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O19 Can express treatment reduce onward transmission?
  1. Ruth Byrne,
  2. Farhad Cooper,
  3. Tim Appleby,
  4. Leigh Chislett,
  5. Lucy Freeman,
  6. Elizabeth Kershaw,
  7. Nneka Nwokolo,
  8. Gary Whitlock,
  9. Alan McOwan
  1. Chelsea and Westminster Hospital, London, UK


Background/introduction The introduction of onsite Cepheid® GeneXpert diagnostics for asymptomatic STI screens cut ‘test to treatment’ time by 190 h.

Aim(s)/objectives To evaluate the Public Health benefit of faster treatment.

Methods Patients with chlamydia (CT) and/or gonorrhoea (GC) over 8 weeks in February 2014 were retrospectively identified. We compared the timing of testing, treatment and number of recent sexual partners with a control group from November 2013. Assuming rate of partners remains unchanged, we calculated ‘partners spared’ exposure per infected patient due to faster treatment.

Results 431 patients were identified with CT and/or GC infection. 81% (349/431) were MSM. Median age was 29 years. 23% of index patients disclosed high risk behaviour including fisting, chemsex and injecting drug use. Median ‘test to treatment’ time dropped from 238 h to 48 h. The number of partners spared exposure was 0.5 per index case. This equates to a total 196 partners spared exposure over the study period.

Discussion/conclusion For every two people diagnosed with an infection, one partner was spared exposure. Limiting the duration of infectivity and the potential for onward transmission has clear public health benefits and is of particular value in this cohort with multiple partners who engage in high-risk behaviour.

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