title: An effective strategy to diagnose HIV infection: findings from a national audit of HIV partner notification outcomes in sexual health and infectious disease clinics in the UK.
abstract: Partner notification (PN) is a key public health intervention in the control of STIs. Data regarding its clinical effectiveness in the context of HIV are lacking. We sought to audit HIV PN outcomes across the UK.
  
  
  
  All UK sexual health and HIV services were invited to participate. Clinical audit consisted of retrospective case-note review for up to 40 individuals diagnosed with HIV per site during 2011 (index cases) and a review of PN outcomes for up to five contacts elicited by PN per index case.
  
  
  
  169/221 (76%) clinical services participated (93% sexual health/HIV services, 7% infectious diseases/HIV units). Most (97%) delivered PN for HIV. Data were received regarding 2964 index cases (67% male; 50% heterosexual, 52% white). PN was attempted for 88% of index cases, and outcomes for 3211 contacts were audited (from an estimated total of 6400): 519 (16%) were found not to be at risk of undiagnosed HIV infection, 1399 (44%) were informed of their risk and had an HIV test, 310 (10%) were informed of the risk but not known to have tested and 983 (30%) were not informed of their risk of HIV infection. Of 1399 contacts tested through PN, 293 (21%) were newly diagnosed with HIV infection. Regular partners were most likely to test positive (p<0.001).
  
  
  
  HIV PN is a highly effective diagnostic strategy. Non-completion of PN thus represents a missed opportunity to diagnose HIV in at-risk populations. Vigorous efforts should be made to pursue PN to identify people living with, and at risk of, HIV infection.
authors: Directorate of HIV/GU Medicine, Chelsea and Westminster NHS Foundation Trust, London, UK.
authors: Michael
authors: M
authors: Rayment
authors: Audit and Standards Sub-committee, British HIV Association, London, UK.
authors: Hilary
authors: H
authors: Curtis
authors: Genitourinary Medicine, Cambridge Community Services, Cambridge, UK.
authors: Chris
authors: C
authors: Carne
authors: City Health Care Partnership, Hull, Kingston Upon Hull, UK.
authors: Hugo
authors: H
authors: McClean
authors: Department of GU Medicine, Royal Hallamshire Hospital, Sheffield, UK.
authors: Gill
authors: G
authors: Bell
authors: Reader in Sexual Health and HIV, Barts and the London School of Medicine and Dentistry, Centre for Immunology and Infectious Disease, London, UK.
authors: Claudia
authors: C
authors: Estcourt
authors: Brighton and Sussex University Hospital NHS Trust, Brighton, East Sussex, UK.
authors: Jonathon
authors: J
authors: Roberts
authors: Department of Infectious Diseases, North Manchester General Hospital, Manchester, UK.
authors: Ed
authors: E
authors: Wilkins
authors: Epsom and St Helier University Hospitals NHS Trust, Surrey, UK.
authors: Steven
authors: S
authors: Estreich
authors: Department of Genitourinary Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
authors: Georgina
authors: G
authors: Morris
authors: Genitourinary Medicine, Whittall Street Clinic, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors: Jara
authors: J
authors: Phattey
authors: Directorate of HIV/GU Medicine, Chelsea and Westminster NHS Foundation Trust, London, UK.
authors: Ann K
authors: AK
authors: Sullivan
mesh_terms: D000328:Adult; D054869:Clinical Audit; D016358:Contact Tracing / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006291:Health Policy; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D006113:United Kingdom; D055815:Young Adult
keywords: AUDIT; HIV; HIV TESTING; PARTNER NOTIFICATION; SERVICE DELIVERY