array:24 [ "pii" => "S2387020620301108" "issn" => "23870206" "doi" => "10.1016/j.medcle.2019.11.006" "estado" => "S300" "fechaPublicacion" => "2020-05-08" "aid" => "5059" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2020;154:366-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0025775320300452" "issn" => "00257753" "doi" => "10.1016/j.medcli.2019.11.011" "estado" => "S300" "fechaPublicacion" => "2020-05-08" "aid" => "5059" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2020;154:366-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artículo especial</span>" "titulo" => "Confidencialidad de datos, secreto profesional y búsqueda de contactos en infecciones de transmisión sexual" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "366" "paginaFinal" => "369" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Data confidentiality, professional secret and contact research in sexually transmitted infections" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Antonio Macaya, Juan J. Guardia Hernández, Pablo Nuevo" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Antonio" "apellidos" => "Macaya" ] 1 => array:2 [ "nombre" => "Juan J." "apellidos" => "Guardia Hernández" ] 2 => array:2 [ "nombre" => "Pablo" "apellidos" => "Nuevo" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020620301108" "doi" => "10.1016/j.medcle.2019.11.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020620301108?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775320300452?idApp=UINPBA00004N" "url" => "/00257753/0000015400000009/v1_202004270601/S0025775320300452/v1_202004270601/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2387020620301200" "issn" => "23870206" "doi" => "10.1016/j.medcle.2018.12.025" "estado" => "S300" "fechaPublicacion" => "2020-05-08" "aid" => "4739" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2020;154:370-1" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Efficacy of secukinumab in psoriasis and psoriatic arthritis: A retrospective multicentre study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "370" "paginaFinal" => "371" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Eficacia del secukinumab en psoriasis y artritis psoriásica: estudio multicéntrico retrospectivo" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ricardo Ruiz-Villaverde, Lourdes Rodriguez-Fernandez-Freire, Manuel Galán-Gutierrez, Leandro Martinez-Pilar" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ricardo" "apellidos" => "Ruiz-Villaverde" ] 1 => array:2 [ "nombre" => "Lourdes" "apellidos" => "Rodriguez-Fernandez-Freire" ] 2 => array:2 [ "nombre" => "Manuel" "apellidos" => "Galán-Gutierrez" ] 3 => array:2 [ "nombre" => "Leandro" "apellidos" => "Martinez-Pilar" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775319300065" "doi" => "10.1016/j.medcli.2018.12.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775319300065?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020620301200?idApp=UINPBA00004N" "url" => "/23870206/0000015400000009/v2_202005120646/S2387020620301200/v2_202005120646/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S238702062030111X" "issn" => "23870206" "doi" => "10.1016/j.medcle.2019.12.001" "estado" => "S300" "fechaPublicacion" => "2020-05-08" "aid" => "5065" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "rev" "cita" => "Med Clin. 2020;154:358-65" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Review</span>" "titulo" => "Effect of antiresorptive and bone forming treatments in bone erosions in rheumatoid arthritis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "358" "paginaFinal" => "365" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Efecto del tratamiento antirresortivo y osteoformador en las erosiones óseas en la artritis reumatoide" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1408 "Ancho" => 750 "Tamanyo" => 66726 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Pathogenesis of bone erosion in patients with rheumatoid arthritis and mechanism of action of denosumab.</p> <p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">ACPAs recognize citrullinated vimentin expressed on the surface of osteoclast precursor cells; this union promotes osteoclast differentiation by releasing TNF-α. Further, chronic inflammation of the synovial membrane generates proinflammatory cytokines that promote osteoclast differentiation from precursor cells and the production of proteolytic enzymes that degrade articular cartilage, generating bone erosion.</p> <p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">ACPA: anti-citrullinated peptide antibodies; Dmab: denosumab; IL-6: interleukin 6; IL-1: interleukin 1; RANKL: Receptor Activator of Nuclear Factor Kappa κB Ligand; TNF-α: tumour necrosis factor alpha.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Belén Azuaga-Piñango, Pilar Peris" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Ana Belén" "apellidos" => "Azuaga-Piñango" ] 1 => array:2 [ "nombre" => "Pilar" "apellidos" => "Peris" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775320300518" "doi" => "10.1016/j.medcli.2019.12.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775320300518?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S238702062030111X?idApp=UINPBA00004N" "url" => "/23870206/0000015400000009/v2_202005120646/S238702062030111X/v2_202005120646/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Special article</span>" "titulo" => "Data confidentiality, professional secret and contact research in sexually transmitted infections" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "366" "paginaFinal" => "369" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Antonio Macaya, Juan J. Guardia Hernández, Pablo Nuevo" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Antonio" "apellidos" => "Macaya" "email" => array:1 [ 0 => "macaya@uic.