 [95% CI, 1.48-6.51]). People in the letter and telephone group had higher odds of a subsequent test than people in the letter-only group (aOR = 1.72; 95% CI, 1.04-2.74). Most people in the letter and telephone (136/200, 68.0%) and the letter, text, and telephone (71/99, 71.7%) groups could not be reached, primarily because telephone numbers were incorrect or out of service. CONCLUSION Reaching out to people soon after first report or prioritizing groups in which more recent contact information can be found might improve outcomes of future outreach.
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Affiliation(s)
- Rachel Webster
- 364931 New York City Department of Health and Mental Hygiene, Bureau of Communicable Disease, Division of Disease Control, Viral Hepatitis Program, Queens, NY, USA
| | - Miranda S Moore
- 364931 New York City Department of Health and Mental Hygiene, Bureau of Communicable Disease, Division of Disease Control, Viral Hepatitis Program, Queens, NY, USA
| | - Angelica Bocour
- 364931 New York City Department of Health and Mental Hygiene, Bureau of Communicable Disease, Division of Disease Control, Viral Hepatitis Program, Queens, NY, USA
| | - Nirah Johnson
- 364931 New York City Department of Health and Mental Hygiene, Bureau of Communicable Disease, Division of Disease Control, Viral Hepatitis Program, Queens, NY, USA
| | - Ann Winters
- 364931 New York City Department of Health and Mental Hygiene, Bureau of Communicable Disease, Division of Disease Control, Viral Hepatitis Program, Queens, NY, USA
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Historical and Current Trends in the Epidemiology of Early Syphilis in San Francisco, 1955 to 2016. Sex Transm Dis 2019; 45:S55-S62. [PMID: 29787467 DOI: 10.1097/olq.0000000000000870] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Seventeen years into a sustained epidemic, early syphilis (ES) rates in San Francisco (SF) are continuing to increase and the demographics of the affected population are changing. We provide a historical overview of ES in SF among men who have sex with men (MSM) and describe trends in the epidemiology and disease investigation outcomes. METHODS We examined data from the SF Department of Public Health's patient-based registry of integrated STD surveillance, clinical, and field investigation data to describe demographic and behavioral characteristics of ES cases, as well as outcomes of syphilis partner services (PS). χ Tests were performed to examine categorical differences across periods. Analysis of variance was used to examine differences in continuous variables. RESULTS In 2016, 1095 ES cases were reported among males in SF, a 219% increase from the 343 cases identified 10 years ago. Between 1996-1999 and 2010-2016, an increasing proportion of ES cases were among MSM younger than 25 years, nonwhite, and HIV negative (P < 0.05). A decreasing proportion of ES cases were assigned for PS, among whom a smaller proportion of reported sex partners were identified by name, resulting in an overall decline in the proportion of cases who had at least one named partner treated as a result of PS (Disease Intervention Rate) from 30.5 in 2000-2004 to 14.8 in 2010-2016. CONCLUSIONS Syphilis case rates continue to increase in SF and the epidemic is expanding beyond a core population. Additional resources and innovative prevention approaches are needed to reduce the burden of syphilis among MSM.
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The Use of Technology for Sexually Transmitted Disease Partner Services in the United States: A Structured Review. Sex Transm Dis 2019; 45:707-712. [PMID: 29771868 DOI: 10.1097/olq.0000000000000864] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Since the late 1990s, health departments and sexually transmitted disease (STD) programs throughout the United States have used technologies, such as the Internet and mobile phones, to provide services to persons with a sexually transmitted infection, including human immunodeficiency virus (HIV), and their sex partners, also known as partner services. This study reviewed the published literature to assess and compare partner services outcomes as a result of using technology and to calculate cost savings through cases averted. METHODS We conducted a structured literature review of all US studies that examined the use of technology to notify persons exposed to an STD (syphilis, chlamydia, gonorrhea), including HIV, by health care professionals in the United States from 2000 to 2017. Outcome measures, including the number of partners notified, screened or tested; and new positives identified, were captured and cost savings were calculated, when data were available. RESULTS Seven studies were identified. Methods used for partner services differed across studies, although email was the primary mode in 6 (83%) of the 7 studies. Only 2 of the 7 studies compared use of technology for partner services to traditional partner services. Between 10% and 97% of partners were successfully notified of their exposure through the use of technology and between 34% and 81% were screened or tested. Five studies reported on new infections identified, which ranged from 3 to 19. Use of technology for partner serves saved programs between US $22,795 and US $45,362 in direct and indirect medical costs. CONCLUSIONS Use of technology for partner services increased the number of partners notified, screened or tested, and new infections found. Importantly, the use of technology allowed programs to reach partners who otherwise would not have been notified of their exposure to an STD or HIV. Improved response times and time to treatment were also seen as was re-engagement into care for previous HIV positive patients. Data and outcome measures across the studies were not standardized, making it difficult to generalize conclusions. Although not a replacement for traditional partner services, the use of technology enhances partner service outcomes.
