Improved effectiveness of partner notification for patients with sexually transmitted infections: systematic review.
Open accessAbstract
OBJECTIVE: To examine the effectiveness of methods to improve partner notification by patient referral (index patient has responsibility for informing sex partners of their exposure to a sexually transmitted infection). DESIGN: Systematic review of randomised trials of any intervention to supplement simple patient referral. DATA SOURCES: Seven electronic databases searched (January 1990 to December 2005) without language restriction, and reference lists of retrieved articles. REVIEW METHODS: Selection of trials, data extraction, and quality assessment were done by two independent reviewers. The primary outcome was a reduction of incidence or prevalence of sexually transmitted infections in index patients. If this was not reported data were extracted according to a hierarchy of secondary outcomes: number of partners treated; number of partners tested or testing positive; and number of partners notified, located, or elicited. Random effects meta-analysis was carried out when appropriate. RESULTS: 14 trials were included with 12 389 women and men diagnosed as having gonorrhoea, chlamydia, non-gonococcal urethritis, trichomoniasis, or a sexually transmitted infection syndrome. All studies had methodological weaknesses that could have biased their results. Three strategies were used. Six trials examined patient delivered partner therapy. Meta-analysis of five of these showed a reduced risk of persistent or recurrent infection in patients with chlamydia or gonorrhoea (summary risk ratio 0.73, 95% confidence interval 0.57 to 0.93). Supplementing patient referral with information for partners was as effective as patient delivered partner therapy. Neither strategy was effective in women with trichomoniasis. Two trials found that providing index patients with chlamydia with sampling kits for their partners increased the number of partners who got treated. CONCLUSIONS: Involving index patients in shared responsibility for the management of sexual partners improves outcomes. Health professionals should consider the following strategies for the management of individual patients: patient delivered partner therapy, home sampling for partners, and providing additional information for partners.
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U.S. trials and a meta-analysis of EPT revealed that the magnitude of reduction in reinfection of index patients, compared with patient referral, differed according to the STI and the sex of the index patient.
“U.S. trials and a meta-analysis of EPT revealed that the magnitude of reduction in reinfection of index patients, compared with patient referral, differed according to the STI and the sex of the index patient (110,125–127).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [110]
The Patient delivered partner therapy section reports fewer persistent or recurrent infections with partner therapy than with patient referral for chlamydia or gonorrhoea, but not for trichomonas. Its trial table lists outcomes for groups of men and women, but the review does not establish that the magnitude of the reduction differed according to the index patient's sex. Page numbers are unavailable in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredAcross EPT trials, reductions in chlamydia prevalence at follow-up were approximately 20%, and reductions in gonorrhea were approximately 50% at follow-up.
“However, across trials, reductions in chlamydia prevalence at follow-up were approximately 20%, and reductions in gonorrhea were approximately 50% at follow-up.”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [110]
The Patient delivered partner therapy section (page unavailable) reports fewer persistent or recurrent infections with partner therapy across chlamydia and gonorrhoea trials, with a pooled risk ratio of 0.73. It does not report separate across-trial reductions of approximately 20% for chlamydia and 50% for gonorrhoea, or describe the pooled outcome as prevalence at follow-up. (LLM, conf=0.86)
Experimental — accuracy not yet measuredClinicians' efforts to ensure treatment of patients' sex partners can reduce the risk for reinfection and potentially diminish transmission of STIs.
“Clinicians’ efforts to ensure treatment of patients’ sex partners can reduce the risk for reinfection and potentially diminish transmission of STIs (110).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [110]
Providing patients with written information to share with sex partners can increase rates of partner treatment.
“Evidence indicates that providing patients with written information to share with sex partners can increase rates of partner treatment (110).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [110]
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- Authors
- Trelle, S., Shang, A., Nartey, L., Cassell, J. A., & Low, N.
- Affiliations
- University of Bern (CH)
- The Royal Free Hospital (GB)
- Corresponding author
- Low, Nicola
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2007-01-19
- Volume
- 334
- Issue
- 7589
- Pages
- 354
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC1801006
- OpenAlex
- W2098327330
- Cited by
- 199
- References
- 24
- Citations by year
- 2025: 3 · 2024: 6 · 2023: 10 · 2022: 7 · 2021: 4 · 2020: 7 · 2019: 10 · 2018: 5 · 2017: 11 · 2016: 10 · 2015: 8 · 2014: 11 · 2013: 17 · 2012: 14
- FWCI
- 2.46
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Sussex Research Online (University of Sussex) (submittedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Social Sciences › General Social Sciences › HIV, TB, and STIs Epidemiology
- Keywords
- partner notification, sexually transmitted infections, patient-delivered partner therapy, referral, gonorrhea, chlamydia, non-gonococcal urethritis, trichomoniasis, partner testing, partner treatment, shared responsibility
- MeSH terms
- Humans, Referral and Consultation, Sexual Partners, Sexually Transmitted Diseases, Truth Disclosure, Randomized Controlled Trials as Topic, Contact Tracing
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