Systematic review of Economic studies of Partner Notification and management interventions for sexually transmitted infections including HIV in men who have sex with men

Objectives: Men who have sex with men (MSM) are disproportionately affected by sexually transmitted infections (STIs). Partner notification (PN) to identify, test and treat sex partners of MSM with bacterial STIs is challenging because MSM often report larger numbers of sex partners and a higher proportion of one-off partners who may be difficult to engage. However, one-off partners contribute disproportionately to onward transmission. Economic research on PN has typically focused on heterosexual people and evidence of effectiveness of PN in MSM is scant. We conducted a systematic review of economic studies of PN interventions in MSM to inform the development of a novel PN intervention for MSM with one-off partners. Method: Six electronic databases were searched up to June 2020. Cost studies and full economic evaluations, which focused on PN and/or testing and treatment (in the context of PN) of sex partners of MSM with STIs, and/or HIV, were included. A two-stage categorisation process was used for study selection and a narrative synthesis was reported. Results: Twenty-six studies of a possible 1909 met the selection criteria. Sixteen focused on MSM but only three of these were on PN. Few studies reported on patients characteristics and settings. Most studies were cost-utility analyses with outcomes reported as quality-adjusted life years (QALYs) which were derived from studies on heterosexual people. Conclusions: None of the identified studies specifically addressed cost-effectiveness of PN in MSM. The few studies identified as potentially relevant relied on costs and QALYs data from studies in heterosexual people, which may be inappropriate given the different patterns of sexual partnerships reported by these two groups. The lack of evidence on efficient PN approaches for MSM, a group with a high burden of infection, supports the need for new interventions tailored to the needs and preferences of MSM with parallel economic evaluation.