Internet-based partner notification for HIV: an additional
tool for provider and patient, no magic bullet
Hélène ACM Voeten1,2, Anita Watzeels1, Hanna Bos3, Liesbeth Vasen1, Francine van den Heuvel4, Hannelore Götz1,2
1
GGD Rotterdam-Rijnmond; 2 Erasmus MC, Rotterdam; 3 Soa Aids Nederland; 4 GGD Amsterdam
Background
Partner notification is an important method to trace undiagnosed cases of (acute) HIV.
An internet-based partner notification system for verified diagnoses of STI/HIV was
developed for use at STI clinics (GGD) and general practices (GP). Index patients
receive a unique code from their professional to use www.partnerwaarschuwing.nl,
sending standard notifications, thereby choosing a method per partner (email/sms;
anonymous/non-anonymous). Partners receive with their notification a personal link/
code, to check out for which STI they are notified.
Results
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In the study period, 68 codes were created for clients with HIV and HIV coinfections to notify their partners (see Flowchart).
Of these, 33 clients did not notify their partners by the internet tool (49%), 16 sent
notifications with the tool themselves (24%), and 19 asked the professional to
notify their partners with the tool (28%). For non-HIV STI, less clients asked the
professional to notify (7%, p<0.001).
The 16 clients with HIV who had sent notifications themselves notified 47 partners
with the tool (mean 2.9 partners per index); for the 19 clients for whom the
professional had sent the notifications, 28 partners were notified (mean 1.5 partners
per index).
For non-HIV STI, 64% of notified partners checked out their online advice (i.e. the
STI they were notified for). For HIV, partners who were notified by professionals
less often checked out their online advice (i.e. the STI they were notified for) than
partners notified by clients (39% versus 77%, p<0.001). This lower percentage can
not be explained by professionals sending exclusively anonymous notifications,
versus clients sending sometimes notifications by name. In fact, of the eight
partners who were notified by name by clients, only two checked out the STI they
were notified for (the others were maybe told by the index partners for which STI
they were notified).
Conclusion
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Methods
Use of the webtool to notify for HIV was evaluated from 14 April 2014 - 2 September
2015. Data were extracted from the notification database: number of created codes,
number of codes used by professional and clients, number of partners notified, and
number of partners checking out for which STI they were notified. Figure 1. Flowchart of partner notification by
the webtool www.partnerwaarschuwing.nl,
from 14 April 2014 till 2 September 2015.
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Clients with HIV often ask the professional to send notifications
61% of partners notified for HIV by professionals do not check out the STI
they are notified for, and thus remain unaware that they are notified for HIV.
It is therefore of utmost importance that professionals who use the
webtool to notify for HIV additionally try to reach partners by phone.
This is in line with the new RIVM draaiboek “Partnermanagement”, which
states that the professional has the obligation to make the best effort
possible to notify partners, especially for HIV.
Partner notification is an important method to trace undiagnosed cases of
(acute) HIV. Our Internet-based system is an additional tool in this, but no
magic bullet.
1997 codes created for online
partner notification for STI/HIV
68 codes (3%) for clients with
HIV / HIV co-infections
63 (93%) created by GGD
33x (49%) no
notification sent
36 (77%) checked
out their advice
5 (7%) created by GP
16x (24%) client
sent notification(s)
47 partners were notified
by 16 clients (mean 2.9)
11 (23%) did not
check out their advice
1929 codes (97%) for
clients with non-HIV STI
19x (28%) professional
sent notification(s)
28 partners were notified by
19 professionals (mean 1.5)
11 (39%) checked
out their advice
17 (61%) did not
check out their advice
1711 (89) created by GGD
1241x (64%) no
notification sent
218 (11%) created by GP
554x (29%) client
sent notification(s)
1841 partners were notified by
554 clients (mean 3.3)
1321 (64%) checked
out their advice
134x (7%) professional
sent notification(s)
213 partners were notified by
134 professionals (mean 1.6)
733 (36%) did not
check out their advice
Correspondence: [email protected]