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Martin EG, Myderrizi A, Kim H, Schumacher P, Jeong S, Gift TL, Hutchinson AB, Delaney KP, Chesson HW. Disease Intervention Specialist-Delivered Interventions and Other Partner Services for HIV and Sexually Transmitted Infections: A Systematic Review. Am J Prev Med 2024:S0749-3797(24)00270-8. [PMID: 39142501 DOI: 10.1016/j.amepre.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 08/05/2024] [Accepted: 08/05/2024] [Indexed: 08/16/2024]
Abstract
INTRODUCTION Disease intervention specialists (DIS) are critical for delivering partner services programs that provide partner notification, counseling, referral, and other services for HIV, sexually transmitted infections (STIs), and other infections. This systematic review of partner services and other DIS-delivered interventions for HIV and STIs was conducted to summarize the effectiveness of these programs and identify evidence gaps. METHODS A systematic literature review was conducted with a narrative synthesis. Articles were located using keyword searches in MEDLINE, Web of Science, CINAHL, and ProQuest through December 2022 and analyzed in 2023-2024. Included studies addressed an intervention of partner services or other DIS-delivered services for HIV or STIs; a United States setting; primary data collection; and an external comparison group or pre-post design. RESULTS A total of 1,915 unique records were screened for eligibility, with 30 studies included. Overall, DIS-delivered interventions improved clinical outcomes among index patients and population outcomes. Many studies focused on program process measures rather than population-level epidemiologic outcomes. All but one studies were scored as having low or medium strength of evidence. CONCLUSIONS The evidence could be strengthened by establishing a streamlined set of core metrics, assessing impact using rigorous causal inference methodologies, linking program and clinical data systems, and supplementing impact evaluations with evidence on implementation strategies.
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Affiliation(s)
- Erika G Martin
- Public Health Accreditation Board, Alexandria, Virginia; Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, University at Albany, Albany, New York.
| | - Arzana Myderrizi
- Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, University at Albany, Albany, New York
| | - Heeun Kim
- Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, University at Albany, Albany, New York
| | - Patrick Schumacher
- Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, University at Albany, Albany, New York
| | - Soyun Jeong
- Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, University at Albany, Albany, New York
| | - Thomas L Gift
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Angela B Hutchinson
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kevin P Delaney
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Harrell W Chesson
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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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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Iyer S, Zionts DL, Psaros C, Tyagi A, Jarolimova J, Platt L, Kalweit AH, Ard KL, Bassett IV. Electronic Partner Notification for Sexually Transmitted Infections: A Qualitative Assessment of Patient, Clinical Staff, and State Field Epidemiologist Perspectives. AIDS Patient Care STDS 2024; 38:82-92. [PMID: 38381947 PMCID: PMC10890957 DOI: 10.1089/apc.2023.0184] [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: 02/23/2024] Open
Abstract
In Massachusetts (MA), partner notification is routinely offered for new HIV and infectious syphilis cases, but there are no formal partner notification services for gonorrhea and chlamydia. Electronic partner notification (ePN), which allows patients to anonymously notify their partners of sexually transmitted infection exposure, could fill this gap. We evaluated the acceptability of and ideal characteristics for a statewide ePN service in MA. We performed semistructured interviews with patients at a Boston area sexual health clinic and conducted focus groups with clinicians and Massachusetts Department of Public Health Field Epidemiologists (FEs). We developed a codebook and thematically analyzed interview and focus group data; 25% of interviews were double coded. We identified six main themes from our data: (1) partner notification is a relational process and (2) partner notification is situation dependent. There are three pairs of challenges and core values for an effective ePN system: (3) stigmatization versus inclusivity, (4) trust versus mistrust, and (5) privacy versus helpful information sharing. Therefore, (6) a statewide ePN platform must be customizable at each possible step. Although ePN was acceptable across all three groups, the likelihood of individual use was grounded in a patient's sociocultural context, interpersonal relationships, trust in the platform and health authorities, desire to avoid stigmatization, and privacy needs. These factors are best accommodated by a platform that adapts to users' preferences and needs. ePN presents an opportunity to link partners at risk for gonorrhea or chlamydia to clinical care that is complementary to the more labor-intensive FE role.
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Affiliation(s)
- Surabhi Iyer
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Dani L. Zionts
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Christina Psaros
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Anisha Tyagi
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jana Jarolimova
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Department of Medicine, Boston, Massachusetts, USA
| | - Laura Platt
- Harvard Medical School, Department of Medicine, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Massachusetts Department of Public Health, Boston, Massachusetts, USA
| | - Andrew H. Kalweit
- Massachusetts Department of Public Health, Boston, Massachusetts, USA
| | - Kevin L. Ard
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Department of Medicine, Boston, Massachusetts, USA
| | - Ingrid V. Bassett
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Department of Medicine, Boston, Massachusetts, USA
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Ibragimov U, Livingston MD, Young AM, Feinberg J, Korthuis PT, Akhtar WZ, Jenkins WD, Crane HM, Westergaard RP, Nance R, Miller WC, Bresett J, Khoury D, Hurt CB, Go VF, Nolte K, Cooper HLF. Correlates of Recent HIV Testing Among People Who Inject Drugs in Rural Areas: A Multi-site Cross-Sectional Study, 2018-2020. AIDS Behav 2024; 28:59-71. [PMID: 37515742 PMCID: PMC10823036 DOI: 10.1007/s10461-023-04140-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 07/31/2023]
Abstract
The Rural Opioid Initiative surveyed 2693 people who inject drugs (PWID) in eight rural U.S. areas in 2018-2020 about self-reported HIV testing in the past 6 months. Correlates of interest included receipt of any drug-related services, incarceration history, and structural barriers to care (e.g., lack of insurance, proximity to syringe service programs [SSP]). Overall, 20% of participants reported receiving an HIV test within the past 6 months. Multivariable generalized estimating equations showed that attending substance use disorder (SUD) treatment (OR 2.11, 95%CI [1.58, 2.82]), having health insurance (OR 1.42, 95%CI [1.01, 2.00]) and recent incarceration (OR 1.49, 95%CI [1.08, 2.04]) were positively associated with HIV testing, while experiencing a resource barrier to healthcare (inability to pay, lack of transportation, inconvenient hours, or lack of child care) had inverse (OR 0.73, 95%CI [0.56, 0.94]) association with HIV testing. We found that the prevalence of HIV testing among rural PWID is low, indicating an unmet need for testing. While SUD treatment or incarceration may increase chances for HIV testing for rural PWID, other avenues for expanding HIV testing, such as SSP, need to be explored.