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Juan J." "apellidos" => "Guardia Hernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Pablo" "apellidos" => "Nuevo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Universitat Internacional de Catalunya, Servicio de Dermatología y Venereología del Hospital Universitari de Bellvitge, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Facultad de Derecho, Universitat Abat Oliba – CEU de Barcelona, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Confidencialidad de datos, secreto profesional y búsqueda de contactos en infecciones de transmisión sexual" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Early identification of people suffering from a sexually transmitted infection (STI) helps decrease the transmission chain and prevents new infections. A study of the contacts of a STI patient (known as the “index case”) is one of the most important measures in the diagnosis of people who may be infected and be asymptomatic. One of the main factors associated with poor control of STIs is a malfunctioning contact search system. For example, it is suspected that one of the causes of congenital syphilis is the lack of diagnosis and treatment of pregnant women whose partners have not reported their disease.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Health authorities are implementing policies to optimize the search for contacts, guarantee their right to healthcare and improve this important public health problem.</p><p id="par0015" class="elsevierStylePara elsevierViewall">However, when the index case reveals the identity or other data of his/her contacts to the health personnel, or when they process this data, personal data protection rights may be violated, which could have legal implications. A special difficulty arises when the index case refuses to communicate his/her illness to his/her contacts.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The objective of this article is to show the current legal framework and problems that may affect routine clinical practice, with the aim of improving contact search strategies.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contact search</span><p id="par0025" class="elsevierStylePara elsevierViewall">There are 3 ways to notify contacts: through the index case (<span class="elsevierStyleItalic">patient referral</span>), through the healthcare professional (<span class="elsevierStyleItalic">provider referral</span>), or by means of an agreement by which, if the patient does not report after a while, the healthcare professional will do it (<span class="elsevierStyleItalic">contract referral</span>). There is no evidence on what is the most effective method of contact notifying.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In clinical practice, when the health personnel suggest that they will need to inform the contacts, the index case usually declares that he/she will tell his/her contacts about the STI. However, the actual percentage of index cases that carry out such reporting is not known. The available studies use the information reported by the patients themselves, which is a known source of bias.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In a recent study, among 275 participants, only 62% said they informed their contacts of their STIs. Less than half (48.3%) did it when it was a stable couple. Other variables associated in a statistically significant way to the non-notification of STIs were age, unprotected anal sex with sporadic partners and the practice of <span class="elsevierStyleItalic">chemsex</span>.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In another study of 924 young people aged 13–24, 77.6% reported having notified “at least one of their contacts”.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">In another study, 253 men who have sex with men (MSM) reported that 83.7% of relationships had been “casual sex,” and only 24.9% of these partners were contacted.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">5</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The contacts have negative reactions when informed: feeling of having been betrayed, suicidal ideation, fear of dying or suffering from an incurable disease, fear of acceptance and stigmatization by the family or the rest of their social network. These reactions are more pronounced when the index case is the contact's partner and their STI is the result of a relationship with a casual partner.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">6</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">A systematic review of contact notification found that between 58% and 93% of index cases prefer to communicate the infection themselves to their partners (<span class="elsevierStyleItalic">patient referral</span>). However, only 20–30% of partners actually went to a clinic to be evaluated.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">7</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">The search for contacts by the healthcare professional (<span class="elsevierStyleItalic">provider referral</span> and <span class="elsevierStyleItalic">contract referral</span>) involves delegation by the index case to people who do not know those contacts and from whom no consent has been requested to access their personal data.</p><p id="par0065" class="elsevierStylePara elsevierViewall">There is a growing tendency to stimulate the search for contacts by health authorities. Royal Decree 2210/1995 created the National Epidemiological Surveillance Network, and the management of Notifiable Diseases (ND) is regulated by Royal Decree 2210/1995 and Regulation SSI/445/2015. In Catalonia, for example, epidemiological surveillance networks have been created and the notifiable disease system has been regulated.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">8</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">The implementation of this type of searches can help reach people whom the index case does not really notify. However, it raises relevant legal and ethical problems regarding data confidentiality, professional secrecy and the duty to help people at risk. When the index case reveals his contacts to the healthcare staff (either for the medical record or for the <span class="elsevierStyleItalic">contract referral</span>), or when the latter searches for contacts, confidential data about a third party is often revealed without their consent (identity and often sexual practices, exercise or use of prostitution, telephone number, email, recreational drug use and number of partners). Due to the seriousness of the ND, the General Law of Public Health 33/2011, of 4th October, considers this data processing as shared confidentiality and not personal data disclosure.