Internet partner notification: another arrow in the quiver.

摘要

As we look at the ever-increasing technological innovation in public health, one of the authors recalls the suspicion with which a nameless health department treated e-mail in the late 1990s, something akin to how the Luddites felt about the horseless carriage. Times have changed, however, and innovation in partner management for STD and HIV has expanded to the Internet. In this issue of Sexually Transmitted Diseases, Mimiaga and colleagues surveyed men who have sex with men (MSM) using an online site to meet sex partners. Given the high rates of anonymous and semianonymous sex that results from online-initiated encounters, sometimes the only means of contacting those partners subsequently is through the Internet, assessed in Mimiaga's article via e-mail.Results from Mimiaga et al. clarify some basic points about partner notification with MSM. They found high overall acceptability of partner notification via e-mail across respondents: 92%. This is a similar finding to acceptance of partner notificationamong MSM in surveys of in-person patient referral or health department involvement, and reminds us that partner notification is about as widely acceptable as a concept among MSM as among other partitions of society. Partner notification effectiveness with MSM is also comparable to that for heterosexual patients, albeit if judged by traditional indices of effectiveness. A review of partner notification efforts among cities with largely MSM-driven syphilis outbreaks in the early 2000s found proportions of partners notified and brought to treatment that were similar to statistics for the population at large. A specific comparison of syphilis partner notification with MSM patients compared to heterosexual male patients in Georgia found almost identical yields for partner notification in each group. The differences between MSM and heterosexual men lie in the proportion of total partners claimed: MSM claimed more partners overall and more partners for whom no in-person investigation could be started. For these partners especially, innovations in contact methods such as e-mail are sorely needed.