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Objectives1.5 million people in the UK have mild to moderate learning disabilities. STIs and bloodborne viruses (BBVs) are over-represented in people experiencing broader health inequalities, which include those with mild learning disabilities. Self-managed care, including self-sampling for STIs/BBVs, is increasingly commonplace, requiring agency and health literacy. To inform the development of a partner notification trial, we explored barriers and facilitators to correct use of an STI/BBV self-sampling pack among people with mild learning disabilities.MethodsUsing purposive and convenience sampling we conducted four interviews and five gender-specific focus groups with 25 people (13 women, 12 men) with mild learning disabilities (July–August 2018) in Scotland. We balanced deductive and inductive thematic analyses of audio transcripts to explore issues associated with barriers and facilitators to correct use of the pack.ResultsAll participants found at least one element of the pack challenging or impossible, but welcomed the opportunity to undertake sexual health screening without attending a clinic and welcomed the inclusion of condoms. Reported barriers to correct use included perceived overly complex STI/BBV information and instructions, feeling overwhelmed and the manual dexterity required for blood sampling. Many women struggled interpreting anatomical diagrams depicting vulvovaginal self-swabbing. Facilitators included pre-existing STI/BBV knowledge, familiarity with self-management, good social support and knowing that the service afforded privacy.ConclusionIn the first study to explore the usability of self-sampling packs for STI/BBV in people with learning disabilities, participants found it challenging to use the pack. Limiting information to the minimum required to inform decision-making, ‘easy read’ formats, simple language, large font sizes and simpler diagrams could improve acceptability. However, some people will remain unable to engage with self-sampling at all. To avoid widening health inequalities, face-to-face options should continue to be provided for those unable or unwilling to engage with self-managed care.

IntroductionPartner notification (PN) is a process aiming to identify, test and treat the sex partners of people (index patients) with sexually transmitted infections (STIs). Accelerated partner therapy (APT) is a PN method whereby healthcare professionals assess sex partners, by telephone consultation, before giving the index patient antibiotics and STI self-sampling kits to deliver to their sex partner(s). The Limiting Undetected Sexually Transmitted infections to RedUce Morbidity programme aims to determine the effectiveness of APT in heterosexual women and men with chlamydia and determine whether APT could affect Chlamydia trachomatis transmission at population level.Methods and analysisThis protocol describes a cross-over cluster randomised controlled trial of APT, offered as an additional PN method, compared with standard PN. The trial is accompanied by an economic evaluation, transmission dynamic modelling and a qualitative process evaluation involving patients, partners and healthcare professionals. Clusters are 17 sexual health clinics in areas of England and Scotland with contrasting patient demographics. We will recruit 5440 heterosexual women and men with chlamydia, aged ≥16 years.The primary outcome is the proportion of index patients testing positive for C. trachomatis 12-16 weeks after the PN consultation. Secondary outcomes include: proportion of sex partners treated; cost effectiveness; model-predicted chlamydia prevalence; experiences of APT.The primary outcome analysis will be by intention-to-treat, fitting random effects logistic regression models that account for clustering of index patients within clinics and trial periods. The transmission dynamic model will be used to predict change in chlamydia prevalence following APT. The economic evaluation will use mathematical modelling outputs, taking a health service perspective. Qualitative data will be analysed using interpretative phenomenological analysis and framework analysis.Ethics and disseminationThis protocol received ethical approval from London—Chelsea Research Ethics Committee (18/LO/0773). Findings will be published with open access licences.Trial registration numberISRCTN15996256.

The ability to access and navigate online sexual health information and support is increasingly needed in order to engage with wider sexual healthcare. However, people from underserved populations may struggle to pass though this \"digital doorway\". Therefore, using a behavioural science approach, we first aimed to identify barriers and facilitators to i) seeking online sexual health information and ii) seeking online sexual health support. Subsequently, we aimed to generate theory-informed recommendations to improve these access points. The PROGRESSPlus framework guided purposive recruitment (15.10.21-18.03.22) of 35 UK participants from diverse backgrounds, including 51% from the most deprived areas and 26% from minoritised ethnic groups. Using semi-structured interviews and thematic analysis, we identified barriers and facilitators to seeking online sexual health information and support. A Behaviour Change Wheel (BCW) analysis then identified recommendations to better meet the needs of underserved populations. We found diverse barriers and facilitators. Barriers included low awareness of and familiarity with online information and support; perceptions that online information and support were unlikely to meet the needs of underserved populations; overwhelming volume of information sources; lack of personal relevancy; chatbots/automated responses; and response wait times. Facilitators included clarity about credibility and quality; inclusive content; and in-person assistance. Recommendations included: Education and Persuasion e.g., online and offline promotion and endorsement by healthcare professionals and peers; Training and Modelling e.g., accessible training to enhance searching skills and credibility appraisal; and Environmental Restructuring and Enablement e.g., modifications to ensure online information and support are simple and easy to use, including video/audio options for content. Given that access to many sexual health services is now digital, our analyses produced recommendations pivotal to increasing access to wider sexual healthcare among underserved populations. Implementing these recommendations could reduce inequalities associated with accessing and using online sexual health service.

