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Woodward C, Bloch S, McInnes-Dean A, Lloyd KC, McLeod J, Saunders J, Flowers P, Estcourt CS, Gibbs J. Digital interventions for STI and HIV partner notification: a scoping review. Sex Transm Infect 2024; 100:242-250. [PMID: 38754986 PMCID: PMC11187395 DOI: 10.1136/sextrans-2023-056097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/21/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Partner notification (PN) is key to the control of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Digital interventions have been used to facilitate PN. A scoping review was conducted to describe the interventions used, user preferences and acceptability of digital PN interventions from patient and partner perspectives. METHODS A systematic literature search was conducted of eight databases for articles published in English, available online with digital PN outcome data. Articles were assessed using the Mixed Methods Appraisal Tool. Quantitative and qualitative data were synthesised and analysed using thematic analysis. RESULTS Twenty-six articles met the eligibility criteria. Articles were heterogeneous in quality and design, with the majority using quantitative methods. Nine articles focused solely on bacterial STIs (five on syphilis; four on chlamydia), one on HIV, two on syphilis and HIV, and 14 included multiple STIs, of which 13 included HIV. There has been a shift over time from digital PN interventions solely focusing on notifying partners, to interventions including elements of partner management, such as facilitation of partner testing and treatment, or sharing of STI test results (between index patients and tested sex partners). Main outcomes measured were number of partners notified (13 articles), partner testing/consultation (eight articles) and treatment (five articles). Relationship type and STI type appeared to affect digital PN preferences for index patients with digital methods preferred for casual rather than established partner types. Generally, partners preferred face-to-face PN. CONCLUSION Digital PN to date mainly focuses on notifying partners rather than comprehensive partner management. Despite an overall preference for face-to-face PN with partners, digital PN could play a useful role in improving outcomes for certain partner types and infections. Further research needs to understand the impact of digital PN interventions on specific PN outcomes, their effectiveness for different infections and include health economic evaluations.
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Affiliation(s)
| | - Sonja Bloch
- Institute for Global Health, University College London, London, UK
| | | | - Karen C Lloyd
- Institute for Global Health, University College London, London, UK
| | - Julie McLeod
- School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - John Saunders
- Institute for Global Health, University College London, London, UK
| | - Paul Flowers
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Claudia S Estcourt
- School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
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Kocur W, McLeod J, Bloch SCM, MacDonald JJ, Woodward C, McInnes-Dean A, Gibbs JJ, Saunders JJ, Blandford AA, Estcourt C, Flowers P. Improving digital partner notification for sexually transmitted infections and HIV through a systematic review and application of the Behaviour Change Wheel approach. Sex Health 2024; 21:SH23168. [PMID: 38402852 DOI: 10.1071/sh23168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/30/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Partner notification (PN) is key to controlling sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Digital PN options (e.g. social media, short message service (SMS), emails) are promising in increasing PN behaviour. However, their implementation is often challenging and studies report varied levels of acceptability and uptake of PN, highlighting the need to optimise digital PN interventions. METHODS A systematic review of barriers and facilitators to digital PN interventions for STIs, including HIV, across eight research databases (from 2010 to 2023) identified eight relevant studies, two of which addressed HIV. Data extraction identified 98 barriers and 54 facilitators to the use of digital PN interventions. These were synthesised into 18 key barriers and 17 key facilitators that were each deemed amenable to change. We then used the Behaviour Change Wheel approach, the Acceptability, Practicability, Effectiveness, Affordability, Side-effects and Equity criteria, and multidisciplinary expert input, to systematically develop practical recommendations to optimise digital PN. RESULTS Thirty-two specific recommendations clustered around three themes. Digital PN interventions should: (1) empower and support the index patient by providing a range of notification options, accompanied by clear instructions; (2) integrate into users' existing habits and the digital landscape, meeting contemporary standards and expectations of usability; and (3) address the social context of PN both online and offline through normalising the act of PN, combating STI-related stigma and stressing the altruistic aspects of PN through consistent messaging to service users and the public. CONCLUSIONS Our evidence-based recommendations should be used to optimise existing digital PN interventions and inform the co-production of new ones.
