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Background: Assisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW). This study aimed to explore the awareness of and need for HIV partner notification, as well as to outline potential strategies for APNS based on identified barriers and facilitators.Methods: We conducted semi-structured interviews to explore partner notification with MSM, TW, and counselors. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS.Results: Most participants reported experiences with informal partner notification and serostatus disclosure, but not with APNS. Only one counselor indicated assisting notification systematically. The main barriers for notifying or disclosing mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier to inform a formal partner, conditional of being well informed about HIV. Given current stigma and lack of awareness, it was suggested that APNS should be preceded by HIV awareness efforts, and be provided by counselors or peers to mitigate potential rejection or violent reactions.Conclusions: While APNS are not formally implemented in Mexico, all participants supported the service, indicating that APNS could potentially enhance early HIV diagnosis in Mexico. Strategies to implement such services need to be flexible addressing the individual needs of participants, guaranteeing the safety of more vulnerable participants. [ABSTRACT FROM AUTHOR]

Contact tracing has been a key element of the public health response to infectious diseases for decades. These practices have been powerful in slowing the spread of tuberculosis, HIV, and other sexually transmitted infections. Despite success in other contexts, contact tracing for hepatitis C virus (HCV) has historically been considered infeasible because of a long asymptomatic period, which often makes it difficult to pinpoint the time of acquisition. Additionally, individuals may be reluctant to identify injecting partners because of stigma or fear of criminal repercussions. However, multiple factors - including the improved curability of HCV with advances in direct acting antiviral agents (DAAs), the implementation of age-based screening, and the current opioid epidemic -- have led to rapid changes in the landscape of HCV. HCV is increasingly concentrated among young people who inject drugs (PWID), many of whom are inadequately being reached by current screening practices. With the shift in the population most at risk for HCV and the fundamental changes in how we manage this disease, it's time to also rethink the public health response in identifying and informing those who may have been exposed. Contact tracing programs for HCV can augment existing screening strategies to provide curative treatment for patients and their partners, prevent reciprocal transmission of HCV between risk partners and within networks, and ultimately reach individuals who aren't yet engaged in healthcare and harm reduction. While there remain limitations to contact tracing for HCV, it has the potential to be a powerful tool in slowing the spread of the virus as we attempt to achieve viral elimination. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the psychometric properties of a Mandarin-language version of an instrument that assesses the Consequences of HIV Disclosure (CoHD).Patients and methods: The original CoHD instrument developed by Serovich was translated into Mandarin and administered to a random sample of 184 persons living with HIV (PLWH) using face-to-face and structured interviews. The CoHD instrument required respondents to rate the importance of eight costs (eg, might lose the relationship) and ten rewards (eg, would bring us closer) in their decision about whether to self-disclose their HIV status. The participants were directed to respond with respect to a current (or hypothetical) sexual partner.Results: Internal consistency was acceptable (Cronbach's α for the overall scale 0.82, costs 0.71, and rewards 0.86), as was stability (test–retest reliability overall 0.74, cost 0.63, and rewards 0.82). The CVI for the scale was 0.83, with items rated by subject experts ranging from 0.80 to 1.0. To determine structural validity, exploratory factor analysis extracted two subscales consistent with the original CoHD subscales. The Mandarin CoHD scores were significantly correlated with disclosure self-efficacy (indicating convergent validity), but they were unrelated to safer sex efficacy (indicating divergent validity). This criterion was tested by comparing the scores of PLWH who disclosed their HIV status (mean±SD 53.57±9.06) with those who did not disclose it (mean±SD 49.63±7.45); however, the difference was not statistically significant.Conclusion: The Mandarin version of the CoHD instrument demonstrates promising psychometric properties when assessing costs and rewards with respect to sexual partner disclosure. This suggests that it might be useful in research on partner notification strategies. In further studies, larger and more diverse samples and an analysis of responses for different disclosure targets are warranted. Moreover, whether the CoHD score is related to the decision of disclosure should be determined. [ABSTRACT FROM AUTHOR]

Background: This study explored spatial-temporal variation in diagnoses of gonorrhoea to identify and quantify endemic areas and clusters in relation to patient characteristics and outcomes of partner notification (PN) across England, UK. Methods: Endemic areas and clusters were identified using a two-stage analysis with Kulldorff’s scan statistics (SaTScan). Results: Of 2,571,838 tests, 53,547 diagnoses were gonorrhoea positive (positivity = 2.08%). The proportion of diagnoses in heterosexual males was 1.5 times that in heterosexual females. Among index cases, men who have sex with men (MSM) were 8 times more likely to be diagnosed with gonorrhoea than heterosexual males (p<0.0001). After controlling for age, gender, ethnicity and deprivation rank, 4 endemic areas were identified including 11,047 diagnoses, 86% of which occurred in London. 33 clusters included 17,629 diagnoses (34% of total diagnoses in 2012 and 2013) and spanned 21 locations, some of which were dominated by heterosexually acquired infection, whilst others were MSM focused. Of the 53,547 diagnoses, 14.5% (7,775) were the result of PN. The proportion of patients who attended services as a result of PN varied from 0% to 61% within different age, gender and sexual orientation cohorts. A third of tests resulting from PN were positive for gonorrhoea. 25% of Local Authorities (n = 81, 95% CI: 20.2, 29.5) had a higher than expected proportion for female PN diagnoses as compared to 16% for males (n = 52, 95% CI: 12.0, 19.9). Conclusions: The English gonorrhoea epidemic is characterised by spatial-temporal variation. PN success varied between endemic areas and clusters. Greater emphasis should be placed on the role of PN in the control of gonorrhoea to reduce the risk of onward transmission, re-infection, and complications of infection. [ABSTRACT FROM AUTHOR]

