COMMENT
Donal Heath of gay men’s health charity GMFA, project leader on a new partner notifi cation system that could tackle undiagnosed cases of HIV in the UK, explains how to eliminate challenges from the notifi cation process.
ON
1 September 2011, the Select Com- mittee on HIV and AIDS in the
United Kingdom published its report, and in it the minister for public health stressed that “more needs to be done to reduce un- diagnosed HIV and particularly the late di- agnosis of HIV”.
The HPA (Health Protection Agency) esti- mates that 26% of people living with HIV in the UK are undiagnosed. Unfortunately, it is hard to target them to test without en- couraging many more uninfected people to test as well.
Probably the most effective tool that health services have for reducing undiagnosed infections of both HIV and other STIs is partner notifi cation (PN) – the process of contacting sexual partners of an individual diagnosed with a sexually acquired infection, and advising them that they may be at risk.
At one leading London clinic, in a recent review of 254 traceable partners who were referred for a health screen by notifi cation from a recently diagnosed patient, 23 of 165 who tested for HIV received a positive result (14%, twice the 7% estimated prevalence of HIV amongst gay men in London).
Evaluation data from the roll-out of RITA (Recent Infection Testing Algorithm) in the UK showed that when the HIV infection of a newly diagnosed individual occurs within the last six months, partner notifi cation is even more likely to result in undiagnosed partners presenting for testing.
Above: A new online service can automatically compose a message to a person’s former sexual partners to notify them of an STI.
With a view to reducing undiagnosed infec- tion in the gay community, in 2009, the El- ton John AIDS Foundation agreed to fund GMFA to develop a new online service that increases the number of opportunities for gay men diagnosed with HIV and other STIs to carry out partner notifi cation.
The obvious advantage of PN over other methods of reducing undiagnosed infec- tions of HIV and other STIs is that only people who are at high risk of infection are encouraged to attend for testing, treatment and information.
However, while many patients take noti- fying their recent sexual partners in their stride, there are still a signifi cant propor- tion of patients who, for various reasons (embarrassment, fear, lack of contact in- formation) do not carry out PN.
In a survey of over 3,000 men on three gay dating sites in the UK, GMFA learned that 22% of men didn’t notify any of their part- ners after being diagnosed with an STI, and of those who sent some notifi cations, 35% didn’t notify all of their recent partners.
GMFA’s new online service increases the opportunities for gay men diagnosed with HIV or another STI to carry out PN by giv- ing them, and clinics acting on their behalf, one online interface from which to send their notifi cations, (anonymously if they prefer), by text message, email and dating site message.
Patients do not have to agonise over what
to say in the messages, which are com- posed for them, and the service currently allows messages to be sent to members of four of the biggest gay dating sites in the UK (Fitlads, Gaydar, Manhunt and Recon) and has the scope to include additional dating and social networking sites, as well as dating apps for mobile phones.
The pilot service was launched in April 2011 in seven clinics in England, and over the course of 2012 the pilot will be expand- ing, so other clinics that are keen to try the service can help to establish how useful a tool it will be in increasing the number of partners referred for testing, and ultimate- ly in reducing the number of undiagnosed infections in the UK.
Patient choice is a key part of the modern NHS. It is vital for professionals engaging in the process of PN to ensure that the pa- tient feels in control at all times and is able to discuss all available PN options for both themselves and their sexual contacts.
The new GMFA service complements ex- isting GUM processes but also provides new opportunities for PN based on patient choice, which in the end will help services meet their aims of re- ducing undiagnosed infections of both HIV and other STIs.
Donal Heath
FOR MORE INFORMATION Visit
www.gmfa.org.uk
national health executive Nov/Dec 11 | 31
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