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Other situations of this type, relatively common, occur when the index case refuses to notify his/her contacts of the need for an STI screening, or when contacts that have been detected ask for the identity of the index case. In such cases there is a conflict between the right to data confidentiality and the right to health of a third party, or between the right to access the origin of the data itself and professional secrecy in the doctor-patient relationship respectively.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">The index case: right to health of contacts and criminalization of the transmission of sexually transmitted infections</span><p id="par0080" class="elsevierStylePara elsevierViewall">The index case has a legal obligation to report the risk of having contracted a serious illness to his/her contacts, otherwise he/she may incur the crime of bodily harm if it does not do so. The Criminal Code typifies the crime of bodily harm in article 147, which states: “whoever, by any means or procedure, causes another any harm that impairs the other person's bodily integrity or his physical or mental health”. Bodily harm involves imprisonment from 3 months to 3 years or a fine of 6 to 12 months. Article 148.4 increases the penalty to between 2 and 5 years if the affected party is the partner or another person with similar links.</p><p id="par0085" class="elsevierStylePara elsevierViewall">In the court ruling 1/2004 of the Provincial Court of Madrid, a defendant was sentenced to 6 years in prison and to pay compensation of €100,000 for intentional bodily harm for transmitting the human immunodeficiency virus (HIV) to her partner. The defendant, despite knowing she was HIV positive, had sex with the victim for 2 years without warning him of her illness. The aforementioned sentence mentions that the victim can benefit from the provisions of Law 35/95 of 11th December on protection and assistance to victims of violent criminal offences and against sexual freedom.</p><p id="par0090" class="elsevierStylePara elsevierViewall">Refusal to notify a possible contagion to a contact could also be considered a violation of article 195 of the Criminal Code, by not helping “a person who is helpless and in manifest and serious danger”, which can be punished with a 3–12 months fine.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Therefore, the index case needs to be informed during history-taking about his/her obligations regarding the search for contacts, and their right to be duly informed. Such procedure must be recorded in the medical record.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Criminalization involves the use of criminal law to sentence people who know they have an STI and do not notify it to their contacts, exposing them to an infection. In some countries it has been legislated criminalizing the transmission of STIs.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> In Austria the transmission of HIV, syphilis, gonorrhoea, chlamydia, hepatitis B virus and hepatitis C virus is considered a crime. In Belgium, the transmission of STIs is criminalized in general, without distinguishing between types of infections. In most European countries, however, only the transmission of HIV and syphilis is considered a crime. However, the European Center for Disease Prevention and Control suggests that the “criminalization” of contagion could negatively affect the notification to partners, for fear that the index case may be prosecuted by law. In this sense, authors such as Vallès et al. suggest that “the development of contact studies in Spain must be accompanied by the design of a legal framework which, among other things, protects against the possible criminalization observed in other countries regarding HIV infection”.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Health personnel: data protection and professional secrecy</span><p id="par0105" class="elsevierStylePara elsevierViewall">The healthcare professional needs to comply with professional secrecy, including not disclosing any personal data about the people to whom he/she provides care, as in the case of notifying the identity of the index case to his/her contacts.</p><p id="par0110" class="elsevierStylePara elsevierViewall">However, confidentiality is also violated when the index case reveals the identity of his/her contacts and other sensitive data to the healthcare professional. The index case would require the consent of their contacts to reveal their identity and sexual practices to the healthcare professional.</p><p id="par0115" class="elsevierStylePara elsevierViewall">The Criminal Code contemplates the crime of revealing confidential information in its articles 197–199. Prison sentences of 2–5 years are stipulated if the one who discovers secrets discloses them to third parties (197.3) and 2–6 years if the right to confidentiality is violated by a professional subject to a secrecy obligation (199.2).</p><p id="par0120" class="elsevierStylePara elsevierViewall">The Basic Law 41/2002, of 14th November, regulating patient autonomy and rights and obligations regarding clinical information and documentation, is also a guarantee: “Everyone has the right to confidentiality regarding their health data, and no one can access these data without prior authorization under the Law” (art. 7.1).</p><p id="par0125" class="elsevierStylePara elsevierViewall">Law 3/2018 on the Protection of Personal Data and guarantee of digital rights also stipulates the duty of confidentiality and data processing based on the consent of the affected party (articles 5 and 6).