Background: Partner notification services (PNS) are highly effective in reducing transmission of sexually transmitted diseases (STDs). We assessed outcomes of PNS before and after integration of an on-site disease intervention specialist (DIS) at a publicly-funded STD clinic. Methods: From August 2014 to December 2015, patients testing positive for infectious syphilis or gonorrhea at the Rhode Island STD Clinic were referred to on-site DIS for partner notification. Data on PNS outcomes were reviewed for eight months before integration of DIS at the clinic and compared to eight months after. Results: Of the 145 index patients referred for PNS during the study period (n = 58 before DIS integration, n = 87 after), 86% were interviewed. DIS integration resulted in a significantly greater proportion of index patients interviewed overall (92% versus 76%, p<0.01), on the day of diagnosis (85% versus 61%; p<0.01), and in person at the STD clinic (64% versus 11%; p<0.01). However, there was no significant difference in number of sexual partners named or treated. Conclusions: Integrating DIS at a publicly-funded STD clinic resulted in a greater number of index cases interviewed, a greater number interviewed in person, and a greater number interviewed on the day of diagnosis. Challenges remain in identifying and engaging partners for treatment. [ABSTRACT FROM AUTHOR]

Patient-delivered partner therapy (PDPT) is the practice of providing patients diagnosed with a bacterial sexually transmitted infection (STI) medication to give directly to their partner for treatment without requiring the partner to participate in diagnostic testing and counseling. Despite a growing body of evidence in support of PDPT, literature is limited to date on the influence of perceived risk of intimate partner violence (IPV) on PDPT use. We analyzed mixed-method data from 196 quantitative surveys (61% male, M age = 31.2, 92% Black or African-American) and 25 qualitative interviews to better understand the barriers and facilitators associated with PDPT delivery for patients attending a Midwestern, publicly funded STI clinic in the U.S. Nearly a third of surveyed patients (29; 34% of women, 26% of men) expressed worry about IPV when delivering PDPT. Patients had concerns about infidelity worry, embarrassment, and anxiety (referred to as IWEA hereafter) associated with partner notification and PDPT delivery. We found IWEA was highly correlated with IPV concerns in a fully adjusted logistic regression model. Women had 2.43 (95% CI = 1.09-5.42) times greater odds of worrying about IPV than men; other significant factors associated with IPV worry included higher condom use, no prior STI diagnosis, and being uninsured (as compared to having Medicare/Medicaid insurance). Encouraging communication between healthcare providers and their patients about the potential for IPV could facilitate patient triaging that results in the consideration of alternative partner referral mechanisms for patients or partners at risk of harm and better outcomes for patients and their partners. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The article presents abstracts related to sexually transmitted diseases including associations between substance use and sexual risk behavior among women, sharing website pages to support disease and partner notification, and review of hepatitis C testing in a district general hospital.

Background: In Barbados sexually transmitted infections (STIs) including HIV are not notifiable diseases and there is not a formal partner notification (PN) programme. Objectives were to understand likely attitudes, barriers, and challenges to introducing mandatory disease notification (DN) and partner notification (PN) for HIV and other STIs in a small island state. Methods: Six key informants identified study participants. Interviews were conducted, recorded, transcribed and analysed for content using standard methods. Results: Participants (16 males, 13 females, median age 59 years) included physicians, nurses, and representatives from governmental, youth, HIV, men's, women's, church, and private sector organisations. The median estimated acceptability by society of HIV/STI DN on a scale of 1 (unacceptable) to 5 (completely acceptable) was 3. Challenges included; maintaining confidentiality in a small island; public perception that confidentiality was poorly maintained; fear and stigma; testing might be deterred; reporting may not occur; enacting legislation would be difficult; and opposition by some opinion leaders. For PN, contract referral was the most acceptable method and provider referral the least. Contract referral unlike provider referral was not "a total suspension of rights" while taking into account that "people need a little gentle pressure sometimes". Extra counselling would be needed to elicit contacts or to get patients to notify partners. Shame, stigma and discrimination in a small society may make PN unacceptable and deter testing. With patient referral procrastination may occur, and partners may react violently and not come in for care. With provider referral patients may have concerns about confidentiality including neighbours becoming suspicious if a home visit is used as the contact method. Successful contact tracing required time and effort. With contract referral people may neither inform contacts nor say that they did not. Strategies to overcome barriers to DN and PN included public education, enacting appropriate legislation to allow DN and PN, good patient counselling and maintaining confidentiality. Conclusions: There was both concern that mandatory DN and PN would deter testing and recognition of the benefits. Public and practitioner education and enabling legislation would be necessary, and the public needed to be convinced that confidentiality would be maintained. [ABSTRACT FROM AUTHOR]

There has been a recent increase in legislative and regulatory frameworks to govern HIV in Africa. This includes rules on when and how a health practitioner may disclose the HIV status of a patient to a spouse or sexual partner. In balancing the right to privacy against a doctor's duty of care, two international model laws have emerged, and have been wholly or partially copied by a number of African countries. This paper questions the usefulness of such model laws as legal transplants in national legislatures through an analysis of the regulations developed in thirty-eight African countries. [ABSTRACT FROM AUTHOR]