IntroductionIn an increasingly digitalised world where people seek and first contact sex partners online, digital interventions offer the potential to enhance PN for STIs and HIV. However, the ways in which they could improve PN outcomes are unknown.MethodsWe conducted a systematic review of digital PN interventions for STIs/HIV in 8 databases to understand barriers and facilitators to such interventions. We used narrative synthesis to summarise the literature. We extracted barriers and facilitators for the behavioural foci: general notification (including but not differentiating between traditional and digital methods); digital notification (e.g., email, SMS, phone application); and partner management (sex partner testing/treatment). We then conducted a frequency analysis.ResultsEight studies fulfilled the inclusion criteria. They were heterogeneous in participants, digital interventions, and STIs/HIV considered. Unique to digital notification, barriers included problems with accessing technology. Facilitators included effective app functionality and apps enabling PN when contact details are unknown. These occurred alongside barriers and facilitators to notification in general, such as concerns about negative partner reactions and fear of shame (barriers) and social appropriateness of notification modality (e.g., email appropriate if face-to-face is not available) (facilitator).Abstract P11 Table 1Study characteristics of barriers and facilitators to digital partner notification for sexually transmitted infections and HIV Author (year), country Study sample Nature of intervention Aims STIs/HIV Study design and method Main results related to barriers and facilitators Balan et al. (2022), USA 48 cisgender MSM & TWSM Digital management:Phone application for self- & partner-testing(SMARTtest) - To describe participants’ use of test for self- & partner-testing, including general acceptability, challenges to use, & handling reactive Results - To report on how participants used the app to support use of the test Syphilis & HIV Mixed Methods Questionnaire (CASI); Post-test & app use: follow-up CASI & qualitative in-depth interview - Participants liked the test for its ease of use, quick results, & dual HIV/syphilis testing- Its blood-based nature hindered use with partners- Acceptability of the SMARTtest app was high for functionality & helpfulness Kutner et al. (2021), USA 60 cisgender MSM & TWSM Digital PN & management: Phone application for self- & partner-testing(SMARTtest) - To explore the interest in disclosing test results through an app Syphilis & HIV Mixed Methods In-person survey & interview - Smartphone sharing was envisioned as means to normalise testing, to notify partners of results & to expedite linkage to care- Authenticity of results shared by smartphone was questioned- Others voiced optimism that a personalised, authenticated app could ensure the security & veracity of results Contesse et al. (2019), USA Cisgender MSM using GSN apps to meet partners Digital PN & management1) PN through GSN apps from staff on a health department profile; 2) PN through app with patient‘s profile; 3) PN through in-app anonymous messaging system - To examine how MSM across the US use GSN apps & their perspectives regarding delivery of HIV/STD partner notification Not specified Qualitative: Online focus groups - Most participants were comfortable with HIV/STD PN delivered via GSN apps, either by partner services staff using a health department profile or through an in-app anonymous messaging system- Most participants expressed a responsibility to notify partners on their own, but app-based PN may be preferred for casual or hard-to-reach partners- Participants indicated that health departments will need to build trust with MSM app users to ensure acceptable & effective app-based delivery of PN Lessard et al. (2019), France PrEP Users, community mediators, HIV/STI management decision-makers Digital PN & management: Smartphone application (WeFLASH) - To describe stakeholders’ perspectives on the acceptability of a digital smartphone STI PN tool Not specified Qualitative: Focus groups & one-to-one interviews - Benefits of app: improve PN & STI screening, by notification of anonymous partners; provide customised linkage-to-care, through tailored information; & provide transferable epidemiological data, through real-time data- Risks of app: privacy & confidentiality, participants suggested specific security settings to protect users’ identity; sexual behaviour, participants suggested game-like functions to improve the integration of the tool in sexual contexts; fairness, emphasised importance of making the app accessible to all MSM Wang et al. (2016), China 372 MSM Digital PN: SMS, email, messenger programme - To examine willingness & preferences for PN among MSM to measure feasibility & optimise uptake Syphilis Quantitative: Factorial survey, sociodemographic questionnaire - Mean probability of participation in a syphilis PN programme was 64.5% for index patients & 63.7% for partners- Referral of partner to a private clinic or MSM CBO for follow-up decreased participation compared to the local CDC