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Cheng W, Jin W, Gu Y, Zhong F, Han Z, Xu H, Tang W. HIV Partner Notification Across Different Sexual Partner Types Among Men Who Have Sex with Men in Guangzhou, China. AIDS Patient Care STDS 2019; 33:295-298. [PMID: 31194574 DOI: 10.1089/apc.2019.0059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Weibin Cheng
- Department of STD Control and Prevention, Dermatology Hospital, Southern Medical University, Guangzhou, China
- Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Wei Jin
- Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
- Logistics Support Department, China Southern Airlines Henan Airlines Co. Ltd., Zhengzhou, China
| | - Yuzhou Gu
- Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Fei Zhong
- Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Zhigang Han
- Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Huifang Xu
- Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Weiming Tang
- Department of STD Control and Prevention, Dermatology Hospital, Southern Medical University, Guangzhou, China
- School of Public Health, Southern Medical University, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
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15
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Cope AB, Mobley VL, Samoff E, O'Connor K, Peterman TA. The Changing Role of Disease Intervention Specialists in Modern Public Health Programs. Public Health Rep 2018; 134:11-16. [PMID: 30500306 DOI: 10.1177/0033354918813549] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Anna B Cope
- 1 Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.,2 Division of Public Health, North Carolina Department of Health and Human Services, Communicable Disease Branch, Raleigh, NC, USA
| | - Victoria L Mobley
- 2 Division of Public Health, North Carolina Department of Health and Human Services, Communicable Disease Branch, Raleigh, NC, USA
| | - Erika Samoff
- 2 Division of Public Health, North Carolina Department of Health and Human Services, Communicable Disease Branch, Raleigh, NC, USA
| | - Kevin O'Connor
- 1 Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Thomas A Peterman
- 1 Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract
BACKGROUND The success of an intervention to prevent syphilis will depend on the context and the goal of the intervention. To help programs choose interventions, we reviewed major changes in context and types of interventions that may be effective. METHODS We reviewed the literature on the changing context of syphilis in the United States and interventions to prevent syphilis, focusing on articles that included evidence of effectiveness. RESULTS Populations acquiring syphilis are constantly changing. Currently, incidence is very high among men who have sex with men (MSM). Among adults, late disease caused by syphilis has become rare. Congenital syphilis incidence has been low but is increasing, and morbidity and mortality remain high when babies are infected. Congenital syphilis now causes more deaths than syphilis among adults.Routine screening of MSM can identify and treat infections before they progress to disease (secondary prevention). Screening rates are highest when done as part of routine standing orders. Partner notification effectiveness has decreased, partly because many partners are anonymous. Most congenital syphilis can be prevented by screening pregnant women; it has been eliminated in areas where intense primary prevention efforts eliminated syphilis among women. CONCLUSIONS So far, no program has stopped the increasing rates of infection among MSM, but secondary prevention efforts have prevented most disability. Congenital syphilis is increasing, and can be decreased by screening pregnant women and stopped by intensive efforts to prevent infection among women.
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Affiliation(s)
- Thomas A Peterman
- From the Division of STD Prevention, National Center for HIV, Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta GA
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Modernizing Field Services for Human Immunodeficiency Virus and Sexually Transmitted Infections in the United States. Sex Transm Dis 2018; 44:599-607. [PMID: 28876325 DOI: 10.1097/olq.0000000000000652] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Public health field services for sexually transmitted infections (STIs) have not adequately evolved to address the expanding scale of the STI problem, its concentration among men who have sex with men, the emergence of new communication technologies and the availability of antiretroviral therapy as a cornerstone of human immunodeficiency virus (HIV) prevention. Field services need to modernize. Modernization should seek to expand field services objectives beyond sex partner STI testing and treatment to include: HIV testing of persons with bacterial STI and their partners, including efforts to promote frequent HIV/STI testing; increased condom access; linkage and relinkage to HIV care and promotion of viral suppression; preexposure prophylaxis promotion; linkage to long-acting contraception; and referral for health insurance. Field services programs cannot advance these new objectives while simultaneously doing all of the work they have traditionally done. Modernization will require a willingness to reconsider some longstanding aspects of field services work, including the centrality of face-to-face interviews and field investigations. Health departments seeking to modernize will need to carefully assess their ongoing activities and reorganize to align the use of field services resources with program priorities. In some instances, this may require reorganization to allow the staff greater specialization and closer integration with surveillance activities. Adapting programs will require new staff training, improvements in data management systems, and a greater investment in monitoring and evaluation. Although modernization is likely to evolve over many years, the time to start is now.
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Ong JJ, Fu H, Smith MK, Tucker JD. Expanding syphilis testing: a scoping review of syphilis testing interventions among key populations. Expert Rev Anti Infect Ther 2018; 16:423-432. [PMID: 29633888 PMCID: PMC6046060 DOI: 10.1080/14787210.2018.1463846] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Syphilis is an important sexually transmitted infection (STI). Despite inexpensive and effective treatment, few key populations receive syphilis testing. Innovative strategies are needed to increase syphilis testing among key populations. Areas covered: This scoping review focused on strategies to increase syphilis testing in key populations (men who have sex with men (MSM), sex workers, people who use drugs, transgender people, and incarcerated individuals). Expert commentary: We identified many promising syphilis testing strategies, particularly among MSM. These innovations are separated into diagnostic, clinic-based, and non-clinic based strategies. In terms of diagnostics, self-testing, dried blood spots, and point-of-care testing can decentralize syphilis testing. Effective syphilis self-testing pilots suggest the need for further attention and research. In terms of clinic-based strategies, modifying default clinical procedures can nudge physicians to more frequently recommend syphilis testing. In terms of non-clinic based strategies, venue-based screening (e.g. in correctional facilities, drug rehabilitation centres) and mobile testing units have been successfully implemented in a variety of settings. Integration of syphilis with HIV testing may facilitate implementation in settings where individuals have increased sexual risk. There is a strong need for further syphilis testing research and programs.