Background Partner notification (PN) is an essential case-finding tool in the management of sexually transmitted infections (STIs). Yet, data on the effectiveness and factors impacting implementation of PN in the Netherlands are lacking. With the aim of further exploring and improving the PN process, the current study assessed perceived barriers and facilitators among health care professionals in the STI clinical setting. In particular, we explored the management of PN in young heterosexual patients diagnosed with Chlamydia trachomatis (Ct). Methods We conducted semi-structured interviews among 22 health care professionals (response rate 52%) from 5 of the 8 national STI clinics in the Netherlands. We carried out qualitative content analysis using a framework approach. All participants were nurses, aged mid 20's to late 50's, and all but one were female. Results All health care professionals felt comfortable discussing PN. Other perceived facilitators for PN included: time, one-on-one consultations, interviewing skills (i.e. Motivational Interviewing) and a proactive helping style. Important barriers were identified as: sub-optimal guidelines, inaccurate sexual history, a lack of feedback regarding the motivational strategies that were used, and the lack of feedback regarding overall PN effectiveness. The health care professionals placed an emphasis on the care and treatment of the individual index patient rather than on discussion of PN, or on motivating and helping patients to engage in PN. Conclusions Health care professionals identified several barriers that need to be overcome, and facilitators which need to be maintained. Future efforts should concentrate on introducing PN protocols, providing feedback on both the effectiveness of strategies used by health care professionals, and on the PN process as a whole, and educating health care professionals about Motivational Interviewing strategies. Moreover, the possible implementation of an Internet-based PN system should be explored. [ABSTRACT FROM AUTHOR]

Objectives To investigate the methods used by patients diagnosed with a sexually transmissible infection (STI) to inform their partners during contact tracing. Methods At a large Australian sexual health clinic between March and May 2010, we undertook a retrospective, cross sectional analysis of the methods used by patients diagnosed with a bacterial STI to inform their partners. Results Of the 172 index patients contacted 1 week after treatment, 163 (95%) chose patient referral, 3 (2%) provider referral and 6 (3%) could not contact any partners. Index patients nominated 1010 sexual partners of whom 494 (49%) were reported as contactable. A total of 447/494 (91%) of these partners were successfully informed; telephone (37%) and face to face (22%) were the most used methods. After multivariate analysis, predictors of using face to face contact methods were age <30 years (AOR: 2.8; 95% CI 1.4 to 5.7), fewer than 2 sexual partners (AOR 3.6; 95% CI 1.7 to 7.6) and speaking a language other than English (adjusted OR (AOR) 3.1; 95% CI 1.3 to 7.2). The single predictor of using interactive contact methods (face to face+telephone) was reporting fewer than 2 sexual partners (AOR 2.7; 95% CI 1.3 to 5.5). People diagnosed with syphilis were significantly less likely to use an interactive contact tracing method (AOR 0.24; 95% CI 0.09 to 0.67). Conclusions Most patients diagnosed with a bacterial STI at our sexual health clinic report informing their contactable partners directly either face to face or by telephone. Electronic communications methods were more popular for people with more sexual partners and those with syphilis. Effective contact tracing requires access to a range of methods for patients to inform their partners. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To enhance partner notification (PN) practices in Dutch STI clinics, a PN training using motivational interviewing as core strategy was offered to STI professionals and evaluated. Methods: The effectiveness of PN training on professionals’ attitude, self-efficacy, skills and behavior toward PN, was examined using within-subject and between-subject comparison. Before the training and at three months follow-up, a questionnaire was completed by the intervention group (n =54) and a non-random control group (n =37). Results: In the within-subject comparison, positive changes were observed in self-efficacy, skills, and PN behaviors (all p <.05), but not in attitudes toward PN. When we examined differences in change-scores between the intervention and control group, self-efficacy was no longer significant. Conclusion: The PN training significantly improved PN skills and -behavior, but had no effect on professionals’ attitudes or self-efficacy toward PN. The selection of a convenience control sample seems to offer a more rigorous test of hypotheses than pre–post evaluation only. Practice implications: The beneficial effect of PN training of STI professionals seems to support a wider roll-out of the training to all STI clinics in the Netherlands, although effects on the number of partners notified and transmissions prevented need to be examined in future research. [Copyright &y& Elsevier]

The article focuses on the methods to interrupt the transmission of sexually transmitted infections (STI), such as human immunodeficiency virus (HIV), in Rhode Island. It discusses the transmission of HIV in the island and the epidemiology of STI and HIV. It highlights the implementation of partner notification services targeted at syphilis exposure and HIV exposure. It says that molecular epidemiology in HIV involves the application of statistics and phylogenetics to examine and reconstruct the evolutionary patterns of the virus' genetic sequences.

Objective China's sexually transmitted infection (STI) epidemic requires comprehensive control programmes. Partner services are traditional pillars of STI control but have not been widely implemented in China. This study was a systematic literature review to examine STI partner notification (PN) uptake in China. Methods Four English and four Chinese language databases were searched up to March 2011 to identify articles on PN of STIs including HIV in China. PN uptake was defined as the number of partners named, notified, evaluated or diagnosed per index patient. Results A total of 11 studies met inclusion criteria. For STI (excluding HIV) PN, a median 31.6% (IQR 27.4%--65.8%) of named partners were notified, 88.8% (IQR 88.4%--90.8%) of notified partners were evaluated and 37.9% (IQR 33.1%--43.6%) of evaluated partners were diagnosed. For HIV PN, a median 15.7% (IQR 13.2%--36.5%) of named partners were notified, 86.7% (IQR 72.9%--90.4%) of notified partners were evaluated and 27.6% (IQR 24.1%--27.7%) of evaluated partners were diagnosed. A mean of 80.6% (SD=12.6%) of patients attempted PN, and 72.4% (IQR 63.8%--81.1%) chose self-referral when offered more than one method of PN. Perceived patient barriers included social stigma, fear of relationship breakdown, uncertainty of how to notify and lack of partner contact information. Perceived infrastructure barriers included limited time and trained staff, mistrust of health workers and lack of PN guidelines. Conclusion PN programmes are feasible in China. Further research on STI PN, particularly among men who have sex with men and other high-risk groups, is an important public health priority. PN policies and guidelines are urgently needed in China. [ABSTRACT FROM AUTHOR]