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Affiliation(s)
- Will Kocur
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Julie McLeod
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | | | - Jennifer J MacDonald
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Charlotte Woodward
- Institute for Global Health, University College London, London, England, UK
| | | | - Jo J Gibbs
- Institute for Global Health, University College London, London, England, UK
| | - John J Saunders
- Institute for Global Health, University College London, London, England, UK; and UK Health Security Agency, Colindale, England, UK
| | | | - Claudia Estcourt
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Paul Flowers
- Psychological Science and Health, University of Strathclyde, Glasgow, Scotland, UK
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López-de Munain J, Cámara-Pérez MDM, López-Martinez M, Alava-Menica JA, Hernandez-Ragpa L, Imaz-Pérez M, Tejeiro-Pulido MJ, Mojas-Díez I, de la Peña-Trigueros M, Díaz-de Tuesta-Del Arco JL, Muñoz-Sánchez J. Clinical and epidemiological characteristics of Chlamydia trachomatis infection among sexually transmitted infection clinics patients. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:359-366. [PMID: 35550362 DOI: 10.1016/j.eimce.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Chlamydia trachomatis (CT) infections are a public health problem because of its high incidence and consequences on reproductive health. Our aim is to describe the socio-demographic, behavioral and clinical characteristics of patients with CT infection in order to adapt preventive interventions for the highest risk groups. METHODS Prospective case series of all patients diagnosed with CT between September 2016 and January 2019 in the reference STI clinics of Osakidetza (Basque Health Service) in Bizkaia (Spain). RESULTS 847 patients (88.2%) agreed to participate: 41% women, 33.8% heterosexual men and 25% men who has sex with men (MSM); 33% were immigrants and 26% were under the age of 25 (33% of the women). Only 20% systematically used condoms. 36% had previously had STI and 28% had simultaneously another STI. 55% of the infections were asymptomatic (70% among women). In MSM, the rectum was affected in 69.5% of cases, the urethra in 31.4%, and the pharynx in 14.5%. The cervix was affected in 86.5% of the women, the rectum in 17.6%, and the pharynx in 13.8%. A contact study was only carried out in 58% of cases. The reinfection rate at 4 weeks was 17% among those with criteria to perform a test of cure. CONCLUSION Our results justify implement opportunistic screening in women under the age of 25 and young immigrants of both sexes, by taking genital and extragenital samples, as well as developing appropriate guidelines for the notification and follow-up of contacts.
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Affiliation(s)
- Josefina López-de Munain
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, Spain; Instituto de Investigación Biocruces, Bizkaia, Spain.
| | - Maria Del Mar Cámara-Pérez
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, Spain
| | - Miriam López-Martinez
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, Spain
| | - Jose Angel Alava-Menica
- Servicio de Microbiología Clínica y Control de Infección, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, Spain
| | - Leonora Hernandez-Ragpa
- Servicio de Microbiología Clínica y Control de Infección, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, Spain
| | - Manuel Imaz-Pérez
- Servicio de Microbiología Clínica y Control de Infección, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, Spain
| | - Maria José Tejeiro-Pulido
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, Spain
| | - Iker Mojas-Díez
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, Spain
| | - Mireia de la Peña-Trigueros
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, Spain
| | - Jose Luis Díaz-de Tuesta-Del Arco
- Servicio de Microbiología Clínica y Control de Infección, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, Spain
| | - Josefa Muñoz-Sánchez
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, Spain; Instituto de Investigación Biocruces, Bizkaia, Spain
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López-de Munain J, Cámara-Pérez MDM, López-Martinez M, Alava-Menica JA, Hernandez-Ragpa L, Imaz-Pérez M, Tejeiro-Pulido MJ, Mojas-Díez I, de la Peña-Trigueros M, Díaz-de Tuesta-Del Arco JL, Muñoz-Sánchez J. Clinical and epidemiological characteristics of Chlamydia trachomatis infection among sexually transmitted infection clinics patients. Enferm Infecc Microbiol Clin 2021; 40:S0213-005X(21)00200-7. [PMID: 34304925 DOI: 10.1016/j.eimc.2021.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Chlamydia trachomatis (CT) infections are a public health problem because of its high incidence and consequences on reproductive health. Our aim is to describe the socio-demographic, behavioral and clinical characteristics of patients with CT infection in order to adapt preventive interventions for the highest risk groups. METHODS Prospective case series of all patients diagnosed with CT between September 2016 and January 2019 in the reference STI clinics of Osakidetza (Basque Health Service) in Bizkaia (Spain) RESULTS: 847 patients (88.2%) agreed to participate: 41% women, 33.8% heterosexual men and 25% men who has sex with men (MSM); 33% were immigrants and 26% were under the age of 25 (33% of the women). Only 20% systematically used condoms. 36% had previously had STI and 28% had simultaneously another STI. 55% of the infections were asymptomatic (70% among women). In MSM, the rectum was affected in 69.5% of cases, the urethra in 31.4%, and the pharynx in 14.5%. The cervix was affected in 86.5% of the women, the rectum in 17.6%, and the pharynx in 13.8%. A contact study was only carried out in 58% of cases. The reinfection rate at 4 weeks was 17% among those with criteria to perform a test of cure. CONCLUSION Our results justify implement opportunistic screening in women under the age of 25 and young immigrants of both sexes, by taking genital and extragenital samples, as well as developing appropriate guidelines for the notification and follow-up of contacts.