</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Contact health rights</span><p id="par0130" class="elsevierStylePara elsevierViewall">The right to health, included in article 43 of the Spanish Constitution, must be protected by public authorities. In the field of this study, this right is exercised appropriately when contacts know the risk of having an STI because of having had sex with the index case. Even if the index case refuses to report, the current legal framework allows the healthcare professional to communicate the risk to contacts.</p><p id="par0135" class="elsevierStylePara elsevierViewall">The Protocol of the <span class="elsevierStyleItalic">Department of Health of the Generalitat de Catalunya</span> states that “if the index case does not give consent, the legal framework enables the professional to communicate the identity of the index case and the disease in question in order to conduct the study of contacts”.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">The aforementioned protocol refers, as a justification for this statement, to two regulations:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0145" class="elsevierStylePara elsevierViewall">Article 11 of the 1999 LOPD (today replaced by Organic Law 3/2018, of 5th December, on Protection of Personal Data and guarantee of digital rights). Said LOPD article specifies the exceptions in which “the consent required in the previous paragraph shall not be necessary”. The consent will not be necessary “when the transfer of personal data related to health is necessary to solve an emergency that requires access to a file, or to carry out epidemiological studies in the terms established in the legislation on state or regional health” (art. 11.1.f).</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0150" class="elsevierStylePara elsevierViewall">Organic Law 3/1986, on Special Measures in Public Health,<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a> which in its third article states: “In order to control communicable diseases, the health authority, in addition to performing general preventive actions, may take appropriate measures to control the sick, people who are or have been in contact with them and the immediate environment, as well as those deemed necessary in case of risk of a communicable nature”.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel"><span class="elsevierStyleItalic">-</span></span><p id="par0155" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Llei de Salut Pública</span> 18/2009, which in article 55 refers to the previous law.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">11</span></a></p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0160" class="elsevierStylePara elsevierViewall">Basic law regulating patient autonomy and rights and obligations regarding information and clinical documentation. In its article 9, on the limits of informed consent, it is expected that physicians may carry out “interventions in favour of the patient's health in case of risk to public health due to healthcare reasons established by the Law”.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">12</span></a></p></li></ul></p><p id="par0165" class="elsevierStylePara elsevierViewall">The General Data Protection Regulation of the European Union (GDPR), directly applicable in all Member States, establishes 2 exceptions in its Article 9, which could deal with confidential data:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">-</span><p id="par0170" class="elsevierStylePara elsevierViewall">When “processing is necessary to protect vital interests of the interested party or of another person, in the event that the interested party is not physically or legally qualified to give consent” (9.2.c.).</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">-</span><p id="par0175" class="elsevierStylePara elsevierViewall">When “processing is necessary for preventive or occupational medical purposes, for evaluation of the worker's occupational capacity, for medical diagnosis, provision of healthcare assistance or treatment” (9.2.f.).</p></li></ul></p><p id="par0180" class="elsevierStylePara elsevierViewall">The legal system, therefore, seems to provide for exceptions that allow the processing of confidential data when there is a risk to the health of third parties, as in the case of STIs. This legal basis would justify even that the acceptance of the notification by the contacts would be mandatory, as it happens, for example, in Sweden.</p><p id="par0185" class="elsevierStylePara elsevierViewall">However, the Criminal Code does not contemplate exceptions in the access and processing of confidential data. The LOPD, the Organic Law of special measures in the field of public health and the GDPR of the European Union allow the processing of such confidential data “when necessary to solve emergency situations” and of “general interest”, concepts that leave a broad margin for subjective interpretation. The GDPR, on the other hand, seems to indicate that data can only be processed “to protect vital interests”, and when the interested party is physically or legally incapacitated to give consent (art. 9.2.c), something that almost never happens with the contacts of the index case in the field of STIs.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Right to contact data protection</span><p id="par0190" class="elsevierStylePara elsevierViewall">The protocols implemented should also guarantee the right to contact data protection. Their consent should be obtained before disclosing their identity, and in any case, limit as much as possible the data obtained without a consent. Data such as sexual orientation, sexual practices, prostitution and <span class="elsevierStyleItalic">chemsex</span> are not necessary for the initial approach of these cases, and their disclosure does not seem to be supported by the health emergency situations contemplated by current legislation.</p><p id="par0195" class="elsevierStylePara elsevierViewall">The Law also protects the right to access your own data, which is the right to information about whether your data is being processed, the purpose, the planned communications and the origin of such data.