Can we improve partner notification rates through expedited partner therapy in the UK? Findings from an exploratory trial of Accelerated Partner Therapy (APT)

被引:32
作者
Estcourt, Claudia [1 ]
Sutcliffe, Lorna
Cassell, Jackie [2 ]
Mercer, Catherine H. [3 ]
Copas, Andrew [3 ]
James, Laura [3 ]
Low, Nicola [4 ]
Horner, Patrick [5 ]
Clarke, Michael [6 ]
Symonds, Merle
Roberts, Tracy [7 ]
Tsourapas, Angelos [7 ]
Johnson, Anne M. [3 ]
机构
[1] Barts & London NHS Trust, Ctr Infect Dis Sexual Hlth & HIV,Kenton & Lucas W, Blizard Inst Cell & Mol Sci,St Bartholomews Hosp, Barts & London Sch Med & Dent,Barts Sexual Hlth C, London EC1A 5BE, England
[2] Brighton & Sussex Med Sch, Div Primary Care & Publ Hlth, Brighton, E Sussex, England
[3] UCL, Res Dept Infect & Populat Hlth, Ctr Sexual Hlth & HIV Res, London, England
[4] Univ Bern, Inst Social & Prevent Med, Bern, Switzerland
[5] Univ Bristol, Sch Social & Community Med, Bristol, Avon, England
[6] Univ Hosp Bristol NHS Fdn Trust, Bristol, Avon, England
[7] Univ Birmingham, Hlth Econ Unit, Birmingham, W Midlands, England
关键词
SEXUALLY-TRANSMITTED INFECTIONS; INTERVENTIONS; TRANSMISSION;
D O I
10.1136/sti.2010.047258
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives To develop two new models of expedited partner therapy for the UK, and evaluate them for feasibility, acceptability and preliminary outcome estimates to inform the design of a randomised controlled trial (RCT). Methods Two models of expedited partner therapy (APTHotline and APTPharmacy), known as 'Accelerated Partner Therapy' (APT) were developed. A non-randomised comparative study was conducted of the two APT models and routine partner notification (PN), in which the index patient chose the PN option for his/her partner(s) in two contrasting clinics. Results The proportion of contactable partners treated when routine PN was chosen was 42/117 (36%) and was significantly higher if either APT option was chosen: APTHotline 80/135 (59%), p=0.003; APTPharmacy 29/44 (66%) p=0.001. However, partner treatment was often achieved through other routes. Although 40-60% of partners in APT groups returned urine samples for sexually transmitted infection (STI) testing, almost none accessed HIV and syphilis testing. APT options appear to facilitate faster treatment of sex partners than routine PN. Preferences and recruitment rates varied between sites, related to staff satisfaction with existing routine PN; approach to consent; and possibly, characteristics of local populations. Conclusions Both methods of APT were feasible and acceptable to many patients and led to higher rates of partner treatment than routine PN. Preferences and recruitment rates varied greatly between settings, suggesting that organisational and cultural factors may have an important impact on the feasibility of an RCT and on outcomes. Mindful of these factors, it is proposed that APT should now be evaluated in a cluster RCT.
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页码:21 / 26
页数:6
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