Digital interventions for STI and HIV partner notification: a scoping review

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

Improving digital partner notification for sexually transmitted infections and HIV through a systematic review and application of the Behaviour Change Wheel approach

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

Digital interventions for STI and HIV partner notification: a scoping review

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.</p

Digital interventions for STI and HIV partner notification: a scoping review

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

Improving digital partner notification for STIs and HIV through a systematic review and application of the behaviour change wheel approach

Background: Partner notification (PN) is key to controlling sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Digital PN options (e.g., social media, 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 APEASE criteria, and multidisciplinary expert input, to systematically develop practical recommendations to optimise digital PN.Results: 32 specific recommendations clustered around three themes: digital PNinterventions should i) empower and support the index patient by providing a range of notification options, accompanied by clear instructions; ii) integrate into users’ existing habits and the digital landscape, meeting contemporary standards and expectations of usability; and iii) 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

Provision of, and access to, sexual and reproductive health services during Covid-19:qualitative research with staff and clients/patients in England

Background The Covid-19 pandemic put unprecedented pressure on health services, including sexual and reproductive healthcare (SRH). Timely access to SRH prevents poor outcomes for individuals, and for population health. To inform future pandemic preparedness, we explored experiences of providing and accessing SRH services in England (within a multi-country, WHO-funded study).Methods In-depth interviews with a purposive sample of staff (about Covid-19’s impact on staff and services) and clients aged 18+ (about experiences of seeking/receiving care) of three contrasting SRH services in southeast England: a sexual health clinic, an abortion provider, and a sexual assault referral centre (SARC). Descriptive Thematic Analysis.Results Staff (n=8) interviews consistently revealed three themes: (i) Service disruption: severe disruption occurred during the March-July 2020 lockdown, but where feasible SRH services were transferred to telephone (e.g. consultations) and post (e.g. some contraceptive methods, medical abortion, STI self-sampling). Some core services (e.g. STI treatment, SARC services) continued in person. Access was widened during subsequent lockdowns. (ii) Staff impact: staff reported working from home, or providing services in person often with shortages of protective equipment, or redeployment to acute hospital care. Impacts included stress, loneliness, and (for redeployees) mismatches between skill-sets and new responsibilities. (iii) Adjustment and resilience: staff reported continual adjustment in mode of service delivery and breadth of services provided. Remote service delivery was generally welcomed, but considered more time-consuming to deliver. Colleagues’ absences were burdensome and stressful for staff.Provisional themes from clients (n=10, recruitment ongoing) include: (i) Perceptions of services as Covid-safe: despite reporting varying concerns about Covid-19’s severity and personal vulnerability. (ii) Navigating new routes to care: whilst some clients reported being able to access care rapidly and easily, services delivered in person were not always promptly available, which could be distressing.Discussion Prompt access to SRH could not always be maintained, despite efforts by staff/services. Remote delivery of some elements of SRH is popular with staff and clients. Staff concerns contrast with clients’ perceptions of SRH services as Covid-safe.People who did not use SRH â�� for whom perceived risk of Covid-19 may have been a barrier to seeking care â�� should be included in future research. When services were under particular pressure due to staff shortages, referral for client interviews slowed. Experiences of seeking/receiving care at these especially challenging times may therefore be under-explored.Interviews repeated later in 2022 will capture change over time. A quantitative Health Facility Assessment will complement our qualitative findings