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Affiliation(s)
- Josefina López-de Munain
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, España; Instituto de Investigación Biocruces, Bizkaia, España.
| | - Maria Del Mar Cámara-Pérez
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, España
| | - Miriam López-Martinez
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, España
| | - Jose Angel Alava-Menica
- Servicio de Microbiología Clínica y Control de Infección, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, España
| | - Leonora Hernandez-Ragpa
- Servicio de Microbiología Clínica y Control de Infección, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, España
| | - Manuel Imaz-Pérez
- Servicio de Microbiología Clínica y Control de Infección, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, España
| | - Maria José Tejeiro-Pulido
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, España
| | - Iker Mojas-Díez
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, España
| | - Mireia de la Peña-Trigueros
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, España
| | - José Luis Díaz-de Tuesta-Del Arco
- Servicio de Microbiología Clínica y Control de Infección, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, España
| | - Josefa Muñoz-Sánchez
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto (OSI Bilbao-Basurto, Osakidetza), Bilbao, España; Instituto de Investigación Biocruces, Bizkaia, España
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Maloney KM, Bratcher A, Wilkerson R, Sullivan PS. Electronic and other new media technology interventions for HIV care and prevention: a systematic review. J Int AIDS Soc 2020; 23:e25439. [PMID: 31909896 PMCID: PMC6945883 DOI: 10.1002/jia2.25439] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 11/04/2019] [Accepted: 12/04/2019] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Electronic and other new media technologies (eHealth) can facilitate large-scale dissemination of information and effective delivery of interventions for HIV care and prevention. There is a need to both monitor a rapidly changing pipeline of technology-based care and prevention methods and to assess whether the interventions are appropriately diversified. We systematically review and critically appraise the research pipeline of eHealth interventions for HIV care and prevention, including published studies and other funded projects. METHODS Two peer-reviewed literature databases were searched for studies describing the development, trial testing or implementation of new technology interventions, published from September 2014 to September 2018. The National Institutes of Health database of grants was searched for interventions still in development. Interventions were included if eHealth was utilized and an outcome directly related to HIV treatment or prevention was targeted. We summarized each intervention including the stage of development, eHealth mode of delivery, target population and stage of the HIV care and prevention continua targeted. RESULTS AND DISCUSSION Of 2178 articles in the published literature, 113 were included with 84 unique interventions described. The interventions utilize a variety of eHealth technologies and target various points on the prevention and care continua, with greater emphasis on education, behaviour change and testing than linkage to medical care. There were a variety of interventions for HIV care support but none for PrEP care. Most interventions were developed for populations in high income countries. An additional 62 interventions with funding were found in the development pipeline, with greater emphasis on managing HIV and PrEP care. CONCLUSIONS Our systematic review found a robust collection of eHealth interventions in the published literature as well as unpublished interventions still in development. In the published literature, there is an imbalance of interventions favouring education and behaviour change over linkage to care, retention in care, and adherence, especially for PrEP. The next generation of interventions already in the pipeline might address these neglected areas of care and prevention, but the development process is slow. Researchers need new methods for more efficient and expedited intervention development so that current and future needs are addressed.
