Traditional and Web-Based Technologies to Improve Partner Notification Following Syphilis Diagnosis Among Men Who Have Sex With Men in Lima, Peru: Pilot Randomized Controlled Trial

“This approach allowed us to maximize the use of limited resources by assessing two different PN tools within a single clinical trial design, although it was not powered to assess for a synergistic interaction between the interventions [40,41].”

“Previously, printed partner referral cards have been used in various circumstances and appear to be effective in promoting notification within heterosexual partnerships [19,20].”

“To characterize patient-initiated notification systems, Ferreira et al differentiated between simple and enhanced patient referral [10].”

“In the enhanced referral, supplementary tools, including educational video- and theory-based counseling interventions, patient-delivered partner treatment, referral cards, or Web-based notification tools, could be used to motivate and support patient-directed notification efforts [15-18].”

“is generally more effective than patient-directed efforts, resource-limited health systems in low- and middle-income countries (LMIC) often lack the personnel necessary to conduct detailed contact-tracing studies and so depend primarily on patient-based notification [11-14].”

“Previously, printed partner referral cards have been used in various circumstances and appear to be effective in promoting notification within heterosexual partnerships [19,20].”

“Partner-based strategies also provide an opportunity to access individuals and sexual networks that remain unaccessed by traditional HIV or STI education and prevention interventions, such as men who have sex with men (MSM) but do not identify as gay or bisexual [4-6].”

“Partner-based strategies also provide an opportunity to access individuals and sexual networks that remain unaccessed by traditional HIV or STI education and prevention interventions, such as men who have sex with men (MSM) but do not identify as gay or bisexual [4-6].”

“By retracing existing transmission pathways, partner notification (PN) offers the possibility to target efforts to the specific sexual networks structuring the spread of disease in a population [2,3].”

“However, evidence of the effect of referral cards in developing country settings is limited, and their use within MSM partnerships has not, to our knowledge, been evaluated in any previous randomized controlled trials (RCTs) [21-23].”

“This approach allowed us to maximize the use of limited resources by assessing two different PN tools within a single clinical trial design, although it was not powered to assess for a synergistic interaction between the interventions [40,41].”

“However, evidence of the effect of referral cards in developing country settings is limited, and their use within MSM partnerships has not, to our knowledge, been evaluated in any previous randomized controlled trials (RCTs) [21-23].”

“The recent resurgence in syphilis infection among MSM in the United States and Europe (and the persistently high prevalence of syphilis in the global South) highlights the importance of developing and refining partner-based efforts to identify and treat syphilis transmission networks in high-risk populations [7-9].”

“Surveys of STI clinic patients in the United States and Australia, as well as MSM internet users in the United States, have found high levels of acceptability for Web-based notification systems [24-26].”

“In Europe and Australia, provider-managed internet notification has also been found to be useful in supporting PN during routine clinical practice [27-29].”

“In the enhanced referral, supplementary tools, including educational video- and theory-based counseling interventions, patient-delivered partner treatment, referral cards, or Web-based notification tools, could be used to motivate and support patient-directed notification efforts [15-18].”

“In Europe and Australia, provider-managed internet notification has also been found to be useful in supporting PN during routine clinical practice [27-29].”

“is generally more effective than patient-directed efforts, resource-limited health systems in low- and middle-income countries (LMIC) often lack the personnel necessary to conduct detailed contact-tracing studies and so depend primarily on patient-based notification [11-14].”

“United States assessing public awareness and the actual use of PN websites among community-based samples of MSM, as well as male and female visitors to STI clinics, found low levels of penetration into these target populations [31,32].”

“In the enhanced referral, supplementary tools, including educational video- and theory-based counseling interventions, patient-delivered partner treatment, referral cards, or Web-based notification tools, could be used to motivate and support patient-directed notification efforts [15-18].”

“is generally more effective than patient-directed efforts, resource-limited health systems in low- and middle-income countries (LMIC) often lack the personnel necessary to conduct detailed contact-tracing studies and so depend primarily on patient-based notification [11-14].”

“Partner-based strategies also provide an opportunity to access individuals and sexual networks that remain unaccessed by traditional HIV or STI education and prevention interventions, such as men who have sex with men (MSM) but do not identify as gay or bisexual [4-6].”

“Of 479 MSM and TW with latent infection and positive RPR and MHA-TP assays, 74 were diagnosed with a previously treated infection that did not require additional treatment, 64 did not return for their results, and 29 were enrolled in a concomitant trial of expedited partner therapy for gonorrhea or chlamydia infection…”

“By retracing existing transmission pathways, partner notification (PN) offers the possibility to target efforts to the specific sexual networks structuring the spread of disease in a population [2,3].”

“United States assessing public awareness and the actual use of PN websites among community-based samples of MSM, as well as male and female visitors to STI clinics, found low levels of penetration into these target populations [31,32].”

“is generally more effective than patient-directed efforts, resource-limited health systems in low- and middle-income countries (LMIC) often lack the personnel necessary to conduct detailed contact-tracing studies and so depend primarily on patient-based notification [11-14].”

“The only RCT data on the effectiveness of Web-based PN among MSM comes from an incomplete study in Seattle (Washington, USA) that found poor uptake and low levels of acceptability among potential recipients of Web-based notification messages [33].”

“While the Peruvian Ministry of Health maintains detailed guidelines for managing sexual partners of individuals with syphilis (including provider counseling, distribution of referral cards, and home treatment visits for partners of pregnant women), these services are delivered inconsistently in practice [35,36].”

“Surveys of STI clinic patients in the United States and Australia, as well as MSM internet users in the United States, have found high levels of acceptability for Web-based notification systems [24-26].”

“Sample size calculations were based on previous observational studies of Peruvian men and women diagnosed with HIV or STI [12,39].”

“Surveys of STI clinic patients in the United States and Australia, as well as MSM internet users in the United States, have found high levels of acceptability for Web-based notification systems [24-26].”

“These results are consistent with findings from our formative research and imply an absolute increase of 30% in the proportion of stable male partners notified and 15% among casual male partners [30].”

“To the best of our knowledge, no other study has conducted head-to-head comparisons of Web-based systems with other PN technologies [34].”

“The recent resurgence in syphilis infection among MSM in the United States and Europe (and the persistently high prevalence of syphilis in the global South) highlights the importance of developing and refining partner-based efforts to identify and treat syphilis transmission networks in high-risk populations [7-9].”

“However, evidence of the effect of referral cards in developing country settings is limited, and their use within MSM partnerships has not, to our knowledge, been evaluated in any previous randomized controlled trials (RCTs) [21-23].”

“The recent resurgence in syphilis infection among MSM in the United States and Europe (and the persistently high prevalence of syphilis in the global South) highlights the importance of developing and refining partner-based efforts to identify and treat syphilis transmission networks in high-risk populations [7-9].”

“patient-delivered partner therapy) following HIV or STI diagnosis promote treatment of occult infections in exposed partners, limiting the index partner’s risk for (re-) exposure and reducing the prevalence of untreated disease within their sexual network [57,58].”

“Participants were screened at STI clinics and venues frequented by MSM/TW in Lima and Callao, Peru between August 2012 and June 2014 (Clark et al., 2017, 2018).”

“4% successful PN in the United States [19], and 51% successful PN by patient referral card in Peru [20].”

“With reference to Clark et al. (2018), This type of learning describes how students should articulate their knowledge through collaboration and engagement.”

“Previous studies on both patient-initiated (where the individual positive for the disease alerts their contacts) and health care provider–initiated digital contact or partner notification have concluded that the use of emails and/or text messages to notify contacts increases the total number of contacts alerted when u…”