Strategies for sexually transmitted infection partner notification

South Africa's HIV epidemic has increased rapidly over the last 10 years, and developing effective strategies to curb it is a priority. The presence of other sexually transmitted infections (STIs) facilitates the sexual transmission of HIV, and the control of STIs has been shown to be an effective way of reducing HIV incidence. One component of the process of STI control is partner notification: a process whereby the sexual partners of patients who have been diagnosed with an STI are informed of their exposure to infection and of the importance of obtaining effective treatment. Partner notification is one of the two strategies to reach and treat asymptomatic and unrecognised STIs, which are highly prevalent in South Africa. Unfortunately, current partner notification strategies are not very effective, and there is a need to improve their effectiveness. This thesis investigates strategies to improve partner notification in South Africa. This aim is achieved through three separate studies. The first is a systematic review of published and unpublished randomized controlled trials (RCTs) conducted around the world, comparing the effects various partner notification strategies, in an attempt to uncover evidence of effective strategies. The review uses methods advocated by the Cochrane Collaboration. Eleven RCTs were found, including 8014 participants, only two of which were conducted in developing countries. The review found moderately strong evidence that either provider referral alone, or the choice between patient and provider referral, or contract referral, when compared with patient referral, improved partner notification. This evidence is of limited value in South Africa, where public health services have not been able to implement provider or contract referral due to the prohibitive staffing costs involved. The review also found that verbal, nurse-given health education together with intense patient-centred counselling by lay workers, when compared with standard care results in small increases in the rate of partners treated. The review concludes that there is a need for evaluations of patient education interventions (including audiovisual presentations), of interventions combining provider training and patient education, and for evaluations to be conducted in developing countries. Further, there is a need to measure potential harmful effects, such as domestic violence, to ensure that partner notification does more good than harm.

Grantor dc:publisher.institution

Department of Public Health and Family Medicine

Year dc:date.issued

2002

Author dc:creator

• Mathews, Catherine

Advisors dc:contributor.advisor

• Coetzee, Nicol
• Myers, Jonny

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/11427/9377

OAI identifier oai:identifier

oai:open.uct.ac.za:11427/9377