数字干预措施在性传播感染和艾滋病毒伴侣通知中的应用:范围综述。
Digital interventions for STI and HIV partner notification: a scoping review.
机构信息
Institute for Global Health, University College London, London, UK.
Institute for Global Health, University College London, London, UK
出版信息
Sex Transm Infect. 2024 May 31;100(4):242-250. doi: 10.1136/sextrans-2023-056097.
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.
背景
性传播感染(STI)和人类免疫缺陷病毒(HIV)的控制关键在于性伴侣通知(PN)。数字干预措施已被用于促进 PN。本研究进行了范围界定审查,以从患者和伴侣的角度描述干预措施、数字 PN 干预措施的用户偏好和可接受性。
方法
对 8 个数据库进行了系统的文献检索,以获取发表在英文、可在线获取且具有数字 PN 结局数据的文章。使用混合方法评估工具评估文章。使用主题分析对定量和定性数据进行综合和分析。
结果
26 篇文章符合入选标准。文章在质量和设计上存在异质性,其中大多数使用了定量方法。9 篇文章仅关注细菌性 STI(5 篇梅毒;4 篇衣原体),1 篇关注 HIV,2 篇梅毒和 HIV,14 篇包括多种 STI,其中 13 篇包括 HIV。随着时间的推移,数字 PN 干预措施已从单纯通知伴侣转变为包括伴侣管理元素的干预措施,例如促进伴侣检测和治疗,或共享 STI 检测结果(在索引患者和检测性伴侣之间)。主要结局指标为通知的伴侣数量(13 篇文章)、伴侣检测/咨询(8 篇文章)和治疗(5 篇文章)。关系类型和 STI 类型似乎影响了索引患者对数字 PN 的偏好,数字方法更适合于随意性而非固定性的伴侣类型。总体而言,伴侣更喜欢面对面的 PN。
结论
迄今为止,数字 PN 主要集中在通知伴侣而不是全面的伴侣管理上。尽管伴侣普遍更倾向于面对面的 PN,但数字 PN 可能在改善某些特定类型的伴侣和感染的结局方面发挥有用的作用。需要进一步研究来了解数字 PN 干预措施对特定 PN 结局的影响、对不同感染的有效性,并包括健康经济学评价。