From the The Department of Mathematics and Computer Science, Rutgers University, New Brunswick, NJ.
Burrell Street Sexual Health Clinic, Guy's & St Thomas' NHS Foundation Trust, London, England, United Kingdom.
Sex Transm Dis. 2022 Dec 1;49(12):815-821. doi: 10.1097/OLQ.0000000000001707. Epub 2022 Sep 14.
Partner Notification (PN) is a key public health service to alert the partners of patients diagnosed with a sexually transmitted infection and then support these individuals to test. Partner Notification is a challenge to deliver because of the personal nature of this communication and the time it requires to deliver effectively. Digital tools have been developed to support patients to inform their partners; unfortunately, it has not been possible to measure engagement with-and the impact of-these solutions. A digital PN tool (dPNt) was developed for use by the health care provider to (1) deliver anonymous PN, (2) support the partner to locate and test at an appropriate local service, and (3) track real-time outcome metrics. To assess the usefulness of this tool we analyzed dPNt adoption and performance in the delivery of PN services.
A dPNt engagement for 5715 patients diagnosed by 23 health care providers with either gonorrhea or syphilis in 2019 was analyzed to determine what factors were associated with the use of this tool. The PN performance and a sub analysis of the patients who used dPNt was compared with the adjusted aggregate PN performance reported by Public Health England.
Overall, dPNt engagement was 21% and 27% for patients with gonorrhea and syphilis, respectively. Male gender patients with gonorrhea and younger patients with either diagnosis were more likely to engage with dPNt. Nonengagement with dPNt was associated with a significantly higher number of partners reported as already seen and tested at the time that PN was initiated. The overall number of partners seen and tested per index patient increased in the clinics using dPNt from 0.43 to 0.84 for gonorrhea and 0.71 to 0.94 for syphilis, relative to Public Health England baseline results. Half of all prospective partner testing verification was done automatically by dPNt and no interaction was demonstrated between dPNt and standard methods.
Digital PN tool engagement increased when more partners needed to be informed of their risk of infection. Future work is planned to improve the use of and engagement with dPNt to alert and test more partners or their risk and improve public health.
性伴侣通知(PN)是一项重要的公共卫生服务,旨在提醒患者的性伴侣已被诊断患有性传播感染,然后支持这些个体进行检测。PN 服务的实施具有挑战性,因为这种沟通具有隐私性,且需要花费时间才能有效实施。已经开发了数字工具来支持患者通知其性伴侣;不幸的是,尚未能够衡量这些解决方案的参与度和影响。为了便于医疗保健提供者实施匿名 PN 服务、支持伴侣在合适的当地服务机构进行定位和检测,并实时跟踪结果指标,开发了一种数字 PN 工具(dPNt)。为了评估该工具的有用性,我们分析了 dPNt 在 PN 服务实施中的采用情况和性能。
分析了 2019 年 23 名医疗保健提供者对 5715 名淋病或梅毒患者实施 PN 服务时 dPNt 的使用情况,以确定哪些因素与该工具的使用相关。比较了 dPNt 的 PN 性能和使用该工具的患者的子分析结果与英国公共卫生署报告的调整后 PN 总性能。
总体而言,淋病和梅毒患者分别有 21%和 27%使用了 dPNt。淋病男性患者和任何诊断的年轻患者更有可能使用 dPNt。不使用 dPNt 与报告的已就诊和检测的性伴侣数量显著增加有关。与英国公共卫生署的基线结果相比,使用 dPNt 的诊所中每位就诊患者的就诊和检测性伴侣数量从淋病的 0.43 增加到 0.84,梅毒的从 0.71 增加到 0.94。所有前瞻性伴侣检测验证的一半是由 dPNt 自动完成的,并且未发现 dPNt 与标准方法之间存在相互作用。
当需要通知更多性伴侣其感染风险时,dPNt 的使用和参与度会增加。未来的工作计划是改进 dPNt 的使用和参与度,以提醒和检测更多的性伴侣或其风险,从而改善公共卫生。