ORIGINAL ARTICLE A survey of contact tracing practice for sexually transmitted diseases in GUM clinics in England and Wales Tim Stokes MPH MRCGP 1 and Paul Schober FRCP 2 1 Department of General Practice and Primary Health Care, University of Leicester, Leicester General Hospital, Leicester and 2 Department of Genito-Urinary Medicine, The Leicester Royal In®rmary NHS Trust, Leicester, UK Summary: We set out to determine current policy and practice in relation to contact tracing (partner noti®cation) for sexually transmitted diseases (STDs) within genitourinary medicine (GUM) clinics in England and Wales. A con®dential postal questionnaire survey of all GUM clinics in England and Wales was undertaken. Completed questionnaires were returned by 105 GUM clinics (a response rate of 65%). All respondents undertook routine contact tracing for gonorrhoea and chlamydia. The most popular method of contact tracing used was patient referral. The majority of contact tracing was undertaken by health advisers. Information on the time period over which contact tracing was undertaken showed wide variation. Audit data on the effectiveness of contact tracing in terms of the proportion of sexual contacts seen were available from only a minority of GUM clinics (33/79, 42%). Only chlamydia (24/79, 30%) and gonorrhoea (22/79, 28%) were the subject of any appreciable audit activity. There is wide variation in contact tracing policy and practice in GUM clinics in England and Wales. Audit of contact tracing effectiveness appears to be a minority activity. Further research is needed before an evidence-based approach to contact tracing can be implemented. Keywords: Contact tracing, partner noti®cation INTRODUCTION Contact tracing (partner noti®cation) has long been seen as a core aspect of the work of GUM clinics in the prevention and control of STDs. Contact tracing aims to break the chain of transmission of infection by identifying, counselling and screening sexual partners of an individual with an STD (index patient) and offering treatment if appropriate 1,2 . Three approaches to contact tracing are commonly used: patient referral (when the index patient is encouraged to contact his or her sexual partners and advise them to seek appropriate medical advice); provider referral (when a health-care professional noti®es the partners of the index patient without naming the patient concerned) and conditional referral (when health-care profes- sionals obtain partners’ names from the index patients but the patients are allowed a period of time to notify the partners themselves) 3 . Information on the effectiveness of contact tracing in reducing the prevalence of STDs in the community is, however, lacking 1,4 . A recent systematic review considered the effectiveness of alternative contact tracing strategies for STDs 5 . The authors concluded that only limited conclusions relating to the effectiveness of different approaches to partner noti®cation can be drawn on the basis of the available evidence. Little is known about current practice in relation to contact tracing in English and Welsh GUM clinics. Existing guidance dates from 1980 6 and published studies report disease-speci®c audits of contact tracing effectiveness rather than describing current contact tracing practice 1 . The one exception is a recently published survey of HIV partner noti®cation policy in England 7 . Information about current practice can be used to highlight variations in practice and also to inform the development of updated guidance. The latter approach has been used in Canada where evidence-based guidelines for partner noti®cation for STDs have been developed from both a survey of existing practice and a systematic review of the evidence 3,5,8,9 . International Journal of STD & AIDS 1999; 10: 17±21 17 Correspondence to: Dr PaulSchober, Consultant in Genito-Urinary Medicine, Department of Genito-Urinary Medicine, The Leicester Royal In®rmary NHS Trust, Leicester LE1 5WW, UK at University of Otago Library on October 10, 2016 std.sagepub.com Downloaded from