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">13</span></a> In the case of STIs, the fact that contacts have the right to know the origin of their own data is equivalent to saying that they have the right to know the identity of the index case.</p><p id="par0200" class="elsevierStylePara elsevierViewall">Although access to the medical record is regulated by the Basic Law 41/2002, regulating patient autonomy and of rights and obligations regarding information and clinical documentation, the Spanish Agency for Data Protection has powers to address this access if, once exercised, the interested party does not obtain an answer or this is not satisfactory.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">Current data protection regulations also contemplate the rights to rectification, cancellation (“right to be forgotten”) and the right to oppose the processing of personal data. The exercise of these rights should be facilitated especially in cases where the screening of STIs in contacts is negative, since there is no public health reason that justifies the data access and processing of said contacts.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusions</span><p id="par0210" class="elsevierStylePara elsevierViewall">The search for contacts is considered today an essential tool in the control strategies of STIs.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a> It is a strategy that has been shown to reduce mortality and morbidity associated with gonococcal infection and <span class="elsevierStyleItalic">Chlamydia trachomatis</span>, HIV, syphilis <span class="elsevierStyleItalic">Trichomonas vaginalis</span> and urethral, vaginal, and genital ulcer syndromic conditions.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">16</span></a> However, given the growing awareness regarding data protection among the general population, and the possibility of legal liabilities being demanded from healthcare professionals involved in the care of people with STIs, we believe that legal clarification is needed in the protocols implemented by health authorities.</p><p id="par0215" class="elsevierStylePara elsevierViewall">The efforts of these authorities and the professionals involved cannot lose sight of the fact that the person who is mainly responsible, both legally and ethically for the search of contacts is the index case.</p><p id="par0220" class="elsevierStylePara elsevierViewall">The disclosure of data by the patient in case of diseases of exceptional importance for public health (ND) is regulated by the LGSP (Spanish acronym for General Law of Public Health), and is considered a shared secret, so that legal implications would be avoided. Once the data is disclosed, the processing must be correct. In this sense, it is necessary to improve the contact search and notification systems through strategies that enable the index case to carry it out.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">17</span></a> Patients need professional support to notify their diagnosis to their contacts, especially when these are the result of a casual relationship, and to understand the implications of their STI.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">18</span></a></p><p id="par0225" class="elsevierStylePara elsevierViewall">The contact search protocols by health personnel and the legislation that covers them should include:<ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">(1)</span><p id="par0230" class="elsevierStylePara elsevierViewall">Which STIs pose sufficient risk to justify access to third party data without consent. For example, 9.1% of a large group of English population had an asymptomatic chlamydial infection in 2016.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">19</span></a> It is, without a doubt, a public health problem. However, the risk of contracting a serious illness from third parties is low. Some authors recommend the search for contacts in cases of scabies and pediculosis.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a> In these cases, a judge might consider that there is not enough risk to disclose the identity of the index case or access third-party confidential data, especially if the index case itself is in a position to notify his/her illness to his/her contacts.</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">(2)</span><p id="par0235" class="elsevierStylePara elsevierViewall">The need to request as soon as possible an informed consent from the contacts so as to process their data, as well as guarantee their rights of access, rectification, cancellation, opposition, portability and the right to be forgotten.</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">(3)</span><p id="par0240" class="elsevierStylePara elsevierViewall">A clear strategy of action when the index case refuses to notify his/her contacts, without excluding a possible complaint to the authorities when this is contemplated in the Law. European legislation should be harmonized with regard to the criminalization of the transmission of STIs.</p></li></ul></p><p id="par0245" class="elsevierStylePara elsevierViewall">In summary, a more extensive and better implementation of the contact search system is suggested under a legislation that could contemplate the special complexity of STIs.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflict of interest</span><p id="par0250" class="elsevierStylePara elsevierViewall">All authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Contact search" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "The index case: right to health of contacts and criminalization of the transmission of sexually transmitted infections" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Health personnel: data protection and professional secrecy" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Contact health rights" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Right to contact data protection" ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Conclusions" ] 7 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflict of interest" ] 8 => array:2 [ "identificador" => "xack461296" "titulo" => "Acknowledgements" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-09-10" "fechaAceptado" => "2019-11-07" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Macaya A, Guardia Hernández JJ, Nuevo P. Confidencialidad de datos, secreto profesional y búsqueda de contactos en infecciones de transmisión sexual. Med Clin (Barc). 