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Affiliation(s)
- Umedjon Ibragimov
- BSHES Department of Emory University School of Public Health, Atlanta, GA, USA.
- Emory University, 1518 Clifton RD, GCR 558, Atlanta, GA, USA.
| | - Melvin D Livingston
- BSHES Department of Emory University School of Public Health, Atlanta, GA, USA
| | - April M Young
- Department of Epidemiology and Environmental Health, College of Public Health, University of Kentucky, Lexington, KY, USA
- Center on Drug and Alcohol Research, University of Kentucky, Lexington, KY, USA
| | - Judith Feinberg
- Departments of Behavioral Medicine & Psychiatry and Medicine/Infectious Diseases, School of Medicine, West Virginia University, Morgantown, WV, USA
| | - P Todd Korthuis
- Section of Addiction Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Wajiha Z Akhtar
- Population Health Institute, University of Wisconsin-Madison, Madison, WI, USA
| | - Wiley D Jenkins
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Carbondale, IL, USA
| | - Heidi M Crane
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Ryan P Westergaard
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Robin Nance
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA
| | - William C Miller
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - John Bresett
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Carbondale, IL, USA
- Department of Public Health, Southern Illinois University at Carbondale, Carbondale, IL, USA
| | | | - Christopher B Hurt
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Vivian F Go
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kerry Nolte
- Department of Nursing, College of Health and Human Services, University of New Hampshire, Durham, NH, USA
| | - Hannah L F Cooper
- BSHES Department of Emory University School of Public Health, Atlanta, GA, USA
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Prins H, Coyer L, De Angelis S, Bluemel B, Cauchi D, Baka A. Evaluation of mpox contact tracing activities and data collection in EU/EEA countries during the 2022 multicountry outbreak in nonendemic countries. J Med Virol 2024; 96:e29352. [PMID: 38180437 DOI: 10.1002/jmv.29352] [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: 10/25/2023] [Revised: 12/04/2023] [Accepted: 12/17/2023] [Indexed: 01/06/2024]
Abstract
To control human-to-human mpox transmission during the 2022 outbreak, European Union (EU)/European Economic Area (EEA) countries conducted case investigation and contact tracing (CT). We aimed to provide an overview of CT activities, describe CT data collection practices, and identify related facilitators, barriers, and potential opportunities for improvement. Between April 03, 2023 and May 12, 2023, a survey was distributed to CT stakeholders in 30 EU/EEA countries, asking about mpox CT activities and data collection and requesting to rank enablers, barriers, and improvements for CT on a five-point Likert scale. The 139 respondents from 27 countries indicated having performed case investigations (96%, n = 133), backward CT (88%, n = 122), forward CT (87%, n = 121), and follow-up on contacts' outcomes (77%, n = 107). Sixty percent (n = 80/134) used standardized data collection forms and 73% (n = 91/124) used databases. The highest-rated enablers were clear guidelines (mean = 3.9), quick access to laboratory results (3.6), and sufficient expertise (3.6). Highly rated barriers were inability to contact contacts (3.0) or cases (2.5) and lack of staff (2.4). The most needed improvements were availability of staff (3.5), expertise on affected populations (3.4) and data reporting tools and systems (3.3). To improve CT of mpox and diseases with similar transmission patterns, EU/EEA countries should increase workforce capacity in public and sexual health, offer training on CT operations and communication with affected communities, and use common CT data collection tools and systems.
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Affiliation(s)
- Henrieke Prins
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- Department of Infectious Disease Epidemiology, Robert Koch Institute (RKI), Berlin, Germany
| | - Liza Coyer
- ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
- State Institute for Health II, Task Force for Infectious Diseases (GI), Bavarian Health and Food Safety Authority (LGL), Munich, Germany
| | - Stefania De Angelis
- Emergency Preparedness and Response Section, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Benjamin Bluemel
- STI, Blood-Borne Viruses and TB Section, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Daniel Cauchi
- Emergency Preparedness and Response Section, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Agoritsa Baka
- Emergency Preparedness and Response Section, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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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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Mugumba E, Kagwa M, Muhumuza D, Namukwaya R, Amunyongire R, Maling S. Prevalence and correlates of intimate partner violence following partner notification among index HIV clients attending primary healthcare facilities in Uganda. AIDS Care 2023; 35:859-866. [PMID: 36120933 PMCID: PMC10020122 DOI: 10.1080/09540121.2022.2122390] [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: 06/30/2021] [Accepted: 09/01/2022] [Indexed: 10/14/2022]
Abstract
Assisted partner notification (APN) program was adopted by Uganda to increase individuals testing for HIV through their partners who test HIV positive. Thus, early enrollment in treatment and ensuring prevention services for the affected couple. However, APN is associated with high levels of Intimate partner violence (IPV). We aimed at determining the prevalence of IPV following APN in a cross-sectional study of newly diagnosed HIV clients in southwestern Uganda. We used the modified version of the Conflict Tactics Scale to assess IPV. We also collected information on sociodemographics of the index clients and their sexual partners, and outcome of linkage to care of partner. Logistic regression was used to determine the factors associated with IPV. We enrolled 327 index clients, mean age was 39.1, 63.6% were female and 35.5 experienced IPV following APN. The likelihood of experiencing IPV was more than twice if a health worker/provider disclosed the status to the partner. However, if the partners turned out to be HIV positive, it was protective against experiencing IPV, adjusted odds ratio 0.39, 95% confidence interval 0.23-0.69, p = 0.001. We conclude that IPV is common following partner notification in rural Uganda and should be screened and addressed.