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Affiliation(s)
- Jason J. Ong
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Central Clinical School, Monash University, Victoria, Australia
| | - Hongyun Fu
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- Eastern Virginia Medical School, Norfolk, USA
| | - M. Kumi Smith
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- University of North Carolina at Chapel Hill, North Carolina, USA
| | - Joseph D. Tucker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Social Entrepreneurship to Spur Health (SESH) Global, Guangzhou, China
- University of North Carolina at Chapel Hill, North Carolina, USA
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Magaziner S, Montgomery MC, Bertrand T, Daltry D, Jenkins H, Kendall B, Molotnikov L, Pierce L, Smith E, Sosa L, van den Berg JJ, Marak T, Operario D, Chan PA. Public health opportunities and challenges in the provision of partner notification services: the New England experience. BMC Health Serv Res 2018; 18:75. [PMID: 29386023 PMCID: PMC5793459 DOI: 10.1186/s12913-018-2890-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 01/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partner notification services (PNS) are recommended by the Centers for Disease Control and Prevention as a public health intervention for addressing the spread of HIV and other sexually transmitted diseases (STDs). Barriers and facilitators to the partner notification process from a public health perspective have not been well described. METHODS In 2015, a coalition of New England public health STD directors and investigators formed to address the increasing STD prevalence across the region (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont) and to promote communication between state STD programs. To evaluate barriers and facilitators of PNS programs, a survey was administered to representatives from each state to describe PNS processes and approaches. RESULTS Of the six PNS programs, Connecticut, Maine, Massachusetts, Vermont, and New Hampshire had combined HIV and STD PNS programs; Rhode Island's programs were integrated but employed separate disease intervention specialists (DIS). All states performed PNS for HIV and syphilis. Maine, New Hampshire and Vermont performed services for all gonorrhea cases. Rhode Island, Connecticut, and Massachusetts performed limited partner notification for gonorrhea due to lack of resources. None of the six states routinely provided services for chlamydia, though Maine and Vermont did so for high-priority populations such as HIV co-infected or pregnant individuals. Across all programs, clients received risk reduction counseling and general STD education as a component of PNS, in addition to referrals for HIV/STD care at locations ranging from Planned Parenthood to community- or hospital-based clinics. Notable barriers to successful partner notification across all states included anonymous partners and index cases who did not feel comfortable sharing partners' names with DIS. Other common barriers included insufficient staff, inability of DIS to identify and contact partners, and index cases declining to speak with DIS staff. CONCLUSIONS In New England, state health departments use different strategies to implement PNS programs and referral to STD care. Despite this, similar challenges exist across settings, including difficulty with anonymous partners and limited state resources.
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Affiliation(s)
- Sarah Magaziner
- Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903 USA
| | - Madeline C. Montgomery
- Division of Infectious Diseases, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906 USA
| | - Thomas Bertrand
- Rhode Island Department of Health, 3 Capitol Hill, Providence, RI 02908 USA
| | - Daniel Daltry
- Vermont Department of Health, 108 Cherry Street, Burlington, VT 05402 USA
| | - Heidi Jenkins
- Connecticut Department of Public Health, 410 Capitol Avenue, Hartford, CT 06134 USA
| | - Brenda Kendall
- Maine Center for Disease Control and Prevention, State House Station 11, Augusta, ME 04333 USA
| | - Lauren Molotnikov
- Massachusetts Department of Public Health, 250 Washington Street, Boston, MA 02108 USA
| | - Lindsay Pierce
- New Hampshire Department of Health and Human Services, 29 Hazen Drive, Concord, NH 03301 USA
| | - Emer Smith
- Maine Center for Disease Control and Prevention, State House Station 11, Augusta, ME 04333 USA
| | - Lynn Sosa
- Connecticut Department of Public Health, 410 Capitol Avenue, Hartford, CT 06134 USA
| | - Jacob J. van den Berg
- Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903 USA
- Brown University School of Public Health, 121 South Main Street, Providence, RI 02903 USA
| | - Theodore Marak
- Division of Infectious Diseases, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906 USA
| | - Don Operario
- Brown University School of Public Health, 121 South Main Street, Providence, RI 02903 USA
| | - Philip A. Chan
- Warren Alpert Medical School of Brown University, 222 Richmond Street, Providence, RI 02903 USA
- Division of Infectious Diseases, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906 USA
- Rhode Island Department of Health, 3 Capitol Hill, Providence, RI 02908 USA
- Brown University School of Public Health, 121 South Main Street, Providence, RI 02903 USA
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Comparison of In-Person Versus Telephone Interviews for Early Syphilis and Human Immunodeficiency Virus Partner Services in King County, Washington (2010-2014). Sex Transm Dis 2017; 44:249-254. [PMID: 28282653 DOI: 10.1097/olq.0000000000000583] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The relative effectiveness of in-person versus telephone interviews for human immunodeficiency virus (HIV)/sexually transmitted disease partner services (PS) is uncertain. METHODS We compared outcomes of in-person versus telephone PS interviews for early syphilis (ES) and newly diagnosed HIV in King County, Washington from 2010 to 2014. We used multivariable Poisson regression to evaluate indices (number of partners per original patient [OP]) for partners named, notified, tested, diagnosed, and treated (ES only). Analyses controlled for OP age, sex, race/ethnicity, sexual orientation, time to interview, place of diagnosis, and staff performing interviews. RESULTS For ES, 682 and 646 OPs underwent in-person and telephone interviews, respectively. In-person syphilis PS were associated with higher indices of partners named (in-person index [IPI], 3.43; telephone index [TI], 2.06; adjusted relative risk [aRR], 1.68; 95% confidence interval [CI], 1.55-1.82), notified (IPI, 1.70; TI, 1.13; aRR, 1.39; 95% CI, 1.24-1.56), tested (IPI, 1.15; TI, 0.72; aRR, 1.34; 95% CI, 1.16-1.54), and empirically treated (IPI, 1.03; TI, 0.74; aRR, 1.19; 95% CI, 1.03-1.37), but no difference in infected partners treated (IPI, 0.28; TI, 0.24; aRR, 0.93; 95% CI, 0.72-1.21). For HIV, 358 and 489 OPs underwent in-person and telephone interviews, respectively. In-person HIV PS were associated with higher indices of partners named (IPI, 1.87; TI, 1.28; aRR, 1.38; 95% CI, 1.18-1.62), notified (IPI, 1.38; TI, 0.92; aRR, 1.24; 95% CI, 1.03-1.50), and newly diagnosed with HIV (IPI, 0.10; TI, 0.05; aRR, 2.17; 95% CI, 1.04-4.50), but no difference in partners tested (IPI, 0.61; TI, 0.48; aRR, 1.15; 95% CI, 0.88-1.52). CONCLUSIONS Although in-person syphilis PS were associated with some increased PS indices, they did not increase the treatment of infected partners. In contrast, in-person HIV PS resulted in increased HIV case finding. These data support prioritizing in-person PS for HIV and suggest that in-person PS for syphilis may not have major public health benefit.
