An effective strategy to diagnose HIV infection: findings from a national audit of HIV partner notification outcomes in sexual health and infectious disease clinics in the UK

Michael Rayment, Chris Carne, Gill Bell, Claudia Estcourt, Jonathon Roberts, Natalie Wilkinson, Ed Wilkins, Steven Estreich, Georgina Morris, Jara Phattey, Ann Sullivan

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Abstract

Objectives Partner notification (PN) is a key public health intervention in the control of STIs. Data regarding its clinical effectiveness in the context of HIV are lacking. We sought to audit HIV PN outcomes across the UK. Methods All UK sexual health and HIV services were invited to participate. Clinical audit consisted of retrospective case-note review for up to 40 individuals diagnosed with HIV per site during 2011 (index cases) and a review of PN outcomes for up to five contacts elicited by PN per index case. Results 169/221 (76%) clinical services participated (93% sexual health/HIV services, 7% infectious diseases/HIV units). Most (97%) delivered PN for HIV. Data were received regarding 2964 index cases (67% male; 50% heterosexual, 52% white). PN was attempted for 88% of index cases, and outcomes for 3211 contacts were audited (from an estimated total of 6400): 519 (16%) were found not to be at risk of undiagnosed HIV infection, 1399 (44%) were informed of their risk and had an HIV test, 310 (10%) were informed of the risk but not known to have tested and 983 (30%) were not informed of their risk of HIV infection. Of 1399 contacts tested through PN, 293 (21%) were newly diagnosed with HIV infection. Regular partners were most likely to test positive (p<0.001). Conclusions HIV PN is a highly effective diagnostic strategy. Non-completion of PN thus represents a missed opportunity to diagnose HIV in at-risk populations. Vigorous efforts should be made to pursue PN to identify people living with, and at risk of, HIV infection.
Original languageEnglish
Pages (from-to)94-100
Number of pages7
JournalBMJ
Early online date5 Aug 2016
DOIs
Publication statusPublished - Mar 2017

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Contact Tracing
Reproductive Health
HIV Infections
Communicable Diseases
HIV
Health Services
Clinical Audit
Heterosexuality
Sexually Transmitted Diseases
Public Health

Keywords

  • HIV partner notification

Cite this

Rayment, Michael ; Carne, Chris ; Bell, Gill ; Estcourt, Claudia ; Roberts, Jonathon ; Wilkinson, Natalie ; Wilkins, Ed ; Estreich, Steven ; Morris, Georgina ; Phattey, Jara ; Sullivan, Ann. / An effective strategy to diagnose HIV infection: findings from a national audit of HIV partner notification outcomes in sexual health and infectious disease clinics in the UK. In: BMJ. 2017 ; pp. 94-100.
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abstract = "Objectives Partner notification (PN) is a key public health intervention in the control of STIs. Data regarding its clinical effectiveness in the context of HIV are lacking. We sought to audit HIV PN outcomes across the UK. Methods All UK sexual health and HIV services were invited to participate. Clinical audit consisted of retrospective case-note review for up to 40 individuals diagnosed with HIV per site during 2011 (index cases) and a review of PN outcomes for up to five contacts elicited by PN per index case. Results 169/221 (76{\%}) clinical services participated (93{\%} sexual health/HIV services, 7{\%} infectious diseases/HIV units). Most (97{\%}) delivered PN for HIV. Data were received regarding 2964 index cases (67{\%} male; 50{\%} heterosexual, 52{\%} white). PN was attempted for 88{\%} of index cases, and outcomes for 3211 contacts were audited (from an estimated total of 6400): 519 (16{\%}) were found not to be at risk of undiagnosed HIV infection, 1399 (44{\%}) were informed of their risk and had an HIV test, 310 (10{\%}) were informed of the risk but not known to have tested and 983 (30{\%}) were not informed of their risk of HIV infection. Of 1399 contacts tested through PN, 293 (21{\%}) were newly diagnosed with HIV infection. Regular partners were most likely to test positive (p<0.001). Conclusions HIV PN is a highly effective diagnostic strategy. Non-completion of PN thus represents a missed opportunity to diagnose HIV in at-risk populations. Vigorous efforts should be made to pursue PN to identify people living with, and at risk of, HIV infection.",
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An effective strategy to diagnose HIV infection: findings from a national audit of HIV partner notification outcomes in sexual health and infectious disease clinics in the UK. / Rayment, Michael; Carne, Chris; Bell, Gill; Estcourt, Claudia; Roberts, Jonathon ; Wilkinson, Natalie; Wilkins, Ed; Estreich, Steven; Morris, Georgina; Phattey, Jara; Sullivan, Ann.