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Affiliation(s)
- Eria Mugumba
- Department of Medical Laboratory Science, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mark Kagwa
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Dickson Muhumuza
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Racheal Namukwaya
- Department of Physiotherapy, Mbarara University of Science and Technology, Mbarara Uganda
| | - Ronaldo Amunyongire
- Department of Nursing, Mbarara University of Science and Technology, Mbarara Uganda
| | - Samuel Maling
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
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Hossain AD, Jarolimova J, Elnaiem A, Huang CX, Richterman A, Ivers LC. Effectiveness of contact tracing in the control of infectious diseases: a systematic review. Lancet Public Health 2022; 7:e259-e273. [PMID: 35180434 PMCID: PMC8847088 DOI: 10.1016/s2468-2667(22)00001-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/23/2021] [Accepted: 01/04/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Contact tracing is used for multiple infectious diseases, most recently for COVID-19, but data regarding its effectiveness in disease control are scarce. To address this knowledge gap and inform public health decision making for COVID-19, we systematically reviewed the existing literature to determine the effectiveness of contact tracing in the control of communicable illness. METHODS We searched PubMed, Embase, and the Cochrane Library from database inception up to Nov 22, 2021, for published studies evaluating associations between provider-initiated contact tracing for transmissible infectious diseases and one of three outcomes of interest: case detection rates among contacts or at the community level, overall forward transmission, or overall disease incidence. Clinical trials and observational studies were eligible, with no language or date restrictions. Reference lists of reviews were searched for additional studies. We excluded studies without a control group, using only mathematical modelling, not reporting a primary outcome of interest, or solely examining patient-initiated contact tracing. One reviewer applied eligibility criteria to each screened abstract and full-text article, and two reviewers independently extracted summary effect estimates and additional data from eligible studies. Only data reported in published manuscripts or supplemental material was extracted. Risk of bias for each included study was assessed with the Cochrane Risk of Bias 2 tool (randomised studies) or the Newcastle-Ottawa Scale (non-randomised studies). FINDINGS We identified 9050 unique citations, of which 47 studies met the inclusion criteria: six were focused on COVID-19, 20 on tuberculosis, eight on HIV, 12 on curable sexually transmitted infections (STIs), and one on measles. More than 2 million index patients were included across a variety of settings (both urban and rural areas and low-resource and high-resource settings). Of the 47 studies, 29 (61·7%) used observational designs, including all studies on COVID-19, and 18 (38·3%) were randomised controlled trials. 40 studies compared provider-initiated contact tracing with other interventions or evaluated expansions of provider-initiated contact tracing, and seven compared programmatic adaptations within provider-initiated contact tracing. 29 (72·5%) of the 40 studies evaluating the effect of provider-initiated contact tracing, including four (66·7%) of six COVID-19 studies, found contact tracing interventions were associated with improvements in at least one outcome of interest. 23 (48·9%) studies had low risk of bias, 22 (46·8%) studies had some risk of bias, and two (4·3%) studies (both randomised controlled trials on curable STIs) had high risk of bias. INTERPRETATION Provider-initiated contact tracing can be an effective public health tool. However, the ability of authorities to make informed choices about its deployment might be limited by heterogenous approaches to contact tracing in studies, a scarcity of quantitative evidence on its effectiveness, and absence of specificity of tracing parameters most important for disease control. FUNDING The Sullivan Family Foundation, Massachusetts General Hospital Executive Committee on Research, and US National Institutes of Health.
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Affiliation(s)
| | - Jana Jarolimova
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
| | - Ahmed Elnaiem
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA
| | - Cher X Huang
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Aaron Richterman
- Division of Infectious Diseases, Hospital of the University of Pennsylvania, Perelman Center for Advanced Medicine, Philadelphia, PA, USA
| | - Louise C Ivers
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA; Center for Global Health, Massachusetts General Hospital, Boston, MA, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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Rahmalia A, Wisaksana R, Laga M, van Crevel R, Peeters Grietens K. Facilitators and barriers to status disclosure and partner testing of women living with HIV in Indonesia: a mixed methods study. Sex Reprod Health Matters 2022; 30:2028971. [PMID: 35167424 PMCID: PMC8856062 DOI: 10.1080/26410397.2022.2028971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This mixed-methods study investigated HIV status disclosure and partner testing of women living with HIV (WLWH) in a concentrated epidemic setting in Bandung, Indonesia. The qualitative exploratory strand used theoretical sampling to carry out semi-structured interviews with 47 HIV-infected women with varying anti-retroviral therapy status. The quantitative strand included 122 female patients receiving HIV care at a referral clinic. HIV diagnosis made women reassess their sexual partnerships. Some lost their partner due to death or divorce. Women with a longstanding HIV infection often formed new partnerships. They disclosed their status to new partners without assistance from health providers; the type and stability of the partnership influenced decision to disclose. Fear of rejection prevented initial disclosure prior to bringing the new partners to a health provider. Disclosure did not always result in partner testing because of low risk-awareness or denial of the partner. Despite a similar proportion of status disclosure to partner (92.8%), only 53.7% of new partners of WLWH were tested in contrast to 89.7% of partners tested among WLWH who stayed with the same partner. In antenatal care, where same-day testing was often done for pregnant couples, more partners were tested. Overall, consistent condom use was low and HIV status forced WLWH who continued sex work to work at settings where condom use was not enforced. WLWH face barriers to HIV status disclosure and partner testing and would benefit from partnership counselling. Guidelines for partner notification and testing should include specific strategies for women with longstanding HIV infection.