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Trends in Syphilis Partner Notification Among Gay, Bisexual, and Other Men who Have Sex With Men in British Columbia, 2010 to 2013. Sex Transm Dis 2017; 43:489-93. [PMID: 27414679 DOI: 10.1097/olq.0000000000000494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Chart reviews of 350 randomly sampled syphilis cases of men who had sex with men in British Columbia from 2010 to 2013 revealed no change in the median number of partners per case, and an increasing proportion of partners notified by cases but fewer partners were known to be tested for syphilis.
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Daher J, Vijh R, Linthwaite B, Dave S, Kim J, Dheda K, Peter T, Pai NP. Do digital innovations for HIV and sexually transmitted infections work? Results from a systematic review (1996-2017). BMJ Open 2017; 7:e017604. [PMID: 29101138 PMCID: PMC5695353 DOI: 10.1136/bmjopen-2017-017604] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 09/20/2017] [Accepted: 09/22/2017] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Digital innovations with internet/mobile phones offer a potential cost-saving solution for overburdened health systems with high service delivery costs to improve efficiency of HIV/STI (sexually transmitted infections) control initiatives. However, their overall evidence has not yet been appraised. We evaluated the feasibility and impact of all digital innovations for all HIV/STIs. DESIGN Systematic review. SETTING/PARTICIPANTS All settings/all participants. INTERVENTION We classified digital innovations into (1) mobile health-based (mHealth: SMS (short message service)/phone calls), (2) internet-based mobile and/or electronic health (mHealth/eHealth: social media, avatar-guided computer programs, websites, mobile applications, streamed soap opera videos) and (3) combined innovations (included both SMS/phone calls and internet-based mHealth/eHealth). PRIMARY AND SECONDARY OUTCOME MEASURES Feasibility, acceptability, impact. METHODS We searched databases MEDLINE via PubMed, Embase, Cochrane CENTRAL and Web of Science, abstracted data, explored heterogeneity, performed a random effects subgroup analysis. RESULTS We reviewed 99 studies, 63 (64%) were from America/Europe, 36 (36%) from Africa/Asia; 79% (79/99) were clinical trials; 84% (83/99) evaluated impact. Of innovations, mHealth based: 70% (69/99); internet based: 21% (21/99); combined: 9% (9/99).All digital innovations were highly accepted (26/31; 84%), and feasible (20/31; 65%). Regarding impacted measures, mHealth-based innovations (SMS) significantly improved antiretroviral therapy (ART) adherence (pooled OR=2.15(95%CI: 1.18 to 3.91)) and clinic attendance rates (pooled OR=1.76(95%CI: 1.28, 2.42)); internet-based innovations improved clinic attendance (6/6), ART adherence (4/4), self-care (1/1), while reducing risk (5/5); combined innovations increased clinic attendance, ART adherence, partner notifications and self-care. Confounding (68%) and selection bias (66%) were observed in observational studies and attrition bias in 31% of clinical trials. CONCLUSION Digital innovations were acceptable, feasible and generated impact. A trend towards the use of internet-based and combined (internet and mobile) innovations was noted. Large scale-up studies of high quality, with new integrated impact metrics, and cost-effectiveness are needed. Findings will appeal to all stakeholders in the HIV/STI global initiatives space.
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Affiliation(s)
- Jana Daher
- Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Rohit Vijh
- Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Blake Linthwaite
- Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - Sailly Dave
- Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montreal, Canada
| | - John Kim
- National HIV/AIDS Labs, National Labs, Winnipeg, Manitoba, Canada
| | - Keertan Dheda
- Department of Pulmonology, UCT Lung Institute, University of Cape Town, Cape Town, South Africa
| | - Trevor Peter
- Clinton Health Access Initiative (CHAI), Boston, USA
| | - Nitika Pant Pai
- Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montreal, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
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Sociodemographic Differences in Clients Preferring Video-Call Over In-person Interview: A Pilot Study of HIV Tele-partner Services. AIDS Behav 2017; 21:3078-3086. [PMID: 27752874 DOI: 10.1007/s10461-016-1586-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The New York City Department of Health Disease Intervention Specialists (DIS) routinely contact newly HIV-diagnosed persons via telephone calls and in-person meetings to conduct partner services (PS) interviews in order to elicit the names and contact information of the HIV-exposed partners for notification and HIV-testing, and to assist clients with linkage to care. From October 2013 to December 2015, we offered PS interviews conducted via video-call alongside voice-call and in-person modes in a selected geographic area of NYC. PS interviews were conducted according to the clients' preferred mode (in-person, voice- or video-call) and location (health care facility, clients' residences, or other NYC locations). At the conclusion of the PS interviews, DIS elicited responses from persons interviewed via video-call on their perception, satisfaction and personal experiences using video-call for public health and personal purposes. Acceptance and satisfaction with PS interviews via video-call were high among clients aged <30 years, men who have sex with men, or with education above high school; while PS yields were similar across modes. These results provide evidence of the potential effectiveness of video-call interviews for specific populations.
