Intention to notify sexual partners about potential HIV exposure among New York city STD clinics' clients

BACKGROUND: Partner notification legislation has recently been implemented in New York State. GOAL: The goal of the study was to assess willingness of individuals seeking HIV testing to (1) give counselors contact information about partners, if infected, and (2) contact partners on their own. STUDY DESIGN: Before implementation of the legislation, 1372 individuals seeking HIV testing at New York City Department of Health STD clinics completed a brief, anonymous survey. RESULTS: More than 90% of heterosexually active individuals and more than 80% of men who have sex with men (MSM) could contact sex partners with whom they had had unprotected vaginal/anal sex. Were they to test HIV-positive, almost all respondents would have been willing to notify sex partners personally; 90% of heterosexually active individuals and 80% of MSM also expressed willingness to provide contact information to providers. Respondents preferred to be notified by a sex partner rather than by a provider. Patient-referred clients reported being more comfortable with the referral than provider-referred clients. CONCLUSIONS: Voluntary partner notification performed by the index case-with notification by the provider should the former fail to occur-is recommended.     

Changes in partnerships and HIV risk behaviors after partner notification

BACKGROUND AND OBJECTIVE: Few studies have examined the effect of partner notification (PN) on behavior change and partnerships. This study investigated both. GOAL: The goal was to examine the effect of PN on sexual behaviors and partnership dissolution and formation. STUDY DESIGN Subjects included HIV-positive persons interviewed to identify partners for notification, partners notified of exposure, and HIV-negative persons receiving HIV counseling and testing (controls). Subjects were interviewed about behaviors and relationships at baseline and at 3- and 6-month visits. Partnerships in which both subject and partner received PN were compared to partnerships in which only the subject received PN and to control partnerships. RESULTS: Partnerships where both persons received PN were less likely to break up or acquire new partners and more likely to use condoms at follow-up. CONCLUSION: PN did not increase partnership dissolution or formation and was associated with higher condom use, suggesting the value of PN in HIV prevention.     

Patient preferences for partner notification

OBJECTIVE: To identify patient preferences for notification of sexual contacts when a sexually transmitted infection (STI) is diagnosed. METHODS: A questionnaire survey of 2544 patients attending three large genitourinary clinics at Derby, Birmingham, and Coventry in the United Kingdom. RESULTS: The median age of the respondents was 24 with 1474 (57.9%) women, 1835 (72.1%) white, 1826 (71.8%) single. The most favoured method of partner notification was patient referral, which was rated a "good" method by 65.8% when they had to be contacted because a sexual partner has an STI. Notifying contacts by letter as a method of provider partner notification is more acceptable than phoning, text messaging, or email. Respondents with access to mobile telephones, private emails, and private letters were more likely to rate a method of partner notification using that mode of communication as "good" compared to those without. With provider referral methods of partner notification respondents preferred to receive a letter, email, or text message asking them to contact the clinic rather than a letter, email or text message informing them that they may have an STI. CONCLUSION: Most respondents think that being informed directly by a partner is the best method of being notified of the risk of an STI. Some of the newer methods may not be acceptable to all but a significant minority of respondents prefer these methods of partner notification. The wording of letters, emails, or text messages when used for partner notification has an influence on the acceptability of the method and may influence success of the partner notification method. Services should be flexible enough to utilise the patients' preferred method of partner notification.     

Case-finding effectiveness of partner notification and cluster investigation for sexually transmitted diseases/HIV

OBJECTIVE: To assess the case-finding effectiveness of partner notification(PN) and cluster investigation for sexually transmitted disease (STD)/human immunodeficiency virus (HIV). STUDY: Literature review and quantitative summary. RESULTS: Since 1975, the median case-finding yield for syphilis, gonorrhea, and chlamydia PN reported in the literature is about 1 new case found for every 4 or 5 cases interviewed. The yield from HIV PN is approximately half as large, although there is substantial variability in yield across reports for each disease. Published reports underline the central role provider referral plays in effective PN and case-finding. Successful PN is more likely with index cases who are of majority ethnicity and detected through screening or spontaneous presentation for care with symptoms and with partners with whom index cases have had sexual contact that is recent, frequent, and of long duration. The case-finding yield for HIV PN also is much higher when cases are diagnosed through confidential, rather than anonymous, testing. Cluster investigation and related strategies tend to have lower case-finding yields than PN but can play a very useful case-finding role, especially in settings with high disease incidence. CONCLUSIONS: STD/HIV PN and cluster investigation can contribute meaningfully to case finding. More research is needed to strengthen the empiric foundation of PN and related strategies, including the impact they have on disease transmission.     