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Affiliation(s)
- Annisa Rahmalia
- Researcher, Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia; Infectious Diseases and Global Health, Radboud University Medical Centre, Nijmegen, The Netherlands. Correspondence:
| | - Rudi Wisaksana
- Head of HIV Research Group, Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia; Department of Internal Medicine, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Marie Laga
- Professor, Sexual Health and HIV, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Reinout van Crevel
- Professor, Radboud Centre for Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Koen Peeters Grietens
- Professor, Head of Socio-Ecological Health Research (SEHR) Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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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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Ostermann J, Flaherty BP, Brown DS, Njau B, Hobbie AM, Mtuy TB, Masnick M, Mühlbacher AC, Thielman NM. What factors influence HIV testing? Modeling preference heterogeneity using latent classes and class-independent random effects. JOURNAL OF CHOICE MODELLING 2021; 40:100305. [PMID: 35422879 PMCID: PMC9007550 DOI: 10.1016/j.jocm.2021.100305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Efforts to eliminate the HIV epidemic will require increased HIV testing rates among high-risk populations. To inform the design of HIV testing interventions, a discrete choice experiment (DCE) with six policy-relevant attributes of HIV testing options elicited the testing preferences of 300 female barworkers and 440 male Kilimanjaro mountain porters in northern Tanzania. Surveys were administered between September 2017 and July 2018. Participants were asked to complete 12 choice tasks, each involving first- and second-best choices from 3 testing options. DCE responses were analyzed using a random effects latent class logit (RELCL) model, in which the latent classes summarize common participant preference profiles, and the random effects capture additional individual-level preference heterogeneity with respect to three attribute domains: (a) privacy and confidentiality (testing venue, pre-test counseling, partner notification); (b) invasiveness and perceived accuracy (method for obtaining the sample for the HIV test); and (c) accessibility and value (testing availability, additional services provided). The Bayesian Information Criterion indicated the best model fit for a model with 8 preference classes, with class sizes ranging from 6% to 19% of participants. Substantial preference heterogeneity was observed, both between and within latent classes, with 12 of 16 attribute levels having positive and negative coefficients across classes, and all three random effects contributing significantly to participants' choices. The findings may help identify combinations of testing options that match the distribution of HIV testing preferences among high-risk populations; the methods may be used to systematically design heterogeneity-focused interventions using stated preference methods.
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Affiliation(s)
- Jan Ostermann
- Department of Health Services Policy & Management, University of South Carolina, 915 Greene Street, Columbia, SC, USA
- South Carolina Smart State Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA
| | - Brian P. Flaherty
- Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Derek S. Brown
- Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA
- Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Bernard Njau
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Amy M. Hobbie
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA
| | - Tara B. Mtuy
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Axel C. Mühlbacher
- Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA
- Institut Gesundheitsökonomie und Medizinmanagement, Hochschule Neubrandenburg, Neubrandenburg, Germany
- Department of Population Health Sciences, Duke University, Durham, NC, USA
| | - Nathan M. Thielman
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Center for Health Policy & Inequalities Research, Duke University, Durham, NC, USA
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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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14
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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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15
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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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Rosenbaum JE, Jennings J, Ellen JM, Borkovic LM, Scott JA, Wylie C, Rompalo A. Giving syphilis and gonorrhea to friends: using in-person friendship networks to find additional cases of gonorrhea and syphilis. BMC Public Health 2020; 20:1526. [PMID: 33081743 PMCID: PMC7575333 DOI: 10.1186/s12889-020-09589-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 09/22/2020] [Indexed: 11/25/2022] Open
Abstract
Background Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking “friendship,” so this study asked people diagnosed with syphilis and gonorrhea to identify their friends. Methods Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n = 331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis. Results Eliciting respondents’ in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio = 2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR = 1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR = 1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR = 0.98, 95% CI (0.62, 1.53)). Conclusions Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.
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Affiliation(s)
- Janet E Rosenbaum
- Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY, USA.
| | - Jacky Jennings
- Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Jonathan M Ellen
- Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Laurel M Borkovic
- Department of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Jo-Ann Scott
- Department of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Charleen Wylie
- Department of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Anne Rompalo
- Department of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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Rosenbaum JE, Jennings J, Ellen J, Borkovic L, Scott JA, Wylie C, Rompalo A. Giving syphilis and gonorrhea to friends: Using in-person friendship networks to find additional cases of gonorrhea and syphilis. RESEARCH SQUARE 2020:rs.3.rs-22332. [PMID: 32793894 PMCID: PMC7402068 DOI: 10.21203/rs.3.rs-22332/v2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking "friendship," so this study asked people diagnosed with syphilis and gonorrhea to identify their friends. Methods Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n=331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis. Results Eliciting respondents' in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio=2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR=1.31,95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR=1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR=0.98, 95% CI (0.62, 1.53)). Conclusions Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.
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Wang C, Zhao P, Tang W, Smith MK, Ong JJ, Wong NS, Fu H, Tucker JD, Zheng H, Luo Z, Yang B. Partner Notification Among Persons With Early Syphilis in Shenzhen, China, 2011-2017: Implications for Practice and Policy. Sex Transm Dis 2020; 47:232-237. [PMID: 32011419 PMCID: PMC8190519 DOI: 10.1097/olq.0000000000001135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Partner notification (PN) is an essential component of syphilis control and is recommended by Chinese Sexually Transmitted Disease guidelines. However, in China, studies examining local practice are limited. This study evaluated PN outcomes among persons with early syphilis infection in an urban district in China. METHODS From 2011 to 2017, persons diagnosed with early syphilis were asked to participate in an evaluation of supportive patient referral partner services for all recent sex partners, and the contact and case finding indices were determined in Nanshan District, Shenzhen, China. RESULTS During the study period, 642 index patients with early syphilis reported 1749 sex partners. Of those partners, 678 were potentially contactable and 525 (30%) were contacted. The overall contact index was 0.82. Among the 1749 partners reported, 1108 (63%) were described as casual partners, and only 37 (3%) were contacted (contact index 0.13) compared with 641 partners who were either spouses and regular partners (contact index, 1.37). Among those 525 partners contacted, 418 (80%) were tested, and 205 (39%) were diagnosed with and treated for syphilis. Among those, 9 (4%) were primary, 26 (13%) were secondary, 16 (8%) were early latent, and 154 (49%) were other syphilis infections. The overall case finding index was 0.29. CONCLUSIONS There is a need to improve PN practices in China, which include developing operational guidelines of PN and to develop and evaluate novel PN ways like using Internet-based strategy.