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24
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Cherutich P, Golden MR, Wamuti B, Richardson BA, Ásbjörnsdóttir KH, Otieno FA, Ng'ang'a A, Mutiti PM, Macharia P, Sambai B, Dunbar M, Bukusi D, Farquhar C. Assisted partner services for HIV in Kenya: a cluster randomised controlled trial. Lancet HIV 2016; 4:e74-e82. [PMID: 27913227 DOI: 10.1016/s2352-3018(16)30214-4] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 10/01/2016] [Accepted: 10/13/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Assisted partner services for index patients with HIV infections involves elicitation of information about sex partners and contacting them to ensure that they test for HIV and link to care. Assisted partner services are not widely available in Africa. We aimed to establish whether or not assisted partner services increase HIV testing, diagnoses, and linkage to care among sex partners of people with HIV infections in Kenya. METHODS In this cluster randomised controlled trial, we recruited non-pregnant adults aged at least 18 years with newly or recently diagnosed HIV without a recent history of intimate partner violence who had not yet or had only recently linked to HIV care from 18 HIV testing services clinics in Kenya. Consenting sites in Kenya were randomly assigned (1:1) by the study statistician (restricted randomisation; balanced distribution in terms of county and proximity to a city) to immediate versus delayed assisted partner services. Primary outcomes were the number of partners tested for HIV, the number who tested HIV positive, and the number enrolled in HIV care, in those who were interviewed at 6 week follow-up. Participants within each cluster were masked to treatment allocation because participants within each cluster received the same intervention. This trial is registered with ClinicalTrials.gov, number NCT01616420. FINDINGS Between Aug 12, 2013, and Aug 31, 2015, we randomly allocated 18 clusters to immediate and delayed HIV assisted partner services (nine in each group), enrolling 1305 participants: 625 (48%) in the immediate group and 680 (52%) in the delayed group. 6 weeks after enrolment of index patients, 392 (67%) of 586 partners had tested for HIV in the immediate group and 85 (13%) of 680 had tested in the delayed group (incidence rate ratio 4·8, 95% CI 3·7-6·4). 136 (23%) partners had new HIV diagnoses in the immediate group compared with 28 (4%) in the delayed group (5·0, 3·2-7·9) and 88 (15%) versus 19 (3%) were newly enrolled in care (4·4, 2·6-7·4). Assisted partner services did not increase intimate partner violence (one intimate partner violence event related to partner notification or study procedures occurred in each group). INTERPRETATION Assisted partner services are safe and increase HIV testing and case-finding; implementation at the population level could enhance linkage to care and antiretroviral therapy initiation and substantially decrease HIV transmission. FUNDING National Institutes of Health.
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Affiliation(s)
- Peter Cherutich
- National AIDS/Sexually Transmitted Diseases Control Programme, Ministry of Health, Nairobi, Kenya.
| | - Matthew R Golden
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Beatrice Wamuti
- Department of Research and Training, Kenyatta National Hospital, Nairobi, Kenya
| | - Barbra A Richardson
- Department of Global Health, University of Washington, Seattle, WA, USA; Department of Biostatistics, University of Washington, Seattle, WA, USA
| | | | - Felix A Otieno
- Department of Research and Training, Kenyatta National Hospital, Nairobi, Kenya
| | - Ann Ng'ang'a
- National AIDS/Sexually Transmitted Diseases Control Programme, Ministry of Health, Nairobi, Kenya
| | - Peter Maingi Mutiti
- Department of Research and Training, Kenyatta National Hospital, Nairobi, Kenya
| | - Paul Macharia
- National AIDS/Sexually Transmitted Diseases Control Programme, Ministry of Health, Nairobi, Kenya
| | - Betsy Sambai
- Department of Research and Training, Kenyatta National Hospital, Nairobi, Kenya
| | - Matt Dunbar
- Department of Computer Science and Demography, University of Washington, Seattle, WA, USA
| | - David Bukusi
- Department of Research and Training, Kenyatta National Hospital, Nairobi, Kenya
| | - Carey Farquhar
- Department of Medicine, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA
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Roberts CP, Klausner JD. Global challenges in human immunodeficiency virus and syphilis coinfection among men who have sex with men. Expert Rev Anti Infect Ther 2016; 14:1037-1046. [PMID: 27626361 DOI: 10.1080/14787210.2016.1236683] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Syphilis and human immunodeficiency virus (HIV) coinfection disproportionately affects men who have sex with men (MSM), and the rate of coinfection has been increasing over the last decade. HIV and syphilis coinfection is particularly challenging because the infections interact synergistically thereby increasing the risk of acquisition and transmission as well as accelerating disease progression. Areas covered: This paper reviews and summarizes the epidemiology, pathogenesis, diagnosis, clinical management and prevention of HIV and syphilis coinfection among MSM. Expert commentary: Research does not support a different syphilis treatment for coinfected individuals; however, coinfection may warrant a recommendation for antiretroviral therapy. In order to reverse the epidemic of syphilis and HIV coinfection, there needs to be greater awareness, improved cultural sensitivity among health care providers, improved access to preventative services and increased screening for syphilis and HIV.