or public STD clinic Carnicer-Pont (2015), Spain 1,578 Spanish residents Digital PN:SMS with pseudonym; identifiable SMS; email with pseudonym; identifiable email; web page using a pseudonym; app - To explore the intention to use new communication technologies compared to F2F/phone call (one category) for PN in Spain Not specified Quantitative: 2 cross-sectional surveys - 37% would be willing to use a website for PN, 26% did not know if they would use one, & 37% would not want to use one- Reasons for not intending to notify STI/HIV were ‘shame or fear’ (stable partner) & ‘not knowing how to contact them’ (casual partner)- Preferred method of notification was F2F (73%) for both stable & casual partners- Using new technologies (SMS, email, web page, app) was widely accepted for notifying casual partners Hopkins et al. (2010), Australia 40 people with recent chlamydia diagnosis Digital PN: Email & SMS - To describe use & acceptability of different PN methods (F2F, phone, email, SMS, letter) to increase number of partners notified Chlamydia Qualitative: Semi-structured telephone interviews - Participants viewed F2F as ‘gold standard’ in PN because it demonstrated caring, respect & courage- Telephone contact, while considered insensitive by some, was valued because it was quick, convenient & less confronting Bilardi et al. (2010)*, Australia 202 men & women with recent chlamydia diagnosis Digital PN: Website with anonymous email & SMS function - To explore PN experiences of individuals diagnosed with chlamydia & to determine what might best assist them Chlamydia Quantitative: Telephone survey - Main reasons for informing partners were out of concern for them or because it was considered ‘the right thing to do’- Preferred methods for contacting partners were telephone & F2F- Nearly half would find website with anonymous email/SMS services useful- Of those who had not informed all partners with known contact details, 34% reported that if web-based tools were available, they would have contacted more partners App = Phone application, CASI = Computer-assisted self-interview, CBO = Community-based organisation, CDC = Center for Disease Control (USA), F2F = Face-to-face, GSN = Geosocial networking, MSM = Men who have sex with men, PN = Partner notification, PrEP = Pre-exposure prophylaxis, STD = Sexually transmitted disease, STI = Sexually transmitted infections, TWSM = Transgender women who have sex with men*Data was collected 2007/2008DiscussionDigital PN interventions are heterogenous and the differences are not clearly distinguished. Most interventions focus on notifying partners. Partner testing and treatment remains underexplored. There is a dearth of evidence on the barriers and facilitators to digital PN and further research is required. However, current evidence suggests that digital interventions can reduce some barriers to notification, but major barriers to PN in general endure.ReferencesBalán, I. C., Rios, J. L., Lentz, C., Arumugam, S., Dolezal, C., Kutner, B., Rael, C. T., Ying, A. W., Macar, O. U., & Sia, S. K. (2022). Acceptability and Use of a Dual HIV/Syphilis Rapid Test and Accompanying Smartphone App to Facilitate Self- and Partner-Testing Among Cisgender Men and Transgender Women Who Have Sex with Men. AIDS and Behavior, 26(1), 35–46. https://doi.org/10.1007/s10461-021-03322-9Bilardi, J. E., Fairley, C. K., Hopkins, C. A., Hocking, J. S., Temple-Smith, M. J., Bowden, F. J., Russell, D. B., Pitts, M., Tomnay, J. E., Parker, R. M., Pavlin, N. L., & Chen, M. Y. (2010). Experiences and outcomes of partner notification among men and women recently diagnosed with chlamydia and their views on innovative resources aimed at improving notification rates. Sexually Transmitted Diseases, 37(4), 253–258. https://doi.org/10.1097/OLQ.0b013e3181d012e0Carnicer-Pont, D., Barbera-Gracia, M. J., Fernández-Dávila, P., García de Olalla, P., Muñoz, R., Jacques-Aviñó, C., Saladié-Martí, M. P., Gosch-Elcoso, M., Arellano Muñoz, E., & Casabona, J. (2015). Use of new technologies to notify possible contagion of sexually-transmitted infections among men. Gaceta Sanitaria, 29(3), 190–197. https://doi.org/10.1016/j.gaceta.2015.01.003Contesse, M. G., Fredericksen, R. J., Wohlfeiler, D., Hecht, J., Kachur, R., Strona, F. V., & Katz, D. A. (2019). Attitudes about the use of geosocial networking applications for HIV/STD partner notification: A qualitative study. AIDS Education and Prevention, 31(3), 273–285. https://doi.org/10.1521/aeap.2019.31.3.273Hopkins, C. A., Temple-Smith, M. J., Fairley, C. K., Pavlin, N. L., Tomnay, J. E., Parker, R. M., Bowden, F. J., Russell, D. B., Hocking, J. S., & Chen, M. Y. (2010). Telling partners about chlamydia: How acceptable are the new technologies? BMC Infectious Diseases, 10(58). http://www.biomedcentral.com/1471-23

