The Use of Technology for Sexually Transmitted Disease Partner Services in the United States: A Structured Review

Background: Since the late 1990s, health departments and sexually transmitted disease (STD) programs throughout the United States have used technologies, such as the Internet and mobile phones, to provide services to persons with a sexually transmitted infection, including human immunodeficiency virus (HIV), and their sex partners, also known as partner services. This study reviewed the published literature to assess and compare partner services outcomes as a result of using technology and to calculate cost savings through cases averted. Methods: We conducted a structured literature review of all US studies that examined the use of technology to notify persons exposed to an STD (syphilis, chlamydia, gonorrhea), including HIV, by health care professionals in the United States from 2000 to 2017. Outcome measures, including the number of partners notified, screened or tested; and new positives identified, were captured and cost savings were calculated, when data were available. Results: Seven studies were identified. Methods used for partner services differed across studies, although email was the primary mode in 6 (83%) of the 7 studies. Only 2 of the 7 studies compared use of technology for partner services to traditional partner services. Between 10% and 97% of partners were successfully notified of their exposure through the use of technology and between 34% and 81% were screened or tested. Five studies reported on new infections identified, which ranged from 3 to 19. Use of technology for partner serves saved programs between US $22,795 and US $45,362 in direct and indirect medical costs. Conclusions: Use of technology for partner services increased the number of partners notified, screened or tested, and new infections found. Importantly, the use of technology allowed programs to reach partners who otherwise would not have been notified of their exposure to an STD or HIV. Improved response times and time to treatment were also seen as was re-engagement into care for previous HIV positive patients. Data and outcome measures across the studies were not standardized, making it difficult to generalize conclusions. Although not a replacement for traditional partner services, the use of technology enhances partner service outcomes.