Partner notification for HIV infection in Denmark: attitudes and preliminary results.

OBJECTIVES: To examine attitudes, experience and preliminary results of partner notification (PN) for HIV infection in Denmark among the doctors who inform one of their patients about being HIV infected. METHOD: The doctors who had reported to the national HIV surveillance unit about a new-identified HIV infected person, during a 9 months period, were searched for one year later. The traced doctors were interviewed. The results of the interview related to 102 out of 195 (52%) reports were compared between the 48 interviewed general practitioners (GPs) and the 33 interviewed hospital doctors (HDs). The proportion of traced reporting doctors were higher among GPs than among HDs. RESULTS: Both GPs and HDs found it difficult to give a positive HIV test result and wanted trained counsellors to work with them in the PN process. Less experience and fewer post-graduate courses about HIV may explain the GPs' lack of confidence to follow-up asymptomatic HIV positive patients. It was neither a routine for all the GPs or for all HDs to ask about patient behaviour nor to discuss safe sex with their index patients, and screening for other sexually transmitted diseases were seldomly performed. The numbers of partners notified, especially by the doctors were low. CONCLUSIONS: HIV reporting doctors in Denmark are motivated for PN. Educational programmes about counselling and care of HIV infected patients should, however, be offered at intervals, especially to GPs. The outcome of PN can only be measured to a certain level as long as exposed partners are neither obliged to be tested nor to be counselled and as long as information about counselling and testing can not be shared between doctors in different settings.     

To notify or not to notify: STD patients' perspectives of partner notification in Seattle

BACKGROUND AND OBJECTIVES: To obtain patients' perspectives on why only some partners are notified in partner-notification programs, the cornerstone of sexually transmitted disease (STD) control, although low proportions of partners are located and evaluated. GOALS: To describe patterns of partner notification reported by persons with STD infection. STUDY DESIGN: In-depth interviews conducted in Seattle with 60 heterosexual men and women with gonorrhea, chlamydial infection, or nongonoccocal urethritis, and 19 men with gonorrhea reporting sex with men (MSM) were tape recorded, transcribed verbatim, and content analyzed. RESULTS: The typical notification pattern was to notify a main partner but not others. Least likely to be notified were partners perceived as transmitters, contacts preceding the onset of symptoms, the oral sex and anonymous contacts of MSM, one-time partners of men, and incarcerated and former partners of women. Fears among young heterosexual participants included gossip and violence (women). Fears among MSM included rejection. CONCLUSIONS: Partner-notification programs should develop innovative approaches for partners perceived as transmitters, oral-sex only contacts of MSM, and contacts preceding symptom onset.     

Partner notification for HIV and STD in the United States: low coverage for gonorrhea,chlamydial infection,and HIV

BACKGROUND: Little is known about the scope of current public health partner-notification (PN) activities in the United States. GOAL: The goal of the study was to define what PN services U.S. health departments provide in areas with high STD/HIV-related morbidity. STUDY DESIGN: The study involved a survey of STD program staff members in U.S. areas with the highest reported rates of infectious syphilis, gonorrhea, chlamydia, and HIV in 1998. RESULTS: Staff members of 60 (77%) of 78 health departments provided data. PN interviews were conducted with 7583 (89%) of 8492 cases of syphilis, 23,097 (17%) of 139,287 cases of gonorrhea, and 26,487 (12%) of 228,210 cases of chlamydia. In areas with mandatory HIV reporting, 4375 (52%) of 8328 persons infected with HIV were interviewed for PN. CONCLUSIONS: Except for patients with syphilis, public health PN services affect only a minority of persons with STD or HIV infection in high-morbidity areas of the United States.     