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Affiliation(s)
- Chelsea P Roberts
- a David Geffen School of Medicine , University of California Los Angeles , Los Angeles , CA , USA
| | - Jeffrey D Klausner
- a David Geffen School of Medicine , University of California Los Angeles , Los Angeles , CA , USA.,b Division of Infectious Diseases, Department of Medicine , University of California, Los Angeles , Los Angeles , CA , USA
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Smartlowit-Briggs L, Pearson C, Whitefoot P, Altamirano BN, Womack M, Bastin M, Dombrowski JC. Community-Based Assessment to Inform a Chlamydia Screening Program for Women in a Rural American Indian Community. Sex Transm Dis 2016; 43:390-5. [PMID: 27196261 PMCID: PMC5446671 DOI: 10.1097/olq.0000000000000456] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rates of chlamydial infection in American Indian/Alaska Native women in the United States are approximately 4-fold those in non-Hispanic white women. We conducted a community-based survey of self-identified American Indian/Alaska Native women 14 to 25 years of age on a reservation in the Northwestern United States to inform a chlamydia screening strategy. METHODS The anonymous survey assessed respondents' knowledge, perceptions, and preferences related to chlamydia screening, results receipt, and partner notification. We recruited women using respondent-driven sampling, school-based sampling, and direct recruitment through social media and fliers. Participants in schools completed the survey as a paper-based, self-administered survey. Other participants could complete the survey in person, by phone as an interviewer-administered survey, or online. RESULTS We recruited 162 participants, most in schools (n = 83; 51%) or by peer referral (n = 55; 34%). Only 1 woman completed the survey online. Thirty-one respondents (19%) reported a history of an unplanned first pregnancy, and 19 (12%) reported a history of a diagnosed sexually transmitted disease. Most women (n = 98; 63%) recognized the potential impact of Chlamydia trachomatis on fertility. The preferred site for chlamydia screening was the Indian Health Service Clinic (n = 114; 70%), but 79 women (41%) would accept a C. trachomatis test at a nonclinical testing site. Of the 56 women (35%) who would accept home testing, most preferred to get the test kit from a clinic. CONCLUSIONS Our results suggest that Indian Health Service efforts to increase chlamydia screening in the clinic and through outreach may be more successful than promotion of home testing in this population.
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Affiliation(s)
| | - Cynthia Pearson
- Indigenous Wellness Research Center, University of Washington, Seattle, WA
- Toppenish School District, Toppenish, WA
| | | | | | | | - Marie Bastin
- Indian Health Services, Yakama Nation, Toppenish, WA
| | - Julia C. Dombrowski
- Center for AIDS and STD, University of Washington, Seattle, WA
- Public Health–Seattle & King County HIV/STD Program, Seattle, WA
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Pellowski J, Mathews C, Kalichman MO, Dewing S, Lurie MN, Kalichman SC. Advancing Partner Notification Through Electronic Communication Technology: A Review of Acceptability and Utilization Research. JOURNAL OF HEALTH COMMUNICATION 2016; 21:629-637. [PMID: 27144318 PMCID: PMC4948177 DOI: 10.1080/10810730.2015.1128020] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A cornerstone of sexually transmitted infection (STI) prevention is the identification, tracing, and notification of sex partners of index patients. Although partner notification reduces disease burden and prevents new infections as well as reinfections, studies show that only a limited number of partners are ever notified. Electronic communication technologies, namely, the Internet, text messaging, and phone calls (i.e., e-notification), have the potential to expand partner services. We conducted a systematic review of studies that have investigated the acceptability and utility of e-notification. We identified 23 studies that met the following criteria: (a) 9 studies presented data on the acceptability of technology-based communications for contacting sex partner(s), and (b) 14 studies reported on the utilization of communication technologies for partner notification. Studies found high levels of interest in and acceptability of e-notification; however, there was little evidence for actual use of e-notification. Taken together, results suggest that electronic communications could have their greatest impact in notifying less committed partners who would otherwise be uninformed of their STI exposure. In addition, all studies to date have been conducted in resource-rich countries, although the low cost of e-notification may have its greatest impact in resource-constrained settings. Research is needed to determine the best practices for exploiting the opportunities afforded by electronic communications for expanding STI partner services.
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Affiliation(s)
- Jennifer Pellowski
- a Department of Psychology , University of Connecticut , Storrs , Connecticut , USA
- c Brown University School of Public Health , Providence , Rhode Island , USA
| | - Catherine Mathews
- b Health Systems Research Unit , South African Medical Research Council , Cape Town , South Africa
| | - Moira O Kalichman
- a Department of Psychology , University of Connecticut , Storrs , Connecticut , USA
| | - Sarah Dewing
- b Health Systems Research Unit , South African Medical Research Council , Cape Town , South Africa
| | - Mark N Lurie
- c Brown University School of Public Health , Providence , Rhode Island , USA
| | - Seth C Kalichman
- a Department of Psychology , University of Connecticut , Storrs , Connecticut , USA
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Abstract
Partner notification is a widely accepted method whose intent is to limit onward HIV transmission. With increasing use of new technologies such as text messaging, e-mail, and social network sites, there is growing interest in using these techniques for "next-generation" HIV partner services (PS). We conducted a systematic review to assess the use and effectiveness of these technologies in HIV PS. Our literature search resulted in 1343 citations, with 7 meeting inclusion criteria. We found programs in 2 domains: (1) Public Health Department usage of new technologies to augment traditional partner notification (n = 3) and (2) patient or provider-led usage of partner notification Web sites (n = 4) The health department-based efforts showed an ability to find new cases in a previously unreachable population but in the limited comparisons to traditional PS had a lower rate of successful contact. Usage data from the partner notification Web sites revealed a high total number of e-notifications sent, with less than 10% of cards sent for HIV. Clear evidence on outcomes and directly traceable utilization for these Web services was lacking. When given a choice, most clients chose to send e-notifications via text versus e-mail. Although successful notification may be lower overall, use of next-generation services provides an avenue to contact those who would previously have been untraceable. Additional research is needed to determine to what extent technology-enhanced PS improves the identification of newly infected persons as well as the initiation of new prevention interventions for HIV-negative clients within high-risk networks.
