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HIV/AIDS
Published in Patricia G. Melloy, Viruses and Society, 2023
The HIV/AIDS pandemic changed many people’s attitudes towards health information privacy too, given the risk of discrimination based on one’s HIV status. How is one’s right to keep their health status private balanced with public health needs? How should partner notification programs work if a person finds out that they are HIV positive? The preferred approach might be different depending on if a person is a public health official, a friend, or a healthcare professional. Also, should exposing someone to potentially acquiring HIV be illegal? The United States and the world still need to address these issues. Also, what is one’s overall “right to health,” including access to preventative care, treatment, and support services within a society (Gostin 2005)? These are all complex issues with no easy answers.
Chlamydia
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Treatment of sexual partners may decrease reinfection rates [16–18]. Common partner-management options include partner notification (partners are notified and instructed to seek evaluation and treatment) and patient-delivered partner therapy (PDPT) (partner is provided with either medication or prescriptions directly via the index patient). As discussed previously, expedited partner therapy is supported by ACOG and recommended for partner treatment and prevention of reinfection. ACOG recommends that patients inform all partners from the two months prior to diagnosis of infection. For those who are unwilling or unable to seek treatment, PDPT should be offered. Depending on provider preference, this usually entails filling the patient's prescription with enough medication to treat the partner, or they may prefer to directly prescribe to the partner. The partner should also be encouraged to seek medical care and screening for additional STIs. The patient should abstain from unprotected intercourse with the partner for 7 days after they have both completed treatment. EPT should not be used in cases where intimate partner violence is suspected, and disclosure of the infection would endanger the patient [20].
Human Immunodeficiency Virus (HIV)
Published in S Paige Hertweck, Maggie L Dwiggins, Clinical Protocols in Pediatric and Adolescent Gynecology, 2022
Kimberly Huhmann, Andrea Zuckerman
Encourage HIV-positive patients to notify partners. Refer patient to health department partner-notification programs. If patient is unwilling to notify their partners, the health department should be informed to use confidential procedures to notify partners
“It’s not safe for me and what would it achieve?” Acceptability of patient-referral partner notification for sexually transmitted infections to young people, a mixed methods study from Zimbabwe
Published in Sexual and Reproductive Health Matters, 2023
Joni Lariat, Chido Dziva Chikwari, Ethel Dauya, Valentine T. Baumu, Victor Kaisi, Laura Kafata, Esnath Meza, Victoria Simms, Constance Mackworth-Young, Helena Rochford, Anna Machiha, Tsitsi Bandason, Suzanna C. Francis, Rashida A. Ferrand, Sarah Bernays
Partner notification (PN) is considered an essential component of the management of STIs, to both treat sexual partners and reduce the risk of re-infection in the index case.5 PN is based upon the premise that once an index case has been identified and treated, they represent a unique opportunity to “contact trace” other potential infections that might otherwise remain unidentified. Key PN strategies include “patient-referral” (index case notifies partner), “provider referral” (provider notifies partner), and “expedited partner therapy” (index case provides treatment or prescription to partner).5,6 Provider referral and expedited partner therapy have demonstrated higher efficacy and acceptability than patient-referral in high-income countries.7,8 Provider referral is expensive when compared with patient-orientated strategies, and requires greater infrastructural and personnel capacity.9 While expedited partner therapy is not legal in some settings, it is more cost-effective and has been shown to significantly reduce rates of reinfection.10 However, its use in southern African settings where it is legal and is included in national guidelines (such as in Zimbabwe), is currently limited to trials.10 Patient-referral has remained the most common PN method in the management of STIs in most resource-constrained settings.11
Assessment of the proportion and the factors associated with partner and family-based index case HIV testing in Woliso Town, Oromia, Ethiopia: a cross-sectional study
Published in AIDS Care, 2023
Teka Haile Uma, Hanna Gulema Bedada
In 2017, it was estimated that 75% of people with HIV were aware of their HIV status, leaving 9.4 million persons undiagnosed (Lasry et al., 2019). Innovative family HIV testing services including children are rarely available in Sub-Saharan Africa, even though pediatric HIV testing barriers are distinct from adult barriers (Myers et al., 2016; Wagner et al., 2018). However, partner notification strategies must be feasible in healthcare setting and acceptable to the population (Federal Ministry of Health Ethiopia (FMOH), 2018b; Kamanga et al., 2015) as well to children’s HIV testing during routine activities (Barro et al., 2018). Healthcare settings screen broadly for HIV using social network and partner testing to select high-risk individuals based on their contacts (Rentz et al., 2017). In order to reach people with unknown HIV status, assisted partner notification strategy should be used (Rayment et al., 2017). In Tanzania, 96% of estimated people with HIV were tested for HIV (Kahabuka et al., 2017), while only 61% of family members identified and tested were children in Kenya (Kulzer et al., 2012).
Facilitators and barriers to status disclosure and partner testing of women living with HIV in Indonesia: a mixed methods study
Published in Sexual and Reproductive Health Matters, 2022
Annisa Rahmalia, Rudi Wisaksana, Marie Laga, Reinout van Crevel, Koen Peeters Grietens
Partner notification by a health provider mostly occurred when a woman was tested with her partner present, such as at antenatal care or when she was sick at the hospital. In a few cases, the health provider notified the partner without the woman’s consent. “ … the labour did not progress so they referred me to [a public hospital] … Then the doctor came and told me I was HIV-positive … He said I had to be referred to [a provincial referral hospital] for caesarean section and he asked who I wanted to disclose to … My aunt was there too and I preferred to tell her than to tell my husband … However, when we got to the [referral] hospital, another doctor asked my husband to sign [the consent form] before the surgery and told him my status … ” (Mita, 24, WLWH who stayed with the same partner)