Background China's sexually transmitted HIV and resurgent syphilis epidemics require comprehensive control programs. Partner services are traditional pillars of sexually transmitted infection (STI) control but have not been widely implemented in China. This systematic review of English and Chinese literature examined the feasibility and uptake of partner notification (PN) in China.
Methods Four English language and four Chinese language databases were searched from 1980 to 2010 to identify original articles on partner services in China. A systematic review was performed to assess: (1) willingness to notify via patient, provider, or contract notification; and (2) PN uptake, defined as the number of partners successfully notified, evaluated, and treated per index case. Approaches to partner services in China, perceived barriers, and implementation consequences were also abstracted. χ2 tests were used to compare the proportions of index patients willing to notify partners using different PN methods.
Results A total of 441 citations were identified, and 17 studies (3 English and 14 Chinese), published between 1997 and 2010, examined PN willingness and uptake. All three types of PN--patient, provider, and contract--were assessed. Overall willingness to notify was 67% (SD±25.0) in nine studies (n=2145). Six studies (n=1380 index cases) reported median STI PN uptakes of: 0.9 (IQR 0.5–1.2) notified, 0.7 (IQR 0.4–0.9) evaluated, and 0.3 (IQR 0.2–0.3) new infections detected. Partner services counselling was shown to reduce reinfection rates, and no adverse events were reported. Perceived patient barriers included social stigma, fear of relationship breakdown, right to confidentiality, and lack of partner contact information. Perceived infrastructure barriers included lack of available patient education, limited resources and trained staff, mistrust between patients and health providers, and lack of partner services regulations. All studies were in heterosexual populations; none examined partner services in men who have sex with men (MSM).
Conclusions Although STI PN is not widespread in China, these limited studies suggest that more structured pilot programs could be feasible. More research on STI partner services, particularly among MSM and other high-risk groups, is an important public health priority.