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Taggart T, Grewe ME, Conserve DF, Gliwa C, Roman Isler M. Social Media and HIV: A Systematic Review of Uses of Social Media in HIV Communication. J Med Internet Res 2015; 17:e248. [PMID: 26525289 PMCID: PMC4642795 DOI: 10.2196/jmir.4387] [Citation(s) in RCA: 113] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 09/03/2015] [Accepted: 10/09/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Social media, including mobile technologies and social networking sites, are being used increasingly as part of human immunodeficiency virus (HIV) prevention and treatment efforts. As an important avenue for communication about HIV, social media use may continue to increase and become more widespread. OBJECTIVE The objective of this paper is to present a comprehensive systematic review of the current published literature on the design, users, benefits, and limitations of using social media to communicate about HIV prevention and treatment. METHODS This review paper used a systematic approach to survey all literature published before February 2014 using 7 electronic databases and a manual search. The inclusion criteria were (1) primary focus on communication/interaction about HIV/acquired immunodeficiency syndrome (AIDS), (2) discusses the use of social media to facilitate communication, (3) communication on the social media platform is between individuals or a group of individuals rather than the use of preset, automated responses from a platform, (4) published before February 19, 2014, and (5) all study designs. RESULTS The search identified 35 original research studies. Thirty studies had low or unclear risk of at least one of the bias items in the methodological quality assessment. Among the 8 social media platform types described, short message service text messaging was most commonly used. Platforms served multiple purposes including disseminating health information, conducting health promotion, sharing experiences, providing social support, and promoting medication adherence. Social media users were diverse in geographic location and race/ethnicity; studies commonly reported users aged 18-40 years and users with lower income. Although most studies did not specify whether use was anonymous, studies reported the importance of anonymity in social media use to communicate about HIV largely due to the stigma associated with HIV. The ability to share and receive information about HIV was the most commonly reported benefit of social media use and the most common challenges were related to technology. Measures of frequency of use, satisfaction, and effects of use varied across studies. CONCLUSIONS Using social media to bridge communication among a diverse range of users, in various geographic and social contexts, may be leveraged through pre-existing platforms and with attention to the roles of anonymity and confidentiality in communication about HIV prevention and treatment. More robust research is needed to determine the effects of social media use on various health and social outcomes related to HIV.
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Affiliation(s)
- Tamara Taggart
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
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Tuddenham S, Ghanem KG. Emerging trends and persistent challenges in the management of adult syphilis. BMC Infect Dis 2015; 15:351. [PMID: 26286439 PMCID: PMC4545322 DOI: 10.1186/s12879-015-1028-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 07/15/2015] [Indexed: 01/13/2023] Open
Abstract
There are an estimated 10.6 million incident cases of syphilis worldwide each year. We highlight some persistent challenges and emerging trends in the clinical management of syphilis with a particular focus on therapy, serology, diagnostics, and prevention. Decades after the introduction of penicillin, the optimal management of early syphilis continues to be a controversial topic, particularly in the setting of HIV co-infection. Similarly, the need for routine lumbar puncture in HIV co-infected asymptomatic persons is an unanswered question. Despite advances in both automation and point-of-care diagnostics, we continue to rely on indirect measures of disease activity to manage this infection. As syphilis rates in some populations continue to rise, novel and effective prevention strategies are needed.
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Affiliation(s)
- Susan Tuddenham
- Johns Hopkins University School of Medicine, 5200 Eastern Ave, MFL Center Tower #378, Baltimore, MD, 21224, USA. .,Division of Infectious Diseases, 1830 E. Monument Street, Room 442, Baltimore, MD, 21287, USA.
| | - Khalil G Ghanem
- Johns Hopkins University School of Medicine, 5200 Eastern Ave, MFL Center Tower #378, Baltimore, MD, 21224, USA. .,Division of Infectious Diseases, 1830 E. Monument Street, Room 442, Baltimore, MD, 21287, USA.
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Abstract
BACKGROUND A substantial proportion of recent sex partners named by persons with sexually transmitted infections are not notified about their exposure despite attempts by public health officials. Although text messaging (texting) and Internet-based communications (dating Web sites, e-mail, etc) are used by a large segment of the public for regular communications, these tools have been underused for partner services (PS). METHODS We augmented PS for HIV in New York City using texting and Internet-based means to contact persons for whom traditional information (landline telephone number, postal address) was unavailable. We compared traditional PS (traditionalPS), Internet-based PS (IPS) in January 2011 to October 2012, and texting PS (txtPS) from January 2012 (when txtPS was initiated) through October 2012 on outcomes of contact attempts, notification, and HIV testing. RESULTS From January 2011 to October 2012, of 3319 partners elicited, 2604 and 275 partners had traditional and only Internet-based contact information and were selected for traditionalPS and IPS, respectively. From January to October 2012, 368 of 1569 partners had only texting-enabled cellphone numbers and were selected for txtPS. The contact rate for txtPS (285/368 [77%]) was significantly higher (P < 0.0001) than the contact rates for traditionalPS (1803/2604 [69%]) and IPS (112/275 [41%]). There was a higher likelihood of notifying contacted IPS (odds ratio, 2.1; 1.2-3.4) and txtPS (odds ratio, 2.4; 1.7-3.2) than traditionalPS partners (P ≤ 0.0001). However, among the notified partners, traditionalPS partners were significantly (P < 0.0001) more likely than txtPS or IPS partners to test for HIV after partner notification (69% vs 45% and 34%, respectively). CONCLUSIONS Augmenting traditionalPS with txtPS and IPS enabled notification of hundreds of previously untraceable partners and several new HIV diagnoses.
