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

• Published in: Journal of medical Internet research 2018-07, Vol.20 (7), p.e232-e232
• Main Authors: Clark, Jesse L, Segura, Eddy R, Oldenburg, Catherine E, Salvatierra, Hector J, Rios, Jessica, Perez-Brumer, Amaya Gabriela, Gonzales, Pedro, Sheoran, Bhupendra, Sanchez, Jorge, Lama, Javier R
• Format: Article
• Language: English
• Subjects: Adult; Antibiotics; Asymptomatic; Clinical trials; Contact Tracing - methods; Counseling; Enrollments; HIV; Homosexuality, Male - psychology; Human immunodeficiency virus; Humans; Infections; Internet; Male; Medical diagnosis; Medical referrals; Men who have sex with men; Notification; Original Paper; Partnerships; Penicillin; Peru; Pilot Projects; Sexual and Gender Minorities - psychology; Sexual and Gender Minorities - statistics & numerical data; Sexual behavior; Sexual Behavior - psychology; Sexual Behavior - statistics & numerical data; Sexual Partners - psychology; Sexually transmitted diseases; Sexually Transmitted Diseases - diagnosis; Sexually Transmitted Diseases - pathology; STD; Syphilis; Syphilis - diagnosis; Syphilis - pathology; Transgender persons
• ISSN: 1438-8871; 1439-4456; 1438-8871
• DOI: 10.2196/jmir.9821

Patient-initiated partner notification (PN) following the diagnosis of a sexually transmitted infection is a critical component of disease control in men who have sex with men (MSM) sexual networks. Both printed and internet-based technologies offer potential tools to enhance traditional partner notification approaches among MSM in resource-limited settings. This randomized controlled trial aimed to evaluate the effect of 2 different PN technologies on notification outcomes following syphilis diagnosis among MSM in Peru: a Web-based notification system and patient-delivered partner referral cards. During 2012-2014, we screened 1625 MSM from Lima, Peru, for syphilis infection and enrolled 370 MSM with symptomatic primary or secondary syphilis (n=58) or asymptomatic latent syphilis diagnosed by serology (rapid plasma reagin, RPR, and Microhemagglutination assay for Treponema pallidum antibody; n=312). Prior to enrollment, potential participants used a computer-based self-interviewing system to enumerate their recent sexual partnerships and provide details of their 3 most recent partners. Eligible participants were randomly assigned to one of 4 intervention arms: (1) counseling and patient-initiated Web-based PN (n=95), (2) counseling with Web-based partner notification and partner referral cards (n=84), (3) counseling and partner referral cards (n=97), and (4) simple partner notification counseling (control; n=94). Self-reported partner notification was assessed after 14 days among 354 participants who returned for the follow-up assessment. The median age of enrolled participants was 27 (interquartile range, IQR 23-34) years, with a median of 2 partners (IQR 1-5) reported in the past month. Compared with those who received only counseling (arm 4), MSM provided with access to Web-based partner notification (arms 1 and 2) or printed partner referral cards (arms 2 and 3) were more likely to have notified one or more of their sexual partners (odds ratio, OR, 2.18, 95% CI 1.30-3.66; P=.003 and OR 1.68, 95% CI 1.01-2.79; P=.045, respectively). The proportion of partners notified was also higher in both Web-based partner notification (241/421, 57.2%; P