The relative clinical effectiveness and cost-effectiveness of three contrasting approaches to partner notification for curable sexually transmitted infections: a cluster randomised trial in primary care

Since 1998 there has been a substantial increase in reported cases of sexually transmitted infection (STI), most strikingly in the 16–24 years age group.1 Across genitourinary medicine (GUM) clinics in the UK in 2007, young people accounted for 65% of chlamydia cases, 50% of cases of genital warts and 50% of gonorrhoea infections.1 Chlamydia is the most common STI in under-25s. Since 1998, the rate of diagnosed chlamydia has more than doubled in the 16–24 years age group (from 447 per 100,000 in 1998 to 1102 per 100,000 in 2007). This may be because of a combination of a higher proportion of young people testing, improved diagnostic methods and increased risk behaviour.1 Chlamydia infection can frequently go undetected, particularly in women, as it is often asymptomatic.1 If left untreated, chlamydia can lead to pelvic inflammatory disease and infertility in women. This highlights the importance of testing this higher-risk age group to ensure prompt diagnosis and treatment. It is estimated that 11–12% of 16- to 19-year-olds presenting at a GUM clinic with an acute STI will become reinfected within a year.2 In order to minimise reinfection, preventative measures are required, including effective methods of notifying partners to ensure rapid diagnosis and treatment and reduce the likelihood of index patients being reinfected from the same source.