Objectives To undertake a costeconsequence analysis to assess two new models of partner notification (PN), known as Accelerated Partner Therapy (APT Hotline and APT Pharmacy), as compared with routine patient referral PN, for sex partners of people with chlamydia, gonorrhoea and non-gonococcal urethritis. Methods Comparison of costs and outcomes alongside an exploratory trial involving two genitourinary medicine clinics and six community pharmacies. Index patients selected the PN method (APT Hotline, APT Pharmacy or routine PN) for their partners. Clinics and pharmacies recorded cost and resource use data including duration of consultation and uptake of treatment pack. Cost data were collected prospectively for two out of three interventions, and data were synthesised and compared in terms of effectiveness and costs. Results Routine PN had the lowest average cost per partner treated (approximately £46) compared with either APT Hotline (approximately £54) or APT Pharmacy (approximately £53) strategies. The costeconsequence analysis revealed that APT strategies were more costly but also more effective at treating partners compared to routine PN. Conclusion The hotline strategy costs more than both the alternative PN strategies. If we accept that strategies which identify and treat partners the fastest are likely to be the most effective in reducing reinfection and onward transmission, then APT Hotline appears an effective PN strategy by treating the highest number of partners in the shortest duration. Whether the additional benefit is worth the additional cost cannot be determined in this preliminary analysis. These data will be useful for informing development of future randomised controlled trials of APT. [ABSTRACT FROM AUTHOR]

Objectives To develop two new models of expedited partner therapy for the UK, and evaluate them for feasibility, acceptability and preliminary outcome estimates to inform the design of a randomised controlled trial (RCT). Methods Two models of expedited partner therapy (APTHotline and APTPharmacy), known as 'Accelerated Partner Therapy' (APT) were developed. A nonrandomised comparative study was conducted of the two APT models and routine partner notification (PN), in which the index patient chose the PN option for his/her partner(s) in two contrasting clinics. Results The proportion of contactable partners treated when routine PN was chosen was 42/117 (36%) and was significantly higher if either APT option was chosen: APTHotline 80/135 (59%), p=0.003; APTPharmacy 29/44 (66%) p=0.001. However, partner treatment was often achieved through other routes. Although 40e60% of partners in APT groups returned urine samples for sexually transmitted infection (STI) testing, almost none accessed HIV and syphilis testing. APT options appear to facilitate faster treatment of sex partners than routine PN. Preferences and recruitment rates varied between sites, related to staff satisfaction with existing routine PN; approach to consent; and possibly, characteristics of local populations. Conclusions Both methods of APT were feasible and acceptable to many patients and led to higher rates of partner treatment than routine PN. Preferences and recruitment rates varied greatly between settings, suggesting that organisational and cultural factors may have an important impact on the feasibility of an RCT and on outcomes. Mindful of these factors, it is proposed that APT should now be evaluated in a cluster RCT. [ABSTRACT FROM AUTHOR]

The article presents a study which evaluates partner treatment that is critical for preventing further transmission of chlamydia infections among women in California family planning clinics. It states that patient-delivered partner therapy (PDPT) has been allowable in the state since 2001 but few data are available regarding PDPT use and treatment outcomes. It also notes that chlamydia is the most common communicable disease in the U.S.

The article focuses on a study regarding the timely notification and treatment of sex partners exposed to a sexually transmitted disease (STD). The study found that in patients with increased self-efficacy who have stronger interpersonal relationships with their sex partners, patient-initiated partner referral is more successful. A baseline interview including questions on demographics, STD history, and partner notification preferences was conducted on enrollment of all participants.

Objectives: To compare different ways of measuring partner notification (PN) outcomes with published audit standards, examine variability between clinics and examine factors contributing to variation in PN outcomes in genitourinary medicine (GUM) clinics in the UK.Methods: Reanalysis of the 2007 BASHH national chlamydia audit. The primary outcome was the number of partners per index case tested for chlamydia, as verified by a healthcare worker or, if missing, reported by the patient. Control charts were used to examine variation between clinics considering missing values as zero or excluding missing values. Hierarchical logistic regression was used to investigate factors contributing to variation in outcomes.Results: Data from 4616 individuals in 169 genitourinary medicine clinics were analysed. There was no information about the primary outcome in 41% of records. The mean number of partners tested for chlamydia ranged from 0 to 1.5 per index case per clinic. The median across all clinics was 0.47 when missing values were assumed to be zero and 0.92 per index case when missing values were excluded. Men who have sex with men were less likely than heterosexual men and patients with symptoms (4-week look-back period) were less likely than asymptomatic patients (6-month look-back) to report having one or more partners tested for chlamydia. There was no association between the primary outcome and the type of the health professional giving the PN advice.Conclusions: The completeness of PN outcomes recorded in clinical notes needs to improve. Further research is needed to identify auditable measures that are associated with successful PN that prevents repeated chlamydia in index cases. [ABSTRACT FROM AUTHOR]

The article presents a study on the feasibility and acceptability of a patient-led syphilis partner notification strategy among pregnant women with syphilis, their male partners, and treatment completion in Bolivia. It was found that more male partners who were notified by women completed syphilis treatment compared to those notified by providers. Multivariate analysis showed that men notified by their partners had a threefold greater odds of treatment completion than those not notified.

The article presents a study which assesses barriers to HIV testing among patients diagnosed concurrently with HIV and AIDS and health care contacts history. The study surveyed HIV/AIDS patients who had participated in the partner notification program of the New York City Department, between January 2008 to December 2008. It is inferred that a lack of perception risk is the main reason for not testing HIV in diagnosed patients.

The article presents a study which examines the programs for sexually transmitted infections (STI)/HIV partner notification (PN) found in the Internet. The study uses clinic-based surveys before and after feasible clinic interventions, and website statistics from inSPOT Colorado service. The study shows that the recognition and use of inSPOT Colorado service determined in the STI clinic patients were less than 6% although there are existing clinic interventions.