IntroductionPatient and Public Involvement and Engagement (PPIE) can improve research relevance, quality, and impact but is challenging because STIs are often transient and stigmatising. We describe the co-production and application of an innovative PPIE strategy within the SEQUENCE Digital research programme (sequencedigital.org.uk), which is developing and evaluating a widely accessible eSexual Health Clinic.MethodsWe co-produced a PPIE strategy, enabling community contributions to on-going and time-limited research activities. Through multiple communication modalities (written and oral involvement through group/individual discussions, via phone, video, messaging, emails and face-to-face), we accommodated contributors’ schedules and preferences (including for anonymity). Research funding enabled remuneration of contributors.ResultsTwelve community contributors of diverse ages, genders, ethnicities, sexual orientations, religions, and experiences of disability, mild learning difficulties and STI healthcare were recruited through various community-based organisations (CBOs), co-production networks and personal contacts. PPIE informed the refinement of the study website, co-production of simple-read website text, and development of consent forms, interview materials, demographic questionnaires, topic guides, case scenarios and clinical pathway diagrams.ConclusionCo-production of the PPIE strategy supported early, flexible and anonymised contributions to STI research while minimising the time, financial and opportunity costs to the public, CBOs and service users. Commitment (of research time and funds) to involve diverse contributors facilitated a participant-centric, culturally appropriate and inclusive study website and materials. These tools supported recruitment of research participants, who less frequently participate in research, have broad lived experiences and varying sexual health needs, thus expanding the research relevance, quality and impact.Abstract P87 Table 1Patient and Public Involvement and Engagement (PPIE) within the SEQUENCE Digital research programme: Activity, Communication Mode & Modification & Impact MatrixNumber of contributorsPre-trial Qualitative Study Activity a, b, c Communication Mode Modification and Impact Emails Zoom meetings Mobile messages Face-toface Phone calls All studies Pre-trial qualitative study protocol 1 • Updated the narrative to make this more lay friendly• Clarified data collection process• Offered examples of barriers to accessing services Website content review (narrative & imagery) 3 • Updated and simple-read website option• Updated text throughout the website Demographic survey review 4 • Updated survey questions to be more inclusive of people with mild learning difficulties (MLD), and from minority ethnicities Access Study (A)Explores barriers and facilitators to engaging with online sexual health care among population groups who may struggle to use them and who have unmet sexual health needs. Visuals and demographics survey review 4 • Updated questions to be more inclusive of people from minority ethnicities and varying sexual orientations• Rephrased the questions to be more inclusive of people with disabilities and/or MLD Informed consent form and participant information sheet review 1* • Co-produced a simple-read informed consent form and participant information sheet to be more inclusive of people with disabilities and MLD Pilot interview and topic guide review 2 • Simplified the questions• Streamlined and rephrased questions for clarity• Rephrased the questions to be more inclusive of gender diverse communities• Streamlined and rephrased explanations of sexual health services• Prioritised the content to maximise the feasibility of conducting interviews within 60 minutes Contact Study (B)Explores the use of online sexual health care services for partner notification and accessing STI treatment. Fictional personas, visuals and document review 2 • Increased inclusivity and accessibility of questions to better represent a wider group of people Pathway Study (C)Explores the use of online sexual health care services to receive STI test results, access treatment and support partner notification. Pilot interview, and topic guide and visuals review 5 • Simplified visuals• Refined questions• Refined existing questions to be more inclusive of gender diverse people and people with disabilities• Added in additional questions to the topic guides to gather specific needs of people who identify as trans/who have a trans history and/or living with a disability a Community Contributors included Yesmin Begum, Tyrone Curtis, India Henry, Adam Nordin, Roeann Osman, Al Richards and six others, to whom the research team would like to extend a note of thanks. Some Community Contributors took part in more than one research activity.b Community Contributors had a wide range of lived experiences, and sexual health needs. The group included people who less frequently engage with research, including people with a trans history or who identify as trans/who have a trans history, people from black and minority ethnic groups, people with a disability, people with mild learning difficulties.c Community Contributors were identified with support from the Co-Production Collective and the Black Health Agency for Equalityv.* The research team also worked with community-based organisation, get2gether who work with adults with disabilities to co-produce a simple-read informed consent form and participant information sheet.

