Expedited Partner Therapy (EPT) increases the frequency of partner notification among MSM in Lima, Peru: a pilot randomized controlled trial

2.50
Hdl Handle:
http://hdl.handle.net/10757/622282
Title:
Expedited Partner Therapy (EPT) increases the frequency of partner notification among MSM in Lima, Peru: a pilot randomized controlled trial
Authors:
Clark, Jesse L.; Segura, Eddy R. ( 0000-0003-3580-7712 ) ; Oldenburg, Catherine E.; Rios, Jessica; Montano, Silvia M.; Perez-Brumer, Amaya; Villaran, Manuel; Sanchez, Jorge; Coates, Thomas J.; Lama, Javier R.
Citation:
Expedited Partner Therapy (EPT) increases the frequency of partner notification among MSM in Lima, Peru: a pilot randomized controlled trial 2017, 15 (1) BMC Medicine
Publisher:
BioMed Central Ltd.
Journal:
BMC Medicine
Issue Date:
4-May-2017
URI:
http://hdl.handle.net/10757/622282
DOI:
10.1186/s12916-017-0858-9
Additional Links:
http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0858-9
Abstract:
Background: Expedited Partner Therapy (EPT) has been shown to improve treatment outcomes among heterosexual partners of individuals with curable sexually transmitted infections (STIs). Although the use of EPT with men who have sex with men (MSM) has been debated, due to the potential for missed opportunities to diagnose unidentified cases of HIV and syphilis infection in symptomatic partners, increases in partner notification (PN) resulting from use of EPT may promote testing and treatment of otherwise unidentified partners. We assessed the impact of EPT on self-reported PN among MSM in Peru with gonorrheal (GC) and/or chlamydial (CT) infection. Methods: We enrolled 173 MSM in Lima, Peru with symptomatic or asymptomatic GC and/or CT infection between 2012 and 2014. We enrolled 44 MSM with symptomatic urethritis/proctitis and 129 MSM with asymptomatic GC/CT infection, diagnosed based on nucleic acid testing (Aptima Combo 2 Transcription-Mediated Amplification [TMA]) from urethral, pharyngeal, and rectal sites. Eligible participants were randomly assigned to receive either standard PN counseling (n = 84) or counseling plus EPT (cefixime 400 mg/azithromycin 1 g) for up to five recent partners (n = 89). Self-reported notification was assessed by computer-assisted self-administered survey among 155 participants who returned for 14-day follow-up. Results: The median age of participants was 26 (interquartile range [IQR]: 23-31) with a median of 3 sexual partners (IQR: 2-4) in the previous 30-day period. Among all participants, 111/155 (71.6%) notified at least one partner at 14-day follow-up with a median of 1 partner notified per participant (IQR: 0-2). For participants randomized to receive EPT, 69/83 (83.1%) reported notifying at least one partner, compared with 42/72 (58.3%) of participants in the control arm (odds ratio = 3.52; 95% confidence interval [CI]: 1.68-7.39). The proportion of all recent partners notified was significantly greater in the EPT than in the control arm (53.5%, 95% CI: 45.0-62.0% versus 36.4%, 95% CI: 27.0-47.4%). Conclusions: Provision of EPT led to significant increases in notification among Peruvian MSM diagnosed with GC/CT infection. Additional research is needed to assess the impact of EPT on biological outcomes, including persistent or recurrent infection, antimicrobial resistance, and HIV/STI transmission, in MSM sexual networks. Trial registration: ClinicalTrials.gov, NCT01720654. Registered on 10/29/2012.
Type:
info:eu-repo/semantics/article
Rights:
info:eu-repo/semantics/restrictedAccess
Language:
eng
Description:
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.
Keywords:
Expedited Partner Therapy; Latin America; MSM; Partner notification
ISSN:
1741-7015
Email:
jlclark@mednet.ucla.edu