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Affiliation(s)
| | - Anna Bratcher
- Department of EpidemiologyUniversity of CaliforniaLos AngelesCAUSA
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Sender and Receiver Acceptability and Usability of an Online Partner Notification Tool for Sexually Transmitted Infection in the Netherlands. Sex Transm Dis 2019; 45:354-357. [PMID: 29642233 DOI: 10.1097/olq.0000000000000738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Users (index patients with a verified sexually transmitted infection and notified partners) rated the health care provider-initiated Internet-based partner notification application Suggestatest.nl acceptable and usable. Both groups were less positive about Suggestatest.nl to notify/get notified of HIV than other sexually transmitted infection. An anonymous notification was perceived less acceptable.
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Xiao X, Zhao J, Tang C, Li X, Simoni JM, Wang H, Fennie KP. Psychometric testing of the consequences of an HIV disclosure instrument in Mandarin: a cross-sectional study of persons living with HIV in Hunan, China. Patient Prefer Adherence 2018; 12:1451-1459. [PMID: 30147303 PMCID: PMC6103303 DOI: 10.2147/ppa.s168571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aimed to examine the psychometric properties of a Mandarin-language version of an instrument that assesses the Consequences of HIV Disclosure (CoHD). PATIENTS AND METHODS The original CoHD instrument developed by Serovich was translated into Mandarin and administered to a random sample of 184 persons living with HIV (PLWH) using face-to-face and structured interviews. The CoHD instrument required respondents to rate the importance of eight costs (eg, might lose the relationship) and ten rewards (eg, would bring us closer) in their decision about whether to self-disclose their HIV status. The participants were directed to respond with respect to a current (or hypothetical) sexual partner. RESULTS Internal consistency was acceptable (Cronbach's α for the overall scale 0.82, costs 0.71, and rewards 0.86), as was stability (test-retest reliability overall 0.74, cost 0.63, and rewards 0.82). The CVI for the scale was 0.83, with items rated by subject experts ranging from 0.80 to 1.0. To determine structural validity, exploratory factor analysis extracted two subscales consistent with the original CoHD subscales. The Mandarin CoHD scores were significantly correlated with disclosure self-efficacy (indicating convergent validity), but they were unrelated to safer sex efficacy (indicating divergent validity). This criterion was tested by comparing the scores of PLWH who disclosed their HIV status (mean±SD 53.57±9.06) with those who did not disclose it (mean±SD 49.63±7.45); however, the difference was not statistically significant. CONCLUSION The Mandarin version of the CoHD instrument demonstrates promising psychometric properties when assessing costs and rewards with respect to sexual partner disclosure. This suggests that it might be useful in research on partner notification strategies. In further studies, larger and more diverse samples and an analysis of responses for different disclosure targets are warranted. Moreover, whether the CoHD score is related to the decision of disclosure should be determined.
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Affiliation(s)
- Xueling Xiao
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China,
| | - Junshi Zhao
- Department of STD/AIDS, Center for Disease Control and Prevention of Hunan Province, Changsha, People's Republic of China
| | - Chulei Tang
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China,
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China,
| | - Jane M Simoni
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha, People's Republic of China,
| | - Kristopher P Fennie
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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Abstract
Effective HIV prevention requires knowledge of the structure and dynamics of the social networks across which infections are transmitted. These networks most commonly comprise chains of sexual relationships, but in some populations, sharing of contaminated needles is also an important, or even the main mechanism that connects people in the network. Whereas network data have long been collected during survey interviews, new data sources have become increasingly common in recent years, because of advances in molecular biology and the use of partner notification services in HIV prevention and treatment programmes. We review current and emerging methods for collecting HIV-related network data, as well as modelling frameworks commonly used to infer network parameters and map potential HIV transmission pathways within the network. We discuss the relative strengths and weaknesses of existing methods and models, and we propose a research agenda for advancing network analysis in HIV epidemiology. We make the case for a combination approach that integrates multiple data sources into a coherent statistical framework.
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