IntroductionOnline sexual health services could widen access to sexual healthcare. However, some may struggle to use online services for various reasons, such as low socio-economic status and learning difficulties1. To inform development of an inclusive and accessible eSexual Health Clinic (eSHC2), this study aims to detail barriers and facilitators (B&Fs) to using online sexual health services among populations who may struggle.MethodsUsing the PROGRESS+ framework3 to inform purposive sampling, we recruited diverse participants (N=35) who had struggled to/never used online sexual health services, across NHS Trusts/Health boards and UK community-based organisations. Interviews investigated B&Fs to accessing sexual health information and advice online, ordering and returning STI self-sampling kits, getting STI results online, completing an online treatment consultation and accessing treatment. We extracted and tabularised B&Fs to each element of the care pathway.ResultsBarriers included lack of familiarity with online services; perceived impersonal nature of online sexual healthcare; concerns about ability to self-sample correctly and about misunderstanding questions/information leading to incorrect treatment. Facilitators included perceived anonymity and protection from judgement; convenience; many sexual healthcare needs being met discretely in one place; and perception that online NHS services could be trusted.DiscussionAmong disadvantaged populations, the eSHC could overcome some barriers to using sexual healthcare, such as embarrassment. However, it introduces novel barriers, including important concerns about misunderstanding information or questions leading to incorrect care and online services feeling too impersonal. Further analysis will develop theory-and-evidence-based recommendations to overcome modifiable barriers and optimise online sexual healthcare for inclusivity.Abstract O05 Table 1ReferencesRobinson L, Schulz J, Blank G, Ragnedda M, Ono H, Hogan B, Mesch G, Cotten SR, Kretchmer SB, Hale TM, Yan P. Digital inequalities 2.0: Legacy inequalities in the information age. First Monday, University of Illinois at Chicago Library, 2020; 25(7): 10.5210/fm.v25i7.10842. halshs-02889893Estcourt CS, Gibbs J, Sutcliffe LJ, Gkatzidou V, Tickle L, Hone K, Aicken C, Harding-Esch EM, Eaton S, Oakeshott P, Szczepura A. The eSexual Health clinic system for sexually transmitted infection management, prevention and control: exploratory studies demonstrating safety, feasibility and public health utility. The Lancet Public Health. 2017 Mar 18; 2(4): e182-e190. https://doi.org/10.1016/S2468-2667(17)30034-8O’Neill J, Tabish H, Welch V, Petticrew M, Pottie K, Clarke M, Evans T, Pardo Pardo J, Waters E, White H, Tugwell P. Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health. Journal of Clinical Epidemiology. 2014; 67(1): 56-64. http://doi.org/10.1016/j.jclinepi.2013.08.005

Background Migrant populations from countries with generalised HIV epidemics make up a significant proportion of all HIV/AIDS cases in many European Union and European Economic Area (EU/EEA) countries, with heterosexual transmission the predominant mode of HIV acquisition. While most of these infections are diagnosed for the first time in Europe, acquisition is believed to have predominantly occurred in the home country. A proportion of HIV transmission is believed to be occurring post-migration, and many countries may underestimate the degree to which this is occurring. Our objectives were to review the literature estimating the proportion of migrants believed to have acquired their HIV post-migration and examine which EU member states are able to provide estimates of probable country of HIV acquisition through current surveillance systems. Methods A systematic review was undertaken to gather evidence of sexual transmission of HIV within Europe among populations from countries with a generalised epidemic. In addition, national surveillance focal points from 30 EU/EEA Member States were asked to complete a questionnaire about surveillance methods and monitoring of the likely place of HIV acquisition among migrants. Results & discussion Twenty-seven papers from seven countries were included in the review and 24 countries responded to the survey. Estimates of HIV acquisition post-migration ranged from as low as 2 % among sub Saharan Africans in Switzerland, to 62 % among black Caribbean men who have sex with men (MSM) in the UK. Surveillance methods for monitoring post-migration acquisition varied across the region; a range of methods are used to estimate country or region of HIV acquisition, including behavioural and clinical markers. There is little published evidence addressing this issue, although Member States highlight the importance of migrant populations in their epidemics. Conclusions There is post-migration HIV acquisition among migrants in European countries but this is difficult to quantify accurately with current data. Migrant MSM appear at particular risk of HIV acquisition post-migration. Countries that identify migrants as an important part of their HIV epidemic should focus on using an objective method for assigning probable country of HIV acquisition. Robust methods to measure HIV incidence should be considered in order to inform national prevention programming and resource allocation.