Full metadata record

DC FieldValue Language
dc.contributor.authorClark, Jesse L.es
dc.contributor.authorSegura, Eddy R.es
dc.contributor.authorOldenburg, Catherine E.es
dc.contributor.authorRios, Jessicaes
dc.contributor.authorMontano, Silvia M.es
dc.contributor.authorPerez-Brumer, Amayaes
dc.contributor.authorVillaran, Manueles
dc.contributor.authorSanchez, Jorgees
dc.contributor.authorCoates, Thomas J.es
dc.contributor.authorLama, Javier R.es
dc.date.accessioned2017-10-23T19:13:33Z-
dc.date.available2017-10-23T19:13:33Z-
dc.date.issued2017-05-04-
dc.identifier.citationExpedited Partner Therapy (EPT) increases the frequency of partner notification among MSM in Lima, Peru: a pilot randomized controlled trial 2017, 15 (1) BMC Medicinees
dc.identifier.issn1741-7015-
dc.identifier.doi10.1186/s12916-017-0858-9-
dc.identifier.urihttp://hdl.handle.net/10757/622282-
dc.descriptionEl texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.es_PE
dc.description.abstractBackground: Expedited Partner Therapy (EPT) has been shown to improve treatment outcomes among heterosexual partners of individuals with curable sexually transmitted infections (STIs). Although the use of EPT with men who have sex with men (MSM) has been debated, due to the potential for missed opportunities to diagnose unidentified cases of HIV and syphilis infection in symptomatic partners, increases in partner notification (PN) resulting from use of EPT may promote testing and treatment of otherwise unidentified partners. We assessed the impact of EPT on self-reported PN among MSM in Peru with gonorrheal (GC) and/or chlamydial (CT) infection. Methods: We enrolled 173 MSM in Lima, Peru with symptomatic or asymptomatic GC and/or CT infection between 2012 and 2014. We enrolled 44 MSM with symptomatic urethritis/proctitis and 129 MSM with asymptomatic GC/CT infection, diagnosed based on nucleic acid testing (Aptima Combo 2 Transcription-Mediated Amplification [TMA]) from urethral, pharyngeal, and rectal sites. Eligible participants were randomly assigned to receive either standard PN counseling (n = 84) or counseling plus EPT (cefixime 400 mg/azithromycin 1 g) for up to five recent partners (n = 89). Self-reported notification was assessed by computer-assisted self-administered survey among 155 participants who returned for 14-day follow-up. Results: The median age of participants was 26 (interquartile range [IQR]: 23-31) with a median of 3 sexual partners (IQR: 2-4) in the previous 30-day period. Among all participants, 111/155 (71.6%) notified at least one partner at 14-day follow-up with a median of 1 partner notified per participant (IQR: 0-2). For participants randomized to receive EPT, 69/83 (83.1%) reported notifying at least one partner, compared with 42/72 (58.3%) of participants in the control arm (odds ratio = 3.52; 95% confidence interval [CI]: 1.68-7.39). The proportion of all recent partners notified was significantly greater in the EPT than in the control arm (53.5%, 95% CI: 45.0-62.0% versus 36.4%, 95% CI: 27.0-47.4%). Conclusions: Provision of EPT led to significant increases in notification among Peruvian MSM diagnosed with GC/CT infection. Additional research is needed to assess the impact of EPT on biological outcomes, including persistent or recurrent infection, antimicrobial resistance, and HIV/STI transmission, in MSM sexual networks. Trial registration: ClinicalTrials.gov, NCT01720654. Registered on 10/29/2012.es
dc.formatapplication/pdfes
dc.language.isoenges
dc.publisherBioMed Central Ltd.es
dc.relation.urlhttp://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0858-9es
dc.rightsinfo:eu-repo/semantics/restrictedAccesses
dc.subjectExpedited Partner Therapyes
dc.subjectLatin Americaes
dc.subjectMSMes
dc.subjectPartner notificationes
dc.titleExpedited Partner Therapy (EPT) increases the frequency of partner notification among MSM in Lima, Peru: a pilot randomized controlled triales
dc.typeinfo:eu-repo/semantics/articlees
dc.identifier.journalBMC Medicinees
dc.description.peerreviewRevisión por pareses_PE
dc.contributor.emailjlclark@mednet.ucla.edues_PE
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