Background Infectious syphilis partner notification (PN) is centrally coordinated at the British Columbia (BC) Centre for Disease Control. Approaches include patient-initiated and provider-initiated PN, and outcomes include the proportion of… Click to show full abstract
Background Infectious syphilis partner notification (PN) is centrally coordinated at the British Columbia (BC) Centre for Disease Control. Approaches include patient-initiated and provider-initiated PN, and outcomes include the proportion of partners (1) notified of possible exposure to syphilis, (2) tested and/or treated, and (3) diagnosed. Among gay, bisexual and other men who have sex with men (gbMSM) who have the greatest burden of syphilis, we evaluated PN outcomes between patient-initiated and provider-initiated PN. Methods All infectious syphilis diagnoses in 2016 in BC were included. Syphilis re-diagnosis was defined as a syphilis diagnosis in 2016 with at least one additional diagnosis in 2006–2016, while first-diagnosis was defined as a syphilis diagnosis in 2016 only. PN outcomes were calculated along a cascade-of-care framework, where the numerator is the denominator of the subsequent indicator. Chi-square tests compared PN outcomes of patient-initiated versus provider-initiated PN, within strata of gbMSM first-diagnosed and re-diagnosed. Results Of the 759 infectious syphilis cases in BC in 2016, 648 (85%) were among gbMSM, among whom 474 (73%) were first-diagnoses and 174 (27%) were re-diagnoses. A significantly greater proportion of gbMSM first-diagnosed chose patient-initiated PN compared to gbMSM re-diagnosed (62% vs 42%; P<0.01). Among gbMSM first-diagnosed, patient-initiated PN resulted in a greater proportion of partners notified compared to provider-initiated PN (177/199; 89% vs 426/603; 70%; P<0.001). There was no difference in the proportion of partners tested and/or treated, (156/177; 88% vs 380/426; 89%; P≥0.05), and diagnosed (24/156 15% vs 51/380 13%; P≥0.05). A similar trend in PN outcomes was observed among partners of gbMSM re-diagnosed. Conclusion Patient-initiated and provider-initiated PN had similar outcomes among partners of both gbMSM first-diagnosed and re-diagnosed. However, gbMSM first-diagnosed were more likely to choose to notify their own partners. These findings demonstrate that patient-initiated PN have similar outcomes to provider-initiated PN and can increase the overall capacity for PN. Disclosure No significant relationships.
               
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