Explaining Experiences Of Accelerated Partner Therapy Partner Notification For People With Chlamydia In The Lustrum Randomised Control Trial: Process Evaluation

Background Accelerated partner therapy (APT) is a partner notification (PN) method whereby healthcare professionals assess sex partners by telephone, then send or give the index patient antibiotics and self-sampling kits for their sex partner(s). APT was implemented within a cluster cross-over randomised control trial in 17 sexual health clinics in Britain (2018–2019, ISRCTN Reference 15996256). We conducted an integral process evaluation to help explain experiences of using APT. Methods Focus groups and telephone interviews with 34 healthcare professionals who delivered APT, and telephone interviews with 15 index patients and 17 sex partners who chose APT. Topic guides focussed on how APT was implemented and overall APT experiences. Data were analysed deductively using a bespoke framework derived from initial conceptualisations of APT, and key trial findings. Results Low uptake of APT was largely because index patients felt it was only suitable for certain types of sex partner. APT was considered best suited to established relationships and not appropriate for relationships with lower emotional connection. However, APT was not always offered by healthcare professionals and many sex partners attended clinic with index patients when they attended for treatment. Nevertheless, those who chose APT felt it worked better than existing options and helped partners overcome barriers to face-to-face care. Most sex partners received APT packs directly from the index patient within a day of consultation; some prioritised taking treatment over self-sampling. Some sex partners reported difficulties in blood sampling (finger-prick) resulting in fewer HIV and syphilis samples being returned than chlamydia and gonorrhoea (urine/vulvo-vaginal swab). Some sex partners did not value testing for infections other than chlamydia/gonorrhoea. Conclusions APT benefits established sexual partnerships with greater emotional connection, by providing treatment rapidly and overcoming barriers to face-to-face care. Targeting of APT combined with interventions to increase sex partner return of self-samples are needed.