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Affiliation(s)
- Cheng Wang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Institute for Global Health and Sexually Transmitted Disease, Southern Medical University, Guangzhou, China
| | - Peizhen Zhao
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Institute for Global Health and Sexually Transmitted Disease, Southern Medical University, Guangzhou, China
| | - Weiming Tang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Institute for Global Health and Sexually Transmitted Disease, Southern Medical University, Guangzhou, China
- University of North Carolina Project-China, Guangzhou, China
| | - M. Kumi Smith
- Division of Epidemiology and Community Health, University of Minnesota Twin Cities, Minneapolis, USA
| | - Jason J. Ong
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Central Clinical School, Monash University, Victoria, Melbourne, Australia
| | - Ngai Sze Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Hongyun Fu
- Division of Community Health and Research, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Joseph D. Tucker
- University of North Carolina Project-China, Guangzhou, China
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Heping Zheng
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Institute for Global Health and Sexually Transmitted Disease, Southern Medical University, Guangzhou, China
| | - Zhenzhou Luo
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Bin Yang
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Institute for Global Health and Sexually Transmitted Disease, Southern Medical University, Guangzhou, China
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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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Contesse MG, Fredericksen RJ, Wohlfeiler D, Hecht J, Kachur R, Strona FV, Katz DA. Attitudes About the Use of Geosocial Networking Applications for HIV/STD Partner Notification: A Qualitative Study. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2019; 31:273-285. [PMID: 31145001 PMCID: PMC6821391 DOI: 10.1521/aeap.2019.31.3.273] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Meeting sex partners through geosocial networking (GSN) apps is common among men who have sex with men (MSM). MSM may choose not to exchange contact information with partners met through GSN apps, limiting their own and health departments' ability to notify partners of HIV/STD exposure through standard notification methods. Using online focus groups (four groups; N = 28), we explored the perspectives of U.S. MSM regarding offer of partner notification features through GSN apps. Most participants were comfortable with HIV/STD partner notification delivered via GSN apps, either by partner services staff using a health department profile or through an in-app anonymous messaging system. While most participants expressed a responsibility to notify partners on their own, app-based partner notification methods may be preferred for casual or hard-to-reach partners. However, participants indicated that health departments will need to build trust with MSM app users to ensure acceptable and effective app-based delivery of partner notification.
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Affiliation(s)
| | | | - Dan Wohlfeiler
- Building Healthy Online Communities, San Francisco, California
| | - Jen Hecht
- Building Healthy Online Communities, San Francisco, California
- San Francisco AIDS Foundation, San Francisco, California
| | - Rachel Kachur
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - F V Strona
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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McGoy SL, Pettit AC, Morrison M, Alexander LR, Johnson P, Williams B, Banister D, Young MK, Wester C, Rebeiro PF. Use of Social Network Strategy Among Young Black Men Who Have Sex With Men for HIV Testing, Linkage to Care, and Reengagement in Care, Tennessee, 2013-2016. Public Health Rep 2019; 133:43S-51S. [PMID: 30457951 PMCID: PMC6262520 DOI: 10.1177/0033354918801893] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Tennessee was 1 of 8 states that received funding from the Care and Prevention in the United States Demonstration Project, which aimed to reduce HIV-related morbidity and mortality among racial/ethnic and sexual minority populations. The objective of this study was to describe implementation of a social network strategy (SNS) program, which leverages personal connections in social networks, to reach people with undiagnosed HIV infection for HIV testing. We targeted young black men who have sex with men (MSM) at 3 agencies in Memphis and Nashville, Tennessee, during 2013-2016. METHODS Specialists at the 3 agencies identified MSM with and without diagnosed HIV infection (ie, recruiters) who could recruit members from their social networks for HIV testing (ie, network associates). Both recruiters and network associates received OraQuick rapid and confirmatory HIV tests. We used χ2 and Fisher exact tests to assess differences in demographic characteristics, HIV testing, and care engagement status by agency. RESULTS Of 1752 people who were tested for HIV in the SNS program, 158 (9.0%) tested positive; of these, 80 (50.6%) were newly diagnosed with HIV. Forty-seven of the 78 (60.3%) people who were previously diagnosed with HIV were not in care in the previous 12 months; of these, 27 (57.4%) were reengaged in medical care. Of 80 people newly diagnosed with HIV, 44 (55.0%) were linked to care. CONCLUSIONS The SNS program ascertained HIV status among a high-risk population in a heavily burdened region. Further program evaluation is needed to understand how to improve linkage to care among people with newly diagnosed HIV.
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Affiliation(s)
- Shanell L McGoy
- 1 HIV/STD/Viral Hepatitis Section, Tennessee Department of Health, Nashville, TN, USA
| | - April C Pettit
- 2 Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Melissa Morrison
- 1 HIV/STD/Viral Hepatitis Section, Tennessee Department of Health, Nashville, TN, USA
| | - Leah R Alexander
- 3 School of Graduate Studies and Research, Meharry Medical College, Nashville, TN, USA
| | - Phadre Johnson
- 1 HIV/STD/Viral Hepatitis Section, Tennessee Department of Health, Nashville, TN, USA
| | | | | | - Mary K Young
- 1 HIV/STD/Viral Hepatitis Section, Tennessee Department of Health, Nashville, TN, USA
| | - Carolyn Wester
- 1 HIV/STD/Viral Hepatitis Section, Tennessee Department of Health, Nashville, TN, USA
| | - Peter F Rebeiro
- 2 Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
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Differences in Partner Services Outcomes for Men Who Have Sex With Men Diagnosed With Primary and Secondary Syphilis by HIV Serostatus. Sex Transm Dis 2019; 45:152-157. [PMID: 29420442 DOI: 10.1097/olq.0000000000000710] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Differences in partner services outcomes in men who have sex with men (MSM) by HIV serostatus have not been explored as a potential driver of differential early syphilis (ES) burden in this population. METHODS We compared partner services outcomes (number of partners named, notified, tested, diagnosed, and treated) between HIV-positive and HIV-negative MSM initiated for ES partner services in Texas from 2013 to 2016 using logistic regression and Wilcoxon-Mann-Whitney tests. Logistic regression was used to assess the relationship between HIV serostatus and having a no-partner-initiated (NPI) partner services interview controlling for demographic characteristics, prior partner services interactions, and geosocial phone application use. RESULTS A total of 4161 HIV-positive MSM and 5254 HIV-negative MSM were initiated for ES partner services. HIV-positive MSM named fewer partners than did HIV-negative MSM (mean, 1.2 vs. 1.9; P < 0.001) and had lower indices of partners notified, tested, diagnosed, and treated. HIV seropositivity was significantly associated with NPI. However, this association was not significant when limited to MSM with previous partner services interviews (adjusted risk ratio [aRR] 1.06; P = 0.38); in this subset of MSM, using geosocial phone application was negatively associated with having an NPI interview (aRR, 0.90), and having 1 (aRR, 1.33) or more than 1 previous NPI interview (aRR, 1.57) was associated with an NPI interview during the study period. CONCLUSIONS Suboptimal outcomes for syphilis partner service may result in missed opportunities for testing and treatment of sexual contacts, which could allow for propagation of syphilis. Implementation of innovative protocols is needed to ensure that partner services continue to be an effective and acceptable method of syphilis disease intervention in MSM.