2020;154:366–369.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0105" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Documento de consenso sobre diagnóstico y tratamiento de las infecciones de transmisión sexual" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2017" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0110" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "ECDC. Public health benefits of partner notification for sexually transmitted infections and HIV. Available from: <a target="_blank" href="https://www.ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/Partner-notification-for-HIV-STI-June-2013.pdf">https://www.ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/Partner-notification-for-HIV-STI-June-2013.pdf</a> [accessed 21 October 2019]." ] ] ] 2 => array:3 [ "identificador" => "bib0115" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Factors associated with partner notification of STIs in men who have sex with men on PrEP in France: a cross-sectional substudy of the ANRS-IPERGAY trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Suzan-Monti" 1 => "L. Cotte" 2 => "L. Fressard" 3 => "E. Cua" 4 => "C. Capitant" 5 => "L. Meyer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/sextrans-2017-053304" "Revista" => array:6 [ "tituloSerie" => "Sex Transm Infect" "fecha" => "2018" "volumen" => "94" "paginaInicial" => "490" "paginaFinal" => "493" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29378903" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0120" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Partner notification for youth living with HIV in 14 cities in the United States" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.J. Van den Berg" 1 => "M. Javanbakht" 2 => "P.M. Gorbach" 3 => "B.J. Rudy" 4 => "A.O. Westfall" 5 => "C.M. Wilson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/QAI.0000000000001565" "Revista" => array:6 [ "tituloSerie" => "J. Acquir Immune Defic Syndr" "fecha" => "2018" "volumen" => "77" "paginaInicial" => "46" "paginaFinal" => "52" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29023252" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0125" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Partner notification in cooperation with community-based organizations among HIV-positive men who have sex with men in two Chinese cities" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "X. Fu" 1 => "J. Qi" 2 => "Y. Hu" 3 => "X. Pan" 4 => "Y. Li" 5 => "H. Liu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0956462416648827" "Revista" => array:6 [ "tituloSerie" => "Int J STD AIDS" "fecha" => "2016" "volumen" => "27" "paginaInicial" => "821" "paginaFinal" => "831" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27140946" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0130" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Partner notification for sexually transmitted infections and perception of notified partners" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E.G.F. Cavalcante" 1 => "M.C.C. Miranda" 2 => "A.Z.F.H.T. de Carvalho" 3 => "I.C.V. de Lima" 4 => "M.T.G. Galvão" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev da Esc Enferm da USP" "fecha" => "2016" "volumen" => "50" "paginaInicial" => "450" "paginaFinal" => "457" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0135" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Partner notification for sexually transmitted infections in developing countries: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "N. Alam" 1 => "E. Chamot" 2 => "S.H. Vermund" 3 => "K. Streatfield" 4 => "S. Kristensen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "BMC Public Health" "fecha" => "2010" "volumen" => "10" "paginaInicial" => "19" "paginaFinal" => "30" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0140" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Departamento de Salud. Generalitat de Catalunya. Decret 203/2015 pel qual es crea la Xarxa de Vigilància Epidemiològica i es regulen els sistemes de notificació de malalties de declaració obligatòria i brots epidèmics. Available from: <a target="_blank" href="http://cido.diba.cat/legislacio/6171237/decret-2032015-de-15-de-setembre-pel-qual-es-crea-la-xarxa-de-vigilancia-epidemiologica-i-es-regulen-els-sistemes-de-notificacio-de-malalties-de-declaracio-obligatoria-i-brots-epidemics-departament-de-salut">http://cido.diba.cat/legislacio/6171237/decret-2032015-de-15-de-setembre-pel-qual-es-crea-la-xarxa-de-vigilancia-epidemiologica-i-es-regulen-els-sistemes-de-notificacio-de-malalties-de-declaracio-obligatoria-i-brots-epidemics-departament-de-salut</a> [accessed 21 October 2019]." ] ] ] 8 => array:3 [ "identificador" => "bib0145" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Generalitat de Catalunya. Protocol per a l’estudi dels contactes de les persones diagnosticades d’ITS a Catalunya" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Departamento de Salud" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2018" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0150" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ley orgánica de medidas especiales en materia de salud pública" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Ministerio de Sanidad del Gobierno de España" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "1986" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0155" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Generalitat de Catalunya. Llei 18/2009 de Salut Pública. Available from: <a target="_blank" href="https://portaljuridic.gencat.cat/ca/pjur_ocults/pjur_resultats_fitxa?action=fitxa%26documentId