In: BMJ, 03.2017, p. 94-100.

Research output: Contribution to journalArticle

TY - JOUR

T1 - An effective strategy to diagnose HIV infection: findings from a national audit of HIV partner notification outcomes in sexual health and infectious disease clinics in the UK

AU - Rayment, Michael

AU - Carne, Chris

AU - Bell, Gill

AU - Estcourt, Claudia

AU - Roberts, Jonathon

AU - Wilkinson, Natalie

AU - Wilkins, Ed

AU - Estreich, Steven

AU - Morris, Georgina

AU - Phattey, Jara

AU - Sullivan, Ann

N1 - Acceptance date from PDF VoR ok according to Romeo Author start date at GCU is after acceptance > apply exception 254a. ET 13/11/19

PY - 2017/3

Y1 - 2017/3

N2 - Objectives Partner notification (PN) is a key public health intervention in the control of STIs. Data regarding its clinical effectiveness in the context of HIV are lacking. We sought to audit HIV PN outcomes across the UK. Methods All UK sexual health and HIV services were invited to participate. Clinical audit consisted of retrospective case-note review for up to 40 individuals diagnosed with HIV per site during 2011 (index cases) and a review of PN outcomes for up to five contacts elicited by PN per index case. Results 169/221 (76%) clinical services participated (93% sexual health/HIV services, 7% infectious diseases/HIV units). Most (97%) delivered PN for HIV. Data were received regarding 2964 index cases (67% male; 50% heterosexual, 52% white). PN was attempted for 88% of index cases, and outcomes for 3211 contacts were audited (from an estimated total of 6400): 519 (16%) were found not to be at risk of undiagnosed HIV infection, 1399 (44%) were informed of their risk and had an HIV test, 310 (10%) were informed of the risk but not known to have tested and 983 (30%) were not informed of their risk of HIV infection. Of 1399 contacts tested through PN, 293 (21%) were newly diagnosed with HIV infection. Regular partners were most likely to test positive (p<0.001). Conclusions HIV PN is a highly effective diagnostic strategy. Non-completion of PN thus represents a missed opportunity to diagnose HIV in at-risk populations. Vigorous efforts should be made to pursue PN to identify people living with, and at risk of, HIV infection.

AB - Objectives Partner notification (PN) is a key public health intervention in the control of STIs. Data regarding its clinical effectiveness in the context of HIV are lacking. We sought to audit HIV PN outcomes across the UK. Methods All UK sexual health and HIV services were invited to participate. Clinical audit consisted of retrospective case-note review for up to 40 individuals diagnosed with HIV per site during 2011 (index cases) and a review of PN outcomes for up to five contacts elicited by PN per index case. Results 169/221 (76%) clinical services participated (93% sexual health/HIV services, 7% infectious diseases/HIV units). Most (97%) delivered PN for HIV. Data were received regarding 2964 index cases (67% male; 50% heterosexual, 52% white). PN was attempted for 88% of index cases, and outcomes for 3211 contacts were audited (from an estimated total of 6400): 519 (16%) were found not to be at risk of undiagnosed HIV infection, 1399 (44%) were informed of their risk and had an HIV test, 310 (10%) were informed of the risk but not known to have tested and 983 (30%) were not informed of their risk of HIV infection. Of 1399 contacts tested through PN, 293 (21%) were newly diagnosed with HIV infection. Regular partners were most likely to test positive (p<0.001). Conclusions HIV PN is a highly effective diagnostic strategy. Non-completion of PN thus represents a missed opportunity to diagnose HIV in at-risk populations. Vigorous efforts should be made to pursue PN to identify people living with, and at risk of, HIV infection.

KW - HIV partner notification

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DO - 10.1136/sextrans-2015-052532

M3 - Article

SP - 94

EP - 100

JO - British Medical Journal

JF - British Medical Journal

SN - 0959-8138

ER -