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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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Mase WA, Hansen AR, Smallwood SW, Shah G, Peden AH, Mulherin T, Bender K. Disease Intervention Specialist Education for the Future: An Analysis of Public Health Curricula. Public Health Rep 2018; 133:738-748. [PMID: 30304646 DOI: 10.1177/0033354918792014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The objectives of this study were to (1) determine the degree of alignment between an existing public health curricula and disease intervention specialist (DIS) workforce training needs, (2) assess the appropriateness of public health education for DISs, and (3) identify existing curriculum gaps to inform future DIS training efforts. METHODS Using the iterative comparison analysis process of crosswalking, we compared DIS job tasks and knowledge competencies across a standard Council on Education for Public Health (CEPH)-accredited bachelor of science in public health (BSPH) and master of public health (MPH) program core curricula offered by the Georgia Southern University Jiann-Ping Hsu College of Public Health. Four researchers independently coded each DIS task and competency as addressed or not in the curriculum and then discussed all matches and non-matches between coders. Researchers consulted course instructors when necessary, and discussion between researchers continued until agreement was reached on coding. RESULTS The BSPH curriculum aligned with 75% of the DIS job tasks and 42% of the DIS knowledge competencies. The MPH core curriculum aligned with 55% of the job tasks and 40% of the DIS knowledge competencies. Seven job tasks and 9 knowledge competencies were considered unique to a DIS and would require on-the-job training. CONCLUSIONS Findings suggest that an accredited public health academic program, grounded in CEPH competencies, could address multiple components of DIS educational preparation. Similar analyses should be conducted at other CEPH-accredited schools and programs of public health to account for variations in curriculum.
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Affiliation(s)
- William A Mase
- 1 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Andrew R Hansen
- 1 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Stacy W Smallwood
- 1 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Gulzar Shah
- 1 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Angela H Peden
- 1 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Ted Mulherin
- 1 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Kaye Bender
- 2 Public Health Accreditation Board, Alexandria, VA, USA
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Campbell CK, Lippman SA, Moss N, Lightfoot M. Strategies to Increase HIV Testing Among MSM: A Synthesis of the Literature. AIDS Behav 2018; 22:2387-2412. [PMID: 29550941 DOI: 10.1007/s10461-018-2083-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
More than 30 years into the HIV epidemic, men who have sex with men (MSM) continue to be disproportionately impacted. It is estimated that worldwide nearly half of MSM infected with HIV are unaware of their status, making HIV testing along with early linkage to care crucial to HIV prevention efforts. However, there remain significant barriers to HIV testing among MSM, due largely to complex issues of layered stigma that deter MSM from accessing traditional, clinic-based testing. We conducted a review and synthesis of the literature on strategies to increase uptake of HIV testing among MSM. We found that social network-based strategies, community-based testing, HIV self-testing, and modifications to the traditional clinic-based model can effectively reach a subset of MSM, but success was often context-specific and there are significant gaps in evidence. We provide recommendations for increasing HIV testing rates and status awareness among MSM.
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Affiliation(s)
- Chadwick K Campbell
- Center for AIDS Prevention Studies, University of California San Francisco, UCSF Mail Code 0886, 550 16th Street, 3rd Floor, San Francisco, CA, 94158-2549, USA.
| | - Sheri A Lippman
- Center for AIDS Prevention Studies, University of California San Francisco, UCSF Mail Code 0886, 550 16th Street, 3rd Floor, San Francisco, CA, 94158-2549, USA
| | - Nicholas Moss
- Division of Communicable Disease Control & Prevention, Alameda County Public Health Department, Oakland, CA, USA
| | - Marguerita Lightfoot
- Center for AIDS Prevention Studies, University of California San Francisco, UCSF Mail Code 0886, 550 16th Street, 3rd Floor, San Francisco, CA, 94158-2549, USA
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Semple SJ, Pines HA, Strathdee SA, Vera AH, Rangel G, Magis-Rodriguez C, Patterson TL. Uptake of a Partner Notification Model for HIV Among Men Who Have Sex With Men and Transgender Women in Tijuana, Mexico. AIDS Behav 2018; 22:2042-2055. [PMID: 29159592 DOI: 10.1007/s10461-017-1984-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Undiagnosed HIV infection is common among men who have sex with men (MSM) and transgender women (TW) in Latin America. We examined uptake of a partner notification (PN) model among MSM and TW in Tijuana, Mexico. Forty-six HIV-positive MSM/TW enrolled as index patients, and reported 132 MSM/TW sexual partners for PN. Of notified partners (90/132), 39% declined eligibility screening or participation, 39% tested for HIV, and of those 28% were newly-diagnosed HIV-positive. Partners who were seen by the index patient more than once in the past 4 months and those who primarily had sex with the index patient in one of their homes were more likely to be notified via PN (76% vs. 50%; p = 0.01 and 86% vs. 64%, p = 0.02, respectively). Lower than expected PN uptake was associated with problems identifying index patients, obtaining reliable partner contact information, and engaging notified partners.
