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Partner Notification for the control of Sexually Transmitted Diseases: Other Influencing Factors
- Pir Shah, Sam Ramaiah (4 March 2007)
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Pir Shah, Junior Doctor Walsall Teaching Primary Care Trust, Jubilee House, Bloxwhich lane Walsall, WS2 7JL, Sam Ramaiah
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With the exponential rise over the last twenty years of sexually transmitted infections (STIs), in both developed and developing countries (1-2). Effective Partner notification has become an essential tool in curbing this rise in STIs especially as only 40-60% of named sexual partners are being referred (2-5). So, it’s important that a comprehensive strategy involving contact-tracing or partner notification is in place. What Sven et al have done is raise this point using systematic review (3). Sven Trelle et al have made a bold attempt of analysing published data. However the data is heterogeneous, and in some cases: has selection- bias and is non-random; making it difficult to draw any definitive conclusions. Majority of the studies analysed have been from the USA, Denmark and Africa; but all three have very different cultural, religious, socioeconomic and ethnic profiles (3). It’s apparent that the systematic review has not in detail addressed the effect of ethnicity, culture, religion; socioeconomic status, disease burden and literacy considering all of these have a profound effect on partner notification. The review has also not addressed the inverse relationship between stigma and partner notification. This being worse for the female populace with the potential of physical harm as indicated in the review; however this is not specific to Africa as minority Asian, African and Middle-Eastern communities in European countries may have similar issues. The effect of all these differentiating factors including stigmatisation is very apparent to varying degrees in all communities (6,7). For example: Walsall has a large proportion of south Asians with distinct cultural, religious differences; with higher levels of unemployment and illiteracy making it more difficult to engage individuals and communities. So it’s essential we develop strategies that engage these communities using education programmes that promote protection from STIs and partner notification. REFERENCES 1. Cassell JA, Mercer CH, Sutcliffe L, Petersen I, Islam A, Brook MG, et al. Trends in sexually transmitted infections in general practice 1990- 2000: population based study using data from the UK general practice research database. BMJ 2006;332:332-4. 2. Low N, Broutet N, Adu-Sarkodie Y, Barton P, Hossain M, Hawkes S. Global control of sexually transmitted infections. Lancet 2006;368:2001-16. 3. Sven Trelle, Aijing Shang, Linda Nartey, Jackie A Cassell, and Nicola Low: Improved effectiveness of partner notification for patients with sexually transmitted infections: systematic review BMJ 2007;334(7589):354 (17 February) 4. World Health Organization and Joint United Nations Programme on HIV/AIDS. Sexually transmitted diseases: policies and principles for prevention and care. Geneva: UNAIDS Best Practice Collection, 1999. 5. Hawkes S, Mabey D, Mayaud P. Partner notification for the control of sexually transmitted infections. BMJ 2003;327:633-4. 6. Sethi G, Lacey CJ, Fenton KA, Williams IG, Fox E, Sabin CA, Shaw A, Kapembwa M. South Asians with HIV in London: is it time to rethink sexual health service delivery to meet the needs of heterosexual ethnic minorities? Sex Transm Infect. 2004 Feb;80(1):75 Competing interests: None declared |
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