title: Can we improve partner notification rates through expedited partner therapy in the UK? Findings from an exploratory trial of Accelerated Partner Therapy (APT).
abstract: OBJECTIVE
  To develop two new models of expedited partner therapy for the UK, and evaluate them for feasibility, acceptability and preliminary outcome estimates to inform the design of a randomised controlled trial (RCT).
  
  
  METHODS
  Two models of expedited partner therapy (APTHotline and APTPharmacy), known as 'Accelerated Partner Therapy' (APT) were developed. A non-randomised comparative study was conducted of the two APT models and routine partner notification (PN), in which the index patient chose the PN option for his/her partner(s) in two contrasting clinics.
  
  
  RESULTS
  The proportion of contactable partners treated when routine PN was chosen was 42/117 (36%) and was significantly higher if either APT option was chosen: APTHotline 80/135 (59%), p=0.003; APTPharmacy 29/44 (66%) p=0.001. However, partner treatment was often achieved through other routes. Although 40-60% of partners in APT groups returned urine samples for sexually transmitted infection (STI) testing, almost none accessed HIV and syphilis testing. APT options appear to facilitate faster treatment of sex partners than routine PN. Preferences and recruitment rates varied between sites, related to staff satisfaction with existing routine PN; approach to consent; and possibly, characteristics of local populations.
  
  
  CONCLUSIONS
  Both methods of APT were feasible and acceptable to many patients and led to higher rates of partner treatment than routine PN. Preferences and recruitment rates varied greatly between settings, suggesting that organisational and cultural factors may have an important impact on the feasibility of an RCT and on outcomes. Mindful of these factors, it is proposed that APT should now be evaluated in a cluster RCT.
authors.affiliation: Centre for Infectious Disease: Sexual Health & HIV, Blizard Institute of Cell and Molecular Science, Barts & The London School of Medicine & Dentistry, Barts and the London NHS Trust, St Bartholomew's Hospital, London, UK. c.s.estcourt@qmul.ac.uk
authors.forename: Claudia
authors.initials: C
authors.lastname: Estcourt
authors.forename: Lorna
authors.initials: L
authors.lastname: Sutcliffe
authors.forename: Jackie
authors.initials: J
authors.lastname: Cassell
authors.forename: Catherine H
authors.initials: CH
authors.lastname: Mercer
authors.forename: Andrew
authors.initials: A
authors.lastname: Copas
authors.forename: Laura
authors.initials: L
authors.lastname: James
authors.forename: Nicola
authors.initials: N
authors.lastname: Low
authors.forename: Patrick
authors.initials: P
authors.lastname: Horner
authors.forename: Michael
authors.initials: M
authors.lastname: Clarke
authors.forename: Merle
authors.initials: M
authors.lastname: Symonds
authors.forename: Tracy
authors.initials: T
authors.lastname: Roberts
authors.forename: Angelos
authors.initials: A
authors.lastname: Tsourapas
authors.forename: Anne M
authors.initials: AM
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D002690:Chlamydia Infections / Q000517:prevention & control; D003157:Community Pharmacy Services / Q000706:statistics & numerical data*; D016358:Contact Tracing / Q000379:methods* / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006069:Gonorrhea / Q000517:prevention & control; D015277:Hotlines / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D057240:Patient Preference / Q000706:statistics & numerical data; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D006113:United Kingdom; D014526:Urethritis / Q000517:prevention & control; D055815:Young Adult