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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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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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van den Berg JJ, Javanbakht M, Gorbach PM, Rudy BJ, Westfall AO, Wilson CM, Lally MA. Partner Notification for Youth Living With HIV in 14 Cities in the United States. J Acquir Immune Defic Syndr 2018; 77:46-52. [PMID: 29023252 PMCID: PMC5730071 DOI: 10.1097/qai.0000000000001565] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Identifying factors associated with partner notification among youth living with HIV is critical for effective HIV prevention and treatment strategies. METHODS A total of 924 male and female behaviorally infected youth aged 13-24 across 14 U.S. cities completed an audio computer-assisted self-interview including questions about demographics and experiences with patient- and provider-referral partner notification. RESULTS The majority of participants self-identified as male (82.5%), Black/non-Hispanic (70.1%), and Hispanic/Latino (18.2%). Most males (93.4%) reported engaging in male-to-male sexual contact. Over three-quarters (77.6%) reported that all or some of their partners were contacted, while 22.4% indicated that none were contacted regarding potential HIV exposure. Most (52.4%) reported that only one person talked to them about notifying partners including the HIV tester (36.5%) followed by their health care provider/doctor (27.6%). Less than a fifth (18.3%) were themselves notified of their own exposure to HIV. Using multivariable logistic regression, 3 factors were associated with successful partner notification: (1) when more than one person talked to participants about partner notification (AOR = 1.87, 1.33-2.62); (2) if they themselves had been notified of their own HIV exposure (AOR = 1.83, 1.13-2.95); and (3) if their education included some college or technical school versus less than high school (AOR = 1.72, 1.04-2.85). CONCLUSIONS Partner notification among youth living with HIV is unsuccessful at least 22.4% of the time, although minimal criteria for partner services are being met almost universally. Partner notification might benefit from enhanced guidelines that call for both HIV testers and HIV care providers to discuss this important strategy with HIV-positive youth.
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Affiliation(s)
- Jacob J. van den Berg
- Department of Behavioral and Social Sciences, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health & Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Pamina M. Gorbach
- Department of Epidemiology, Fielding School of Public Health & Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Bret J. Rudy
- Department of Pediatrics, New York University School of Medicine, New York, NY, USA
| | - Andrew O. Westfall
- Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Craig M. Wilson
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Michelle A. Lally
- Lifespan Hospital Systems and Alpert Medical School of Brown University, Providence, RI, USA
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Rane V, Tomnay J, Fairley C, Read T, Bradshaw C, Carter T, Chen M. Opt-Out Referral of Men Who Have Sex With Men Newly Diagnosed With HIV to Partner Notification Officers: Results and Yield of Sexual Partners Being Contacted. Sex Transm Dis 2017; 43:341-5. [PMID: 27200517 DOI: 10.1097/olq.0000000000000449] [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 Given its potential for reducing the proportion of people with human immunodeficiency virus (HIV) unaware of their diagnosis, partner notification for HIV has been underutilized. This study aimed to determine if the implementation of opt-out referral of men who have sex with men, newly diagnosed with HIV, to partner notification officers (PNO) increased the proportion of sexual partners notified. METHODS In April 2013, all individuals newly diagnosed with HIV at the Melbourne Sexual Health Centre, Australia were referred to Department of Health PNO to facilitate partner notification. The number of sexual partners reported by men and the proportion contacted in the 12 months before (opt-in period) and after (opt-out period) this policy change were determined through review of the clinical PNO records. RESULTS Overall, 111 men were diagnosed with HIV during the study period. Compared with men in the opt-in period (n = 51), men in the opt-out period (n = 60) were significantly more likely to accept assistance from the PNO (12 [24%] vs 51 [85%]; P < 0.001). A significantly higher proportion of reported partners were notified with opt-out referral (85/185, 45.9%; 95% confidence interval, 38.6-53.4) compared with opt-in referral (31/252, 12.3%; 95% confidence interval, 8.5-17.0) (P < 0.001). DISCUSSION Opt-out referral to PNO was associated with a substantially higher proportion of partners at risk of HIV being contacted.
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Affiliation(s)
- Vinita Rane
- From the *Melbourne Sexual Health Centre, Alfred Hospital; †Centre for Excellence in Rural Sexual Health, Melbourne Medical School, University of Melbourne, Melbourne; ‡Central Clinical School, Monash University, Clayton; and §Department of Health, Melbourne, Victoria, Australia
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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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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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Jain J, Santos GM, Scheer S, Gibson S, Crouch PC, Kohn R, Chang W, Carrico AW. Rates and Correlates of Syphilis Reinfection in Men Who Have Sex with Men. LGBT Health 2016; 4:232-236. [PMID: 27991843 DOI: 10.1089/lgbt.2016.0095] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE This study examined rates and correlates of syphilis reinfection in men who have sex with men (MSM). METHODS From 2012 to 2015, time to reinfection was assessed in 323 MSM receiving initial treatment for syphilis in San Francisco. RESULTS One in five men was reinfected (71/323; 22%). The rate of syphilis reinfection was greater among HIV-infected men (adjusted hazard ratio [aHR] = 1.96; 95% confidence interval [95% CI] = 1.16-3.31) and ketamine users (aHR = 2.76; 95% CI = 1.09-7.00). CONCLUSION Expanded prevention efforts are needed with HIV-infected and substance-using MSM to reduce the burden of reinfection in this population.
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Affiliation(s)
- Jennifer Jain
- 1 Department of Community Health Systems, University of California , San Francisco, San Francisco, California
| | - Glenn-Milo Santos
- 1 Department of Community Health Systems, University of California , San Francisco, San Francisco, California.,2 San Francisco Department of Public Health , San Francisco, California
| | - Susan Scheer
- 2 San Francisco Department of Public Health , San Francisco, California
| | - Steve Gibson
- 3 San Francisco AIDS Foundation , San Francisco, California
| | | | - Robert Kohn
- 2 San Francisco Department of Public Health , San Francisco, California
| | - Walter Chang
- 1 Department of Community Health Systems, University of California , San Francisco, San Francisco, California
| | - Adam W Carrico
- 4 Department of Public Health Sciences, University of Miami School of Medicine , Miami, Florida
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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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Abstract
BACKGROUND Partner services have been a mainstay of public health sexually transmitted disease (STD) prevention programs for decades. The principal goals are to interrupt transmission and reduce STD morbidity and sequelae. In this article, we review current literature with the goal of informing STD prevention programs. METHODS We searched the literature for systematic reviews. We found 9 reviews published between 2005 and 2014 (covering 108 studies). The reviews varied by study inclusion criteria (e.g., study methods, geographic location, and infections). We abstracted major conclusions and recommendations from the reviews. RESULTS Conclusions and recommendations were divided into patient referral interventions and provider referral interventions. For patient referral, there was evidence supporting the use of expedited partner therapy and interactive counseling, but not purely didactic instruction. Provider referral through Disease Intervention Specialists was efficacious and particularly well supported for HIV. For other studies, modeling data and testing outcomes showed that partner notification in general reached high-prevalence populations. Reviews also suggested more focus on using technology and population-level implementation strategies. However, partner services may not be the most efficient means to reach infected persons. CONCLUSIONS Partner services programs constitute a large proportion of program STD prevention activities. Value is maximized by balancing a portfolio of patient and provider referral interventions and by blending partner notification interventions with other STD prevention interventions in overall partner services program structure. Sexually transmitted disease prevention needs program-level research and development to generate this portfolio.
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Wang AL, Peng RR, Tucker JD, Chakraborty H, Cohen MS, Chen XS. Optimizing Partner Notification Programs for Men Who Have Sex with Men: Factorial Survey Results from South China. PLoS One 2016; 11:e0157749. [PMID: 27462724 PMCID: PMC4963097 DOI: 10.1371/journal.pone.0157749] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 06/04/2016] [Indexed: 11/24/2022] Open
Abstract
Background Syphilis is prevalent among men who have sex with men (MSM) in China. Syphilis partner notification (PN) programs targeting MSM has been considered as one of effective strategies to prevention and control of the infection in the population. We examined willingness and preferences for PN among MSM to measure feasibility and optimize uptake. Methods Participation in a syphilis PN program was measured using a factorial survey from both the perspective of the index patient and the partner. Respondents were recruited from April-July 2011 using convenience sampling at two sites—a MSM sexually transmitted disease (STD) clinic and a MSM community based organization (CBO). Respondents first evaluated three factorial survey vignettes to measure probability of participation and then an anonymous sociodemographic questionnaire. A two-level mixed linear model was fitted for the factorial survey analysis. Results In 372 respondents with mean age (± SD) 28.5 (± 6.0) years, most were single (82.0%) and closeted gays (66.7%). The Internet was the most frequent place to search for sex. Few (31.2%) had legal names for casual partners, but most had instant messenger (86.5%) and mobile phone numbers (77.7%). The mean probability of participation in a syphilis PN program was 64.5% (± 32.4%) for index patients and 63.7% (± 32.6%) for partners. Referral of the partner to a private clinic or MSM CBO for follow-up decreased participation compared to the local Center for Disease Control and Prevention (CDC) or public STD clinic. Conclusions Enhanced PN services may be feasible among MSM in South China. Internet and mobile phone PN may contact partners untraceable by traditional PN. Referral of partners to the local CDC or public STD clinic may maximize PN participation.
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Affiliation(s)
- Alberta L. Wang
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | | | - Joseph D. Tucker
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Hrishikesh Chakraborty
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, United States of America
| | - Myron S. Cohen
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Xiang-Sheng Chen
- National Center for Sexually Transmitted Disease Control, Chinese Academy of Medical Science and Peking Union Medical College Institute of Dermatology, Nanjing, China
- * E-mail:
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Conserve DF, Jennings L, Aguiar C, Shin G, Handler L, Maman S. Systematic review of mobile health behavioural interventions to improve uptake of HIV testing for vulnerable and key populations. J Telemed Telecare 2016; 23:347-359. [PMID: 27056905 DOI: 10.1177/1357633x16639186] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Introduction This systematic narrative review examined the empirical evidence on the effectiveness of mobile health (mHealth) behavioural interventions designed to increase the uptake of HIV testing among vulnerable and key populations. Methods MEDLINE/PubMed, Embase, Web of Science, and Global Health electronic databases were searched. Studies were eligible for inclusion if they were published between 2005 and 2015, evaluated an mHealth intervention, and reported an outcome relating to HIV testing. We also reviewed the bibliographies of retrieved studies for other relevant citations. The methodological rigor of selected articles was assessed, and narrative analyses were used to synthesize findings from mixed methodologies. Results A total of seven articles met the inclusion criteria. Most mHealth interventions employed a text-messaging feature and were conducted in middle- and high-income countries. The methodological rigor was moderate among studies. The current literature suggests that mHealth interventions can have significant positive effects on HIV testing initiation among vulnerable and key populations, as well as the general public. In some cases, null results were observed. Qualitative themes relating to the use of mobile technologies to increase HIV testing included the benefits of having low-cost, confidential, and motivational communication. Reported barriers included cellular network restrictions, poor linkages with physical testing services, and limited knowledge of appropriate text-messaging dose. Discussion MHealth interventions may prove beneficial in reducing the proportion of undiagnosed persons living with HIV, particularly among vulnerable and key populations. However, more rigorous and tailored interventions are needed to assess the effectiveness of widespread use.
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Affiliation(s)
- Donaldson F Conserve
- 1 Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Larissa Jennings
- 2 Department of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Carolina Aguiar
- 3 Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Grace Shin
- 1 Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Lara Handler
- 4 Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Suzanne Maman
- 1 Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, USA
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Garett R, Smith J, Young SD. A Review of Social Media Technologies Across the Global HIV Care Continuum. Curr Opin Psychol 2016; 9:56-66. [PMID: 26925455 DOI: 10.1016/j.copsyc.2015.10.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
HIV remains one of the main health global threats of the 21st century. There is a great need to reach HIV at-risk and HIV+ populations across the HIV care continuum to improve HIV prevention, testing, and treatment. New technologies, such as Social Media (SM) and Social Networking Sites (SNS) have shown early promise in HIV research studies. To assess the state of research on the use of SM/SNSs across the HIV continuum, we conducted a systematic literature review on HIV-related research using SM during the last 10 years. A total of 44 papers were identified, of which 17 (38.6%) were classified as intervention studies and 19 (61.3%) as observational. The focus areas of the studies was evenly distributed between outreach outreach/recruitment (n=15, 34.1%), surveillance/observation (n=13, 29.5%) and prevention/treatment (n=16, 36.4%). Researchers engaged the community through Facebook (n=26, 59.1%), multiple-platforms (n=13, 29.5%), or one of several geo-social networking sites (n=10, 22.7%). Studies primarily targeted MSM (n=24, 54.5%) and youth (n=13, 29.5%) with little research focused on HIV+ populations (n=5, 11.4%). The current state of the field, trends, and limitations of this work are discussed.
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Affiliation(s)
| | - Justin Smith
- University of California Institute for Prediction Technology, Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA, USA; UCLA Center for Digital Behavior, Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Sean D Young
- University of California Institute for Prediction Technology, Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA, USA; UCLA Center for Digital Behavior, Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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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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