ObjectivesTo develop a classification of sexual partner types for use in partner notification (PN) for STIs.MethodsA four-step process: (1) an iterative synthesis of five sources of evidence: scoping review of social and health sciences literature on partner types; analysis of relationship types in dating apps; systematic review of PN intervention content; and review of PN guidelines; qualitative interviews with public, patients and health professionals to generate an initial comprehensive classification; (2) multidisciplinary clinical expert consultation to revise the classification; (3) piloting of the revised classification in sexual health clinics during a randomised controlled trial of PN; (4) application of the Theoretical Domains Framework (TDF) to identify index patients’ willingness to engage in PN for each partner type.ResultsFive main partner types emerged from the evidence synthesis and consultation: ‘established partner’, ‘new partner’, ‘occasional partner’, ‘one-off partner’ and ‘sex worker’. The types differed across several dimensions, including likely perceptions of sexual exclusivity, likelihood of sex reoccurring between index patient and sex partner. Sexual health professionals found the classification easy to operationalise. During the trial, they assigned all 3288 partners described by 2223 index patients to a category. The TDF analysis suggested that the partner types might be associated with different risks of STI reinfection, onward transmission and index patients’ engagement with PN.ConclusionsWe developed an evidence-informed, useable classification of five sexual partner types to underpin PN practice and other STI prevention interventions. Analysis of biomedical, psychological and social factors that distinguish different partner types shows how each could warrant a tailored PN approach. This classification could facilitate the use of partner-centred outcomes. Additional studies are needed to determine the utility of the classification to improve measurement of the impact of PN strategies and help focus resources.

IntroductionUK sexual health services are shifting online. Uptake of online partner notification and management (OPNM) for sexually transmitted infections (STIs) is low. There is a lack of evidence to guide its development and deployment. This study explored the acceptability of, and barriers and facilitators to, OPNM to inform the optimisation of an eSexual Health Clinic (eSHC).MethodsWe conducted semi-structured qualitative interviews (n=25) with UK sexual health service users recruited from clinics and the community (10/2021–01/2023). Interviews explored experiences of partner notification (PN), barriers to and facilitators of OPNM, and involved a walk-through of an OPNM prototype pathway (Figure 1) using fictional personas/scenarios. We analysed transcripts using thematic analysis.ResultsParticipants were diverse in terms of gender, sexual identity, and disability. Most found OPNM acceptable and described using some online PN methods themselves (e.g., texting). Facilitators included: perception of OPNM as more convenient and less embarrassing than face-to-face/telephone PN; perception of its suitability for use with casual partners; provision of multiple tools for both identifiable and anonymous PN; and facilitation of online partner testing/treatment. Barriers included: perception of OPNM as impersonal and preferences for telling/being told in a more personal way, especially in ongoing relationships; security and privacy concerns; and distrust of online notifications.Abstract O19 Figure 1DiscussionOPNM appears acceptable, but acceptability varied depending on relationship type and communication preferences. In developing an eSHC, consideration should be given to incorporating multiple options for communicating with partners that allow users to identify themselves or remain anonymous, and providing messaging that is personalisable to the relationship and context. Pairing PN with accessible online STI testing/information and treatment, where appropriate, may motivate index patients to engage in PN and efficiently link partners into online management. Building trust with users is key and may be facilitated through NHS branding and security/privacy assurances.