Evidence suggests that Candida can be sexually transmitted; however, the contribution of sexual transmission to the pathogenesis of genital candidosis needs further elucidation. The aim was to evaluate genital candidosis and its transmissibility in heterosexual couples. Heterosexual couples were recruited among attendees of an Sexually Transmitted Diseases clinic. Specimens for yeast culture were collected from the glans penis and inner preputial layer using direct impression on CHROMagar Candida medium; vaginal exudates were collected using a cotton swab with subsequent inoculation on CHROMagar Candida medium. Mitochondrial DNA restriction analysis was performed to compare Candida isolates from both partners. A total of 64 couples were enrolled in the study. Frequency of sexual intercourse was significantly higher in couples where both partners yielded positive cultures and with at least one having genital candidosis (Odds ratios: 6.844; 95% CI 1.408-33.266). The same Candida species was found in both partners in 25% (16/64) of all couples but only 17.2% (11/64) were genetically similar. In total 12 of the 34 women suffering from vulvovaginal candidosis (VVC) had recurrent VVC (RVVC); two sexual partners of RVVC women (16.7%) had candida positive cultures, compared with 15 (68.2%) sexual partners of non RVVC women (Odds ratios: 0.093; 95% CI 0.016-0.544). Only in a few heterosexual couples a genetic similarity of Candida species recovered from both partners was found. RVVC women were more likely to have an asymptomatic candida negative sexual partner. This study suggests that male genitalia do not represent a relevant reservoir for RVVC; thus, the relevance of sexual transmission should not be emphasized. [ABSTRACT FROM AUTHOR]

To examine the conditions under which lay people and health professionals living in Chile and France find it acceptable for a physician to break confidentiality to protect the spouse of a patient with a sexually transmitted disease (STD), 207 lay persons and healthcare professionals indicated the acceptability of breaking confidentiality in 48 scenarios combining five factors: disease severity, time taken to discuss this with the patient, patient's intent to inform his spouse about the disease, patient's intent to adopt protective behaviors, and physician's decision to consult an STD expert. A cluster analysis revealed groups that found breaking confidentiality "always acceptable", requiring "consultation with an expert", "depending on the many circumstances", and "never acceptable" (11%)". Despite differences in legislation and ethics codes, Chilean and French lay people showed similar personal convictions regarding the circumstances in which breaking patient confidentiality is acceptable. In contrast, Chilean physicians were much less supportive than French physicians of complete respect of patient confidentiality in all cases. [ABSTRACT FROM AUTHOR]

The article discusses a study on the efficiency of HIV partner notification (PN) services between Blacks and Hispanics in New York City. It says that 1385 black and Hispanic patients from HIV Field Services Unit (FSU) were interviewed. It tells that stratified analyses were implemented to analyze the role of birth country as confounder as well as logistic regression model to examine the link between race and naming diagnosed partner. Results confirm PN effectivity with slight racial variation.

Background. Partner notification for patients diagnosed with chlamydia is a strategy recommended to interrupt transmission of infection, and patients are commonly encouraged by health practitioners to contact their sexual partners themselves. Few studies, however, have ascertained the psychosocial impact of the chlamydia diagnosis and its effect on partner notification. [ABSTRACT FROM PUBLISHER]

The article evaluates the Department of Health Internet-based Partner Notification (IPN) program of Washington, D.C. on early syphilis infections. It states that the evaluation makes use of the standard Centers for Disease Control and Prevention (CDC) Disease Investigation Specialist (DIS) disposition codes. The study shows that 43% of the sex partners that are investigated are via IPN, which leads to an eight percent increase in the overall number of syphilis patients.

The article reports on a randomized trial comparing the effectiveness of three methods of partner notification and treatment for sexual partners of women with vaginal trichomoniasis in Birmingham, Alabama. Female aging 19 and older with a wet prep positive for Trichomonas vaginalis, attending the Jefferson County Department of Health have been the subject of the study. Findings showed that partner-delivered therapy (PDPT) for trichomoniasis has been safe and well accepted in the study.

Expanded access to antiretroviral therapy (ART) offers opportunities to strengthen HIV prevention in resource-limited settings. We invited 27 ART programmes from urban settings in Africa, Asia and South America to participate in a survey, with the aim to examine what preventive services had been integrated in ART programmes. Twenty-two programmes participated; eight (36%) from South Africa, two from Brazil, two from Zambia and one each from Argentina, India, Thailand, Botswana, Ivory Coast, Malawi, Morocco, Uganda and Zimbabwe and one occupational programme of a brewery company included five countries (Nigeria, Republic of Congo, Democratic Republic of Congo, Rwanda and Burundi). Twenty-one sites (96%) provided health education and social support, and 18 (82%) provided HIV testing and counselling. All sites encouraged disclosure of HIV infection to spouses and partners, but only 11 (50%) had a protocol for partner notification. Twenty-one sites (96%) supplied male condoms, seven (32%) female condoms and 20 (91%) provided prophylactic ART for the prevention of mother-to-child transmission. Seven sites (33%) regularly screened for sexually transmitted infections (STI). Twelve sites (55%) were involved in activities aimed at women or adolescents, and 10 sites (46%) in activities aimed at serodiscordant couples. Stigma and discrimination, gender roles and funding constraints were perceived as the main obstacles to effective prevention in ART programmes. We conclude that preventive services in ART programmes in lower income countries focus on health education and the provision of social support and male condoms. Strategies that might be equally or more important in this setting, including partner notification, prompt diagnosis and treatment of STI and reduction of stigma in the community, have not been implemented widely. [ABSTRACT FROM AUTHOR]

The article presents a study which describes the partner notification experiences and outcomes among men and women diagnosed with Chlamydia and their views on innovative resources to improve notification rates. It says that the study conducted a telephone survey of men and women diagnosed with Chlamydia in 3 Australian jurisdictions between August 2007 and January 2008. Results indicate that the availability of tailored resources can assist patients with Chlamydia in their personal notification.

