Background Partner services have been a mainstay of public health sexually transmitted disease (STD) prevention programs for decades. The principal goals are to interrupt transmission and reduce STD morbidity and sequelae. In this paper, we review current literature with the goal of informing STD prevention programs. Methods We searched the literature for systematic reviews. We found nine reviews published between 2005 and 2014 (covering 108 studies). The reviews varied by study inclusion criteria (e.g., study methods, geographic location, infections). We abstracted major conclusions and recommendations from the reviews. Results Conclusions and recommendations were divided into patient referral interventions and provider referral interventions. For patient referral, there was evidence supporting the use of expedited partner therapy and interactive counseling, but not purely didactic instruction. Provider referral through Disease Intervention Specialists was efficacious and particularly well-supported for HIV. For other studies, modeling data and testing outcomes showed that partner notification in general reached high-prevalence populations. Reviews also suggested more focus on using technology and population-level implementation strategies. However, partner services may not be the most efficient means to reach infected persons. Conclusions Partner services programs constitute a large proportion of program STD prevention activities. Value is maximized by balancing a portfolio of patient and provider referral interventions and by blending partner notification interventions with other STD prevention interventions in overall partner services program structure. STD prevention needs program-level research and development to generate this portfolio.

BackgroundSexually transmitted infection (STI) prevention programs can mitigate the health and economic burden of STIs. A tool to estimate the economic benefits of STI programs could prove useful to STI program personnel.MethodsWe developed formulas that can be applied to estimate the direct medical costs and indirect costs (lost productivity) averted by STI programs in the United States. Costs and probabilities for these formulas were based primarily on published studies.ResultsWe present a series of formulas that can be used to estimate the economic benefits of STI prevention (in 2006 US dollars), using data routinely collected by STI programs. For example, the averted sequelae costs associated with treating women for chlamydia is given as (Cw)(0.16)(0.925)(0.70)($1,995), where Cw is the number of infected women treated for chlamydia, 0.16 is the absolute reduction in the probability of pelvic inflammatory disease (PID) as a result of treatment, 0.925 is an adjustment factor to prevent double-counting of PID averted in women with both chlamydia and gonorrhea, 0.70 is an adjustment factor to account for the possibility of re-infection, and $1,995 is the average cost per case of PID, based on published sources.ConclusionThe formulas developed in this study can be a useful tool for STI program personnel to generate evidence-based estimates of the economic impact of their program and can facilitate the assessment of the cost-effectiveness of their activities.

The estimated rate of P&S syphilis in persons with HIV is considerably higher than that of the general population. These findings highlight the importance of providing sexually transmitted disease prevention and control services to HIV-infected persons.