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Current practices of partner notification among MSM with HIV, gonorrhoea and syphilis in the Netherlands: an urgent need for improvement.

van Aar F, Schreuder I, van Weert Y, Spijker R, Götz H, Op de Coul E, Partner Notification Gro - BMC Infect. Dis. (2012)

Bottom Line: This study aims to fill this gap by assessing current PN practices, case-finding effectiveness, and determinants of being notified among men having sex with men (MSM) in the Netherlands.PN outcomes including case-finding effectiveness (number of newly diagnosed cases in partners/number of partners being tested) for HIV, syphilis, and gonorrhoea were studied among MSM.To enhance PN practices, combined and innovative PN interventions such as Internet-based PN will be implemented for hard-to-reach MSM and other risk groups.

View Article: PubMed Central - HTML - PubMed

Affiliation: Epidemiology & Surveillance department, Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, the Netherlands.

ABSTRACT

Background: Partner notification (PN) among individuals newly diagnosed with HIV/STI is seen as a vital tool to identify others at risk of infection. However, hardly any data are available on the effectiveness of PN on HIV/STI transmission in the Netherlands. This study aims to fill this gap by assessing current PN practices, case-finding effectiveness, and determinants of being notified among men having sex with men (MSM) in the Netherlands.

Methods: Nurses from five STI centers participated in a prospective pilot study on PN outcomes (partners being: at risk, notifiable, notified, and tested) for HIV/STI, by completing a newly developed PN registration form (PN database). PN outcomes including case-finding effectiveness (number of newly diagnosed cases in partners/number of partners being tested) for HIV, syphilis, and gonorrhoea were studied among MSM. Furthermore, the national STI database was analyzed to identify determinants of being notified. The number of infections that remained undetected was estimated based on these two databases.

Results: In total 105 MSM, newly diagnosed with HIV/STI, reported 612 sexual partners at risk of whom 41% were notifiable and 31% were notified. Patient referral was the predominant PN method (90%). The overall case-finding percentage was 36% (HIV: 15-33%, gonorrhoea: 17-50% and syphilis: 4-11%). Case-finding percentages were lower in the national STI database: 21% (5%, 28%, 12%). Persons with one or more sexual partners, known HIV positives, and IDU were more likely to be notified to the STI clinic. Notified clients were more likely to have HIV/STI than unnotified clients (OR 1.7-2.5). Based on these two databases, an estimated 75 to 133 infections remained undetected (HIV: 12-90; gonorrhoea: 28-97; syphilis: 5-12 infections).

Conclusions: Partner notification among MSM in the Netherlands is suboptimal; an extensive number of STI/HIV infections remained undetected mainly due to unnotifiable partners. To enhance PN practices, combined and innovative PN interventions such as Internet-based PN will be implemented for hard-to-reach MSM and other risk groups.

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Case-finding effectiveness of PN among MSM.
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Figure 1: Case-finding effectiveness of PN among MSM.

Mentions: Index patients (n = 96) reported a total of 612 sexual partners at risk for HIV/STI of whom 254 (41%) were notifiable and 221 were notified (36%) (Figure 1). These findings imply that 64% (n = 391) of the partners at risk were lost along the PN process, mainly due to anonymity (being ‘unnotifiable’). However, when partners were notifiable it was likely that they were notified (87%). For 86 index patients, detailed information on type of partners was available (Table 2). Of these, a total of 210 partners was reported of which 79% was casual. Of these, 36% were met through friends, 30% were contacted through Internet and 22% were gained in bars/clubs, (sex) parties or saunas. Index patients reported that for 70% of the casual partners the last sexual contact was unprotected.


Current practices of partner notification among MSM with HIV, gonorrhoea and syphilis in the Netherlands: an urgent need for improvement.

van Aar F, Schreuder I, van Weert Y, Spijker R, Götz H, Op de Coul E, Partner Notification Gro - BMC Infect. Dis. (2012)

Case-finding effectiveness of PN among MSM.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3472393&req=5

Figure 1: Case-finding effectiveness of PN among MSM.
Mentions: Index patients (n = 96) reported a total of 612 sexual partners at risk for HIV/STI of whom 254 (41%) were notifiable and 221 were notified (36%) (Figure 1). These findings imply that 64% (n = 391) of the partners at risk were lost along the PN process, mainly due to anonymity (being ‘unnotifiable’). However, when partners were notifiable it was likely that they were notified (87%). For 86 index patients, detailed information on type of partners was available (Table 2). Of these, a total of 210 partners was reported of which 79% was casual. Of these, 36% were met through friends, 30% were contacted through Internet and 22% were gained in bars/clubs, (sex) parties or saunas. Index patients reported that for 70% of the casual partners the last sexual contact was unprotected.

Bottom Line: This study aims to fill this gap by assessing current PN practices, case-finding effectiveness, and determinants of being notified among men having sex with men (MSM) in the Netherlands.PN outcomes including case-finding effectiveness (number of newly diagnosed cases in partners/number of partners being tested) for HIV, syphilis, and gonorrhoea were studied among MSM.To enhance PN practices, combined and innovative PN interventions such as Internet-based PN will be implemented for hard-to-reach MSM and other risk groups.

View Article: PubMed Central - HTML - PubMed

Affiliation: Epidemiology & Surveillance department, Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, the Netherlands.

ABSTRACT

Background: Partner notification (PN) among individuals newly diagnosed with HIV/STI is seen as a vital tool to identify others at risk of infection. However, hardly any data are available on the effectiveness of PN on HIV/STI transmission in the Netherlands. This study aims to fill this gap by assessing current PN practices, case-finding effectiveness, and determinants of being notified among men having sex with men (MSM) in the Netherlands.

Methods: Nurses from five STI centers participated in a prospective pilot study on PN outcomes (partners being: at risk, notifiable, notified, and tested) for HIV/STI, by completing a newly developed PN registration form (PN database). PN outcomes including case-finding effectiveness (number of newly diagnosed cases in partners/number of partners being tested) for HIV, syphilis, and gonorrhoea were studied among MSM. Furthermore, the national STI database was analyzed to identify determinants of being notified. The number of infections that remained undetected was estimated based on these two databases.

Results: In total 105 MSM, newly diagnosed with HIV/STI, reported 612 sexual partners at risk of whom 41% were notifiable and 31% were notified. Patient referral was the predominant PN method (90%). The overall case-finding percentage was 36% (HIV: 15-33%, gonorrhoea: 17-50% and syphilis: 4-11%). Case-finding percentages were lower in the national STI database: 21% (5%, 28%, 12%). Persons with one or more sexual partners, known HIV positives, and IDU were more likely to be notified to the STI clinic. Notified clients were more likely to have HIV/STI than unnotified clients (OR 1.7-2.5). Based on these two databases, an estimated 75 to 133 infections remained undetected (HIV: 12-90; gonorrhoea: 28-97; syphilis: 5-12 infections).

Conclusions: Partner notification among MSM in the Netherlands is suboptimal; an extensive number of STI/HIV infections remained undetected mainly due to unnotifiable partners. To enhance PN practices, combined and innovative PN interventions such as Internet-based PN will be implemented for hard-to-reach MSM and other risk groups.

Show MeSH
Related in: MedlinePlus