Applying NZ’s Covid contact tracing system to STIs

A centralised system to contact trace sexually transmitted infections, similar to what NZ created for COVID-19, would bring a more consistent approach to what’s currently done at the clinic level, according to a small qualitative study of 12 experts in the field. Interview subjects said such a system could reduce demands on already stretched clinics and give us a more comprehensive view of how STIs are spreading nationally. However, privacy and confidentiality were seen as paramount. Lack of trust was identified as a potential concern for Māori, as well as gay and bisexual men. In the same way that Māori and Pacific communities designed and implemented successful approaches to COVID-19 vaccination, STI contact tracing services designed by and for Māori and Pacific communities are needed, they said.

Journal/conference: New Zealand Medical Journal

Organisation/s: University of Otago

Media release

From: Pasifika Medical Association Group

Media release from NZMJ: A centralised contact tracing workforce was established in 2020 to help reduce transmission of COVID-19. Given high population STI rates and local research revealing gaps in contact tracing (or partner notification) for STIs, we asked key informants for their views on the utility of a centralised contact tracing service for STIs. There was agreement that more resourcing, support and training is needed for STI contact tracing, with potential benefits of a centralised system including training, standardisation and reduced demand on already stretched clinical services. Drawbacks included trust and privacy concerns, lack of local-level knowledge and the possibility that the needs of priority populations might not be met. Given that high levels of trust are critical to the success of STI contact tracing, this might best be achieved through known local providers who could be supported, as needed, by central expertise.

Media release from University of Otago:

COVID-19 contact tracing lessons could be applied to STIs, researcher says

A centralised contact tracing system for sexually transmitted infections, suitably adapted from that used for COVID-19, could improve outcomes for STIs, experts believe.

Public Health registrar Dr Catriona Murray interviewed a dozen professionals with expertise in contact tracing for STIs, as part her Master’s of Public Health at the University of Otago, Wellington.

Her findings are published in the New Zealand Medical Journal today.

Dr Murray says many patients prefer to tell contacts themselves and need to be helped to do this with good information and support. But, she says, local studies indicate that STI contact tracing, also called partner notification, is often incomplete and that the process is under-resourced.

“The health professionals working in primary care, sexual health, public health and research who were interviewed for the study overwhelmingly agreed that more resourcing, support and training is needed to improve STI partner notification.”

She says a centralised system would enable a more consistent and comprehensive approach to partner notification for STIs and alleviate some of the burden on already stretched clinicians.

“Aotearoa has ongoing high rates of curable STIs, including chlamydia, gonorrhoea and syphilis.

“We need more resources to reduce the high and inequitable rates of STIs and to allow us to rapidly respond to new or emerging infections that can be spread via sexual contact.”

She says the health professionals interviewed did raise concerns about trust and privacy if a national contact tracing service was established. They also stressed the importance of local area knowledge and the need for cultural safety for gay, bisexual and other men who have sex with men, and for Māori and Pasifika peoples.

“High levels of trust are clearly a key part of successful partner notification, and for some populations that might be best achieved through trusted local providers who could be supported, as needed, by central expertise.”

Dr Murray says although the objective is a simple one, partner notification for STIs can be difficult to carry out successfully, particularly in cases where there are complexities that may require cultural, medical and/or legal expertise. Patient safety is always a priority and contacts are not informed if there is a risk of violence.

She says there is a lack of STI services in rural areas of New Zealand, and a national STI contact tracing workforce could provide a consistent, expert telehealth service, either directly to cases and contacts, or by supporting local clinicians.

“We may get the best outcomes through the establishment of a centralised STI contact tracing service that also provides training and support for local practitioners.”

SOURCE

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