Extrait

Background and study aims Rates of sexually transmitted infections (STIs) in the UK continue to rise each year. Successful control of STIs relies on reducing the spread of infection in the community. One way of doing this is to cut down the length of time an individual carries the infection before seeking treatment. Partner notification (PN) aims to do this by informing the infected person's sexual partners of the possibility of exposure, offering diagnosis and treatment, and providing advice about preventing future infection. However, the effectiveness of PN as it is currently practised in the UK is doubtful, and many sexual health/Genito Urinary Medicine (GUM) clinics struggle to reach national targets. We do not know the best ways of carrying out PN. The current system relies on the infected person informing their partners and advising them to attend a sexual health clinic or their GP for testing and treatment. This is known as patient referral. However, many sexual contacts are reluctant to come forward and new methods need to be tested. We believe that new methods of PN, which include assessment of the sexual partner by a healthcare professional but do not require clinic attendance, will be key to improving PN in the UK. We call these methods Accelerated Partner Therapy (APT). The aim of this study is to determine the acceptability and feasibility of two new models of APT for STI patients in UK clinics. We will also obtain evidence of the effectiveness of APT as compared with routine PN practice and find out for whom APT is best suited. Who can participate? Patients who are 16 and older and have tested positive for Chlamydia and/or Gonorrhoea (men and women), and men who have been diagnosed with non-gonococcal urethritis, and have at least one contactable partner. What does the study involve? Sexual health advisers in the participating clinics offer eligible patients a choice of three PN strategies: 1. APT Hotline (patient’s sex partner calls the APT hotline for a telephone consultation with a clinic health adviser/nurse practitioner) 2. APT Pharmacy (patient’s sex partner attends pharmacy for consultation) 3. Standard PN using patient referral (patient advises their sex partner to attend a sexual health clinic or their GP) We then compare the outcomes for the APT interventions with standard PN. It is important to give the patient a choice because APT may be more effective if offered as part of a ‘menu’ of PN options, and so we can determine for whom APT is best suited. If APT is successful, it would also be offered as a choice alongside patient referral. Patients who test positive for Gonorrhoea are given antibiotics. Treatment packs include information sheets on the relevant antibiotics, including drug interactions and possible side effects. A study hotline number is also prominently displayed in each pack, which patients can use to obtain advice or support. What are the possible benefits and risks of participating? If the approach we propose is successful, it could enhance the provision of care to partners of patients with STIs, particularly those less likely to access existing services. The net result would be a decrease in STIs in the community and fewer re-infections. Together this would reduce the complications of STIs, such as infertility and pelvic inflammatory disease and their costly health consequences. Where is the study run from? Barts Sexual Health Centre in London and The Milne Centre in Bristol (UK). When is the study starting and how long is it expected to run for? November 2007 to July 2008 Who is funding the study? Medical Research Council (MRC) (UK) Who is the main contact? Dr Lorna Sutcliffe ([email protected]) Dr Claudia Estcourt ([email protected])

Critère d'inclusion

• Topic: Infection; Subtopic: Infection (all Subtopics); Disease: Infectious diseases and microbiology

Liens

• ictrp
• isrctn