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Use of new technologies to notify possible contagion of sexually-transmitted infections among men. GACETA SANITARIA 2015; 29:190-7. [PMID: 25707605 DOI: 10.1016/j.gaceta.2015.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 01/14/2015] [Accepted: 01/14/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Among men who have sex with men (MSM), the association between searching for sexual partners' on the Internet and increased risk of sexually transmitted infections (STIs)/HIV infection, together with current low levels of partner notification (PN), justifies a study to explore the intention to use new communication technologies for PN in Spain. METHODS Two cross-sectional surveys were performed: the first was administered online to visitors to web pages where the survey was advertised; the second was administered on paper to patients attending an STI Unit and centres similar to Community-Based Voluntary Counselling and Testing centres. RESULTS The study population comprised 1578 Spanish residents (median age, 34 years [range: 18 to 74]); 84% lived in urban areas, and 69% reported searching for sexual partners on the Internet. Thirty-seven per cent would be willing to use a website for PN, 26% did not know if they would use one, and 37% would not want to use one. The main reasons for not intending to notify STI/HIV were "shame or fear" (stable partner) and "not knowing how to contact them" (casual partner). The preferred method of notification was face to face (73%) for both stable and casual partners, although using new technologies (Short Messaging System, e-mail, web page, phone applications) was widely accepted for notifying casual partners. CONCLUSIONS Fighting stigma and promoting alternative methods of PN among MSM and health professionals through new technologies could increase the frequency of PN. This approach will improve early detection and reduce transmission in Spain.
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Stoltey JE, Cohen SE. Syphilis transmission: a review of the current evidence. Sex Health 2015; 12:103-9. [PMID: 25702043 DOI: 10.1071/sh14174] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 12/22/2014] [Indexed: 11/23/2022]
Abstract
Syphilis remains widespread worldwide, with increasing rates among men who have sex with men. This paper reviews available evidence regarding syphilis transmission, including data on: sexual transmission (transmission probability per sexual partnership), vertical transmission, transmission via blood products and organ donation, and other rare modes of transmission. In addition, host susceptibility to syphilis infection is discussed. Syphilis screening and treatment, condoms and risk-reduction counselling and how they modify syphilis transmission dynamics are considered.
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Affiliation(s)
- Juliet E Stoltey
- University of California, San Francisco - Division of Infectious Diseases, 513 Parnassus Avenue, Box 0654, San Francisco, CA 94143, USA
| | - Stephanie E Cohen
- San Francisco Department of Public Health, 356 7th Street, San Francisco, CA 94103, USA
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Holloway IW, Dunlap S, Del Pino HE, Hermanstyne K, Pulsipher C, Landovitz RJ. Online Social Networking, Sexual Risk and Protective Behaviors: Considerations for Clinicians and Researchers. CURRENT ADDICTION REPORTS 2014; 1:220-228. [PMID: 25642408 DOI: 10.1007/s40429-014-0029-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Online social networking refers to the use of internet-based technologies that facilitate connection and communication between users. These platforms may be accessed via computer or mobile device (e.g., tablet, smartphone); communication between users may include linking of profiles, posting of text, photo and video content, instant messaging and email. This review provides an overview of recent research on the relationship between online social networking and sexual risk and protective behaviors with a focus on use of social networking sites (SNS) among young people and populations at high risk for sexually transmitted infections (STIs). While findings are mixed, the widespread use of SNS for sexual communication and partner seeking presents opportunities for the delivery and evaluation of public health interventions. Results of SNS-based interventions to reduce sexual risk are synthesized in order to offer hands-on advice for clinicians and researchers interested in engaging patients and study participants via online social networking.
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Affiliation(s)
- Ian W Holloway
- Assistant Professor, Department of Social Welfare, UCLA Luskin School of Public Affairs, 3250 Charles Young Drive, Los Angeles, CA 90095,
| | - Shannon Dunlap
- Graduate Student Researcher, UCLA Luskin School of Public Affairs, 3250 Charles Young Drive,
| | - Homero E Del Pino
- Assistant Professor, Psychiatry and Human Behaviors, Charles R. Drew University of Medicine and Science, 1731 E. 120 St., Building N, Los Angeles, CA 90059,
| | - Keith Hermanstyne
- Robert Wood Johnson Foundation Clinical Scholars Program, University of California, Los Angeles, 10920 Wilshire Boulevard, Suite 710, Los Angeles, CA 90024,
| | - Craig Pulsipher
- Graduate Student Researcher, UCLA Luskin School of Public Affairs, 3250 Charles Young Drive,
| | - Raphael J Landovitz
- Associate Professor of Medicine, Division of Infectious Diseases, David Geffen School of Medicine, Los Angeles, CA 90095, 10833 Le Conte Ave, Los Angeles,
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