Improved effectiveness of partner notification for patients with sexually transmitted infections: systematic reviewBMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39079.460741.7C (Published 15 February 2007) Cite this as: BMJ 2007;334:354
All rapid responses
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
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.
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
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: No competing interests