宁波鄞州地区男男性接触人群艾滋病知晓率及感染状况调查分析

目的:了解宁波市鄞州区2011至2014年男男性接触(MSM)人群艾滋病防治知识知晓率、相关高危行为情况及艾滋病感染状况,为制定防治策略提供依据。方法:通过"滚雪球"法招募到样本,对MSM人群进行问卷调查,并进行HIV、梅毒的血清学检测。结果:2011至2014年共调查MSM 345人,年龄分布以20~49岁年龄段为主,占95.9%;婚姻状况以未婚为主,有223人,占64.6%;文化程度以大专及以上为主。调查对象对艾滋病防治知识知晓率较高,且总体呈上升趋势。2011至2014年HIV阳性检出率介于2.9%~12.5%之间,梅毒抗体阳性检出率介于4.5%~11.8%之间。结论:我区MSM人群艾滋病流行形势较为严峻,改变该人群知识行为偏离的现象,提高其安全性行为,才能有效地降低艾滋病在该人群中的流行。     

性病专科病人HIV相关知识及筛查情况分析

目的：了解性病患者对HIV相关知识的认知度和对HIV筛查的态度。方法：对前来就诊的性病患者通过问卷调查和语言交流的形式获取相关信息和素材。结果：大部分患者对HIV知识欠缺;部分患者希望进行HIV检测。结论：对高危人群加强HIV相关知识宣传和心理疏导,能更有效预防和控制HIV的传播。     

HIV partner notification in the United States: a national survey of program coverage and outcomes

OBJECTIVE: The objective of this study was to define the scope and case-finding success of HIV partner notification (PN) in the United States. STUDY: The authors conducted an analysis of PN data from metropolitan areas >500,000 reporting > or =200AIDS cases in 2001. RESULTS: Data were collected from 28 (72%) of 39 eligible jurisdictions. In 22 jurisdictions with reportable HIV, health departments interviewed 32% of 20,353 persons with newly reported HIV. Among 6394 sex or needle-sharing partners, 19% had been previously HIV-diagnosed; 10% tested HIV-positive; 32% tested HIV-negative; and 39% were not notified, denied previous HIV diagnosis and refused HIV testing, or outcome was unknown. Health departments interviewed 13.8 persons to identify 1 new case of HIV (range, 1.0-196). Areas in which larger proportions of AIDS cases occurred among men who have sex with men reported less success identifying new cases of HIV through PN. CONCLUSIONS: HIV PN programs identify new cases of HIV but have variable success and affect a minority of persons reported with HIV.     

General practitioners' use of internet-based patient materials for partner notification

OBJECTIVES: To determine if general practitioners (GPs) would use chlamydia resources for partner notification (PN) when the address to a website was printed on positive results. STUDY DESIGN: Two surveys (pre-/postintervention) were sent to GPs before half were exposed to the website address on positive chlamydia results. RESULTS: Of 499 eligible GPs, 233 (48%) returned completed preintervention surveys and 173 of 233 GPs (78%) returned postintervention surveys. Partner letters increased from 13% (10/78) to 36% (28/78) (P = 0.0009) and brochures from 33% (26/78) to 54% (42/78) (P = 0.003) among those exposed to the website. There was no significant change among GPs not exposed to the website. GPs who reported practicing PN all of the time did not change but was greater than 93% in all groups. CONCLUSION: When a website was provided with useful documents on it, GPs were more likely to provide resources for clients to pass onto partners.     

HIV partner notification policy and practice within GUM clinics in England: where are we now?

OBJECTIVES: To evaluate the extent to which larger genitourinary medicine (GUM) clinics in England have established local clinic policies for HIV Partner Notification (PN) and to describe the process of HIV PN within this setting. DESIGN: A cross-sectional survey of HIV PN policies and practices within GUM clinics. SUBJECTS AND SETTING: Senior consultants in 59 GUM clinics in England. MAIN OUTCOME MEASURES: The presence of clinic policies for HIV PN, indicators of HIV PN activity (that is, its initiation, documentation, performance and evaluation) and factors hindering the acceptance of HIV PN into clinical practice. RESULTS: Only 18% (10/57) of respondents stated that their clinics had developed their own local policies for HIV PN. Fifteen percent (9/58) of clinics had audited HIV PN activity, 15% had provided specific HIV PN training for doctors and 47% (27/58) for health advisers. Within GUM clinics, health advisers play a key role in the HIV PN process, being responsible for initiating the discussion of partners, patient follow-up and documenting HIV PN activity in patients' notes. Notifying partners was primarily seen as the responsibility of the newly diagnosed HIV positive patient. Although 77% (43/56) of responding consultants believed that HIV PN had become an accepted part of their clinics' practice, the perceived unacceptability of HIV PN to patients and health care workers were seen as important limiting factors. CONCLUSION: In many GUM clinics, local policies on HIV PN have yet to be established and appropriate training for the health personnel provided. Nevertheless, there appears to be wide-spread acceptance of HIV PN in clinical practice with an acknowledgement of its limiting factors. Further research into the acceptability of HIV PN to health care workers and patients in this setting should be undertaken.