The article presents a study which examines an online results system for gonorrhea and Chlamydia test results in an urban sexually transmitted infections (STI) clinic. The study uses the electronic medical records system to test how the results of 9,056 patients were achieved based on the three periods between December 2007 and April 2009. The study shows that the number of patients who received results either online or by telephone are 67% in Period 1, 67% in Period 2, and 70% in Period 3.

The article focuses on the development of a prediction model to maximize the effect of syphilis patients partner notification in San Francisco, California to identify sex partners needing treatment. It states that multivariate analysis is used to randomly show the number of treated patients interviewed from July 2004 to June 2008 on the half of data set. The results showed that 1665 partners in 1340 patient interviews were named and 827 of those were treated.

Background: Partner notification is accepted as a vital component in the control of chlamydia. However, in reality, many sexual partners of individuals diagnosed with chlamydia are never informed of their risk. The newer technologies of email and SMS have been used as a means of improving partner notification rates. This study explored the use and acceptability of different partner notification methods to help inform the development of strategies and resources to increase the number of partners notified. Methods: Semi-structured telephone interviews were conducted with 40 people who were recently diagnosed with chlamydia from three sexual health centres and two general practices across three Australian jurisdictions. Results: Most participants chose to contact their partners either in person (56%) or by phone (44%). Only 17% chose email or SMS. Participants viewed face-to-face as the "gold standard" in partner notification because it demonstrated caring, respect and courage. Telephone contact, while considered insensitive by some, was often valued because it was quick, convenient and less confronting. Email was often seen as less personal while SMS was generally considered the least acceptable method for telling partners. There was also concern that emails and SMS could be misunderstood, not taken seriously or shown to others. Despite these, email and SMS were seen to be appropriate and useful in some circumstances. Letters, both from the patients or from their doctor, were viewed more favourably but were seldom used. Conclusion: These findings suggest that many people diagnosed with chlamydia are reluctant to use the new technologies for partner notification, except in specific circumstances, and our efforts in developing partner notification resources may best be focused on giving patients the skills and confidence for personal interaction. [ABSTRACT FROM AUTHOR]

Background. Repeated Chlamydia trachomatis infections are common among young sexually active women. The relative frequency of reinfection and antibiotic treatment failure is undefined. Methods. Adolescent women enrolled in a longitudinal cohort had behavioral and sexually transmitted infection assessments performed every 3 months, including amplification tests for C. trachomatis, ompA genotyping, and interviews and diary entries to document sex partner-specific coitus and event-specific condom use. Repeated infections were classified as reinfection or treatment failure by use of an algorithm. All infections for which treatment outcomes were known were used to estimate the effectiveness of antibiotic use. Results. We observed 478 episodes of infection among 210 study participants; 176 women remained uninfected. The incidence rate was 34 episodes/100 woman-years. Of the women who were infected, 121 experienced ≥1 repeated infections, forming 268 episode pairs; 183 pairs had complete data available and were classified using the algorithm. Of the repeated infections, 84.2% were definite, probable, or possible reinfections; 13.7% were probable or possible treatment failures; and 2.2% persisted without documented treatment. For 318 evaluable infections, we estimated 92.2% effectiveness of antibiotic use. Conclusions. Most repeated chlamydial infections in this high-incidence cohort were reinfections, but repeated infections resulting from treatment failures occurred as well. Our results have implications for male screening and partner notification programs and suggest the need for improved antibiotic therapies. [ABSTRACT FROM AUTHOR]

Background: The feasibility and acceptability of partner notification (PN) for sexually transmitted infections (STIs) in developing countries was assessed through a comprehensive literature review, to help identify future intervention needs. Methods: The Medline, Embase, and Google Scholar databases were searched to identify studies published between January 1995 and December 2007 on STI PN in developing countries. A systematic review of the research extracted information on: (1) willingness of index patients to notify partners; (2) the proportion of partners notified or referred; (3) client-reported barriers in notifying partners; (4) infrastructure barriers in notifying partners; and (5) PN approaches that were evaluated in developing countries. Results: Out of 609 screened articles, 39 met our criteria. PN outcome varied widely and was implemented more often for spousal partners than for casual or commercial partners. Reported barriers included sociocultural factors such as stigma, fear of abuse for having an STI, and infrastructural factors related to the limited number of STD clinics, and trained providers and reliable diagnostic methods. Client-oriented counselling was found to be effective in improving partner referral outcomes. Conclusions: STD clinics can improve PN with client-oriented counselling, which should help clients to overcome perceived barriers. The authors speculate that well-designed PN interventions to evaluate the impact on STI prevalence and incidence along with cost-effectiveness components will motivate policy makers in developing countries to allocate more resources towards STI management. [ABSTRACT FROM AUTHOR]

Background: Prostatitis and sexually transmitted diseases (STDs) have been positively associated with prostate cancer in previous case-control studies. However, results from recent prospective studies have been inconclusive. Methodogy/Principal Findings: We investigated the association between prostatitis, STDs, and prostate cancer among African American, Asian American, Latino, and White participants of the California Men's Health Study. Our analysis included 68,675 men, who completed a detailed baseline questionnaire in 2002-2003. We identified 1,658 incident prostate cancer cases during the follow-up period to June 30, 2006. Cox proportional hazards models were used to estimate relative risks and 95% confidence intervals. Overall, men having a history of prostatitis had an increased risk of prostate cancer than men with no history (RR = 1.30; 95% CI: 1.10-1.54). Longer duration of prostatitis symptoms was also associated with an increased risk of prostate cancer (P trend = 0.003). In addition, among men screened for prostate cancer (1 or 2 PSA tests), a nonsignificant positive association was observed between prostatitis and prostate cancer (RR = 1.10; 95% CI: 0.75-1.63). STDs were not associated with overall prostate cancer risk. In racial/ethnic stratified analysis, Latinos reporting any STDs had an increased risk of disease than those with no STDs (RR = 1.43; 95% CI: 1.07-1.91). Interestingly, foreign-born Latinos displayed a larger risk associated with STDs (RR = 1.87; 95% CI: 1.16-3.02) than U.S. born Latinos (RR = 1.15; 95% CI: 0.76-3.02). Conclusion: In summary, results from this prospective study suggest that prostatitis and STDs may be involved in prostate cancer susceptibility. While we cannot rule out the possible influence of incidental detection, future studies are warranted to further investigate the role of infectious agents related to prostatitis and STDs in prostate cancer development. [ABSTRACT FROM AUTHOR]

The article presents a study which explores the resources that could better partner notification for chlamydia in primary care. It centers on 234 general practitioners (GP) across Australia. The study found that 95% of GP notes that it is their obligation to discuss partner notification with patients however, only 45% were certain on how they are going to assist their patient. It concludes that GPs seek wide resources to assist them with notifying patient for notification.

Partner notification is the process by which people who are thought to have been exposed to sexually transmitted infections (STIs) are traced, informed about their exposure and invited to attend clinical services. It is the cornerstone of genitourinary medicine for the prevention and treatment of STIs. The central question of the article is whether partner notification (PN) represents the medical regulation of sexual bodies or is an appropriate medical response to health care needs. The question is first of all addressed through contrasting theoretical lenses: a Functionalist Parsonian perspective, a Post-structuralist, Foucauldian perspective and a critical theory Habermasian perspective. The question is then explored empirically by drawing on the perspectives of men who have sex with men (MSM) as drawn from a study of MSM's lay perspectives on partner notification in the context of a syphilis outbreak in Dublin. The findings show that the views of MSM in this study suggest that PN is an appropriate response to health care needs and, thus, the lay views most clearly resonate with a functionalist understanding of trust in the expert and moral status of public health. However, the difficulties MSM experience in complying with PN also suggests that the medical logic of PN needs to be counter-balanced with the social logic as derived from lay experiences of its practice in their lives. A critical theory approach holds potential for mediating between medicine's regulation of sexual health and individual health care needs. [ABSTRACT FROM AUTHOR]

Background: Published individual-based, dynamic sexual network modelling studies reach different conclusions about the population impact of screening for Chlamydia trachomatis. The objective of this study was to conduct a direct comparison of the effect of organised chlamydia screening in different models. Methods: Three models simulating population-level sexual behaviour, chlamydia transmission, screening and partner notification were used. Parameters describing a hypothetical annual opportunistic screening program in 16-24 year olds were standardised, whereas other parameters from the three original studies were retained. Model predictions of the change in chlamydia prevalence were compared under a range of scenarios. Results: Initial overall chlamydia prevalence rates were similar in women but not men and there were age and sex-specific differences between models. The number of screening tests carried out was comparable in all models but there were large differences in the predicted impact of screening. After 10 years of screening, the predicted reduction in chlamydia prevalence in women aged 16-44 years ranged from 4% to 85%. Screening men and women had a greater impact than screening women alone in all models. There were marked differences between models in assumptions about treatment seeking and sexual behaviour before the start of the screening intervention. Conclusions: Future models of chlamydia transmission should be fitted to both incidence and prevalence data. This meta-modelling study provides essential information for explaining differences between published studies and increasing the utility of individual-based chlamydia transmission models for policy making. [ABSTRACT FROM AUTHOR]

The article presents a study conducted by David A. Katz and Matthew Hobgen, regarding the reliability assessment issue of Centers for Disease Control and Prevention (CDC) HIV partner notification (PN) and disposition coding of Disease Intervention Specialists (DIS) in the U.S. Accordingly, researchers have used PN interviews and questionnaires to their 136 DIS respondents in order to determine the reliability of CDC HIV partner notification. It notes that these DIS are using seven different codes in order to assess the effectiveness of PN and its result. Moreover, it is reported that CDC HIV PN disposition codes are effective. However, its reliability is less effective when it comes to reported outcomes of the partners under the elicitation of DIS.

A quasi-experimental study was conducted at a Dutch sexually transmitted infection (STI) clinic to compare the effects of educational counseling and motivational interviewing (MI)-based HIV/STI counseling on determinants of condom use and partner notification at 6-month follow-up. It also examined the feasibility of MI-based counseling in a busy real-life clinic. The counseling approaches were historically compared: respondents in the control condition were recruited between April and July 2005, those in the experimental condition between September and December 2005. The study involved 428 participants. These were all high-risk clients of the STI clinic. Their mean age was 33.7 years, and 39.6% were female. The study showed that MI-based counseling had a more positive effect on self-efficacy, intentions to use condoms with casual partners, and long-term condom use with steady partners. It had no adversarial outcomes on other social cognitions or behaviors compared to educational counseling. Furthermore, MI-based counseling is experienced as a more respectful and structured way of counseling. MI-based counseling was relatively easily implemented into the current clinic procedures. In addition to the implementation of the training, neither specialized staff nor additional or longer client visits were needed. However, some nurses indicated that the new method required more personal investment and effort. Limitations of the current study are the low response rates, the high educational level of most participants, and the small sample size regarding partner notification. Nonetheless, we conclude that MI-based counseling was a more effective approach to preventive counseling compared to educational counseling and feasible in the busy real-life setting. [ABSTRACT FROM AUTHOR]

The article presents a cross-sectional study which examines current control policies for sexually transmitted disease (STD) in the New York State county health departments. In addition, researchers in this study perspectives from head departments on patient-delivered partner therapy (PDPT) and alternative interventions. It notes that researchers reviewed county websites to assess STD service information provided and then surveyed county STD programs from January to March 2007 by telephone to determine conditions diagnosed and to assess perspectives on PDPT. Researchers found that further research on alternative partner intervention strategies and discussion of PDPT is necessary to develop a forward-thinking strategic plan for STD control in the state.

The article presents a study which examines the pharmacists' perceptions about patient delivered partner therapy (PDPT) in the New York State. In this study, researchers conducted a survey of pharmacists and observed privacy-related spaces in pharmacies in order to determine pharmacists' perceptions about PDPT, education on sexually transmitted infections (STI), and potential barriers that need to be addressed in pharmacies for successful implementation of PDPT. According to the article, researchers conclude that pharmacists are open to considering PDPT as part of their professional functions. Although pharmacists need additional education in STI in general, it notes that capacity for this training can be established.

The article presents a cross-sectional, observational study which evaluates the use of client partner notification (CPN) and health-department partner notification strategies to inform sex partners of possible HIV exposure. In this study, researchers observed 590 persons diagnosed with HIV in the prior six months at 51 HIV test, medical, and research providers in Chicago, Illinois, and Los Angeles, California in 2003 and 2004. In addition, researchers performed logistic regression in order to identify independent correlates of using CPN to notify all locatable partners. According to the article, researchers conclude that many locatable sex partners who might benefit from being notified of potential HIV exposure are not notified.

Objectives. We sought to assess the effectiveness of approaches targeting improved sexually transmitted infection (STI) sexual partner notification through patient referral. Methods. From January 2002 through December 2004, 600 patients with Neisseria gonorrhoeae or Chlamydia trachomatis were recruited from STI clinics and randomly assigned to either a standard-of-care group or a group that was counseled at the time of diagnosis and given additional follow-up contact. Participants completed an interview at baseline, 1 month, and 6 months and were checked at 6 months for gonorrhea or chlamydial infection via nucleic acid amplification testing of urine. Results. Program participants were more likely to report sexual partner notification at 1 month (86% control, 92% intervention; adjusted odds ratio [AOR] = 1.8; 95% confidence interval [CI] = 1.02, 3.0) and were more likely to report no unprotected sexual intercourse at 6 months (38% control, 48% intervention; AOR= 1.5; 95% Cl =1.1, 2.1). Gonorrhea or chlamydial infection was detected in 6% of intervention and 11% of control participants at follow-up (AOR=2.2; 95% Cl=1.1, 4.1), with greatest benefits seen among men (for gender interaction, P=.03). Conclusions. This patient-based sexual partner notification program can help reduce risks for subsequent STIs among urban, minority patients presenting for care at STI clinics. (Am J Public Health. 2009;99:S104-S110) [ABSTRACT FROM AUTHOR]

The process of partner notification (or contact tracing) is regarded as the cornerstone in the prevention and control of sexually transmitted infections, yet almost nothing is known of the lay experience of partner notification. This article draws on a mixed methods study designed to explore lay perspectives among men who have sex with men (MSM) in the Greater DublinArea in relation to partner notification for syphilis. Specifically, this article tests two related hypotheses with regard to gay men's help-seeking behaviour: first that MSM might contest a hegemonic masculine model of help-seeking behaviour and second that MSM have difficulties engaging with partner notification because of the difficulties of tracing anonymous sexual contacts. The findings suggest that the health-seeking behaviours ofMSMin this study disrupt binary dualisms of hegemonicmasculine and hegemonic feminine patterns of health-seeking behaviours and also contradict some health professional stereotypes of gay relationships. [ABSTRACT FROM AUTHOR]

Objectives. We assessed Boston-area men who have sex with men (MSM) in terms of their knowledge of partner notification (PN)/partner counseling and referral services (PCRS) and intentions to use such services if exposed to! infected with a sexually transmitted disease (STD) or human immunodeficiency virus (HIV) in the future. Methods. The study used a convenience sample of STD clinic patients (n=48) and a modified respondent-driven sampling method (n=70) to\reach a diverse sample of MSM (total sample n=118) in Massachusetts. Participants completed a one-on-one, open-ended, semistructured qualitative interview and quantitative survey. Results. Overall, white, HIV-infected MSM had the highest level of knowledge about PN activities. MSM who were unfamiliar with PN were disproportionately nonwhite and HIV-uninfected. Participants were more likely to notify past partners of HIV exposure than STD exposure. The preferred method of PN for the majority of MSM was direct person-to-person notification. Notably, nonwhite participants were more likely to endorse Massachusetts Department of Public Health PN services than white MSM, who preferred involvement of primary care providers. Conclusions. PN is an important public health strategy for treating and preventing STDs and HIV among at-risk populations, especially MSM who engage in sexual behavior with anonymous or otherwise non-notifiable sexual partners. Although many MSM had an understanding of the ethical desirability of informing exposed partners and recognized the value of preventative behaviors, they require further education to overcome barriers to PN as well as to gain knowledge of the various methods of both traditional and nontraditional notification, such as Internet PN. [ABSTRACT FROM AUTHOR]

The article discusses three global priorities for the control of sexually transmitted infections (STIs) in 2011. Partner notification reportedly has to be strengthened because it is efficient for case finding, can prevent re-infection and could disrupt the onward transmission in a sexual network. The article states that antenatal syphilis screening programmes should be implemented to eliminate congenital syphilis and that the delivery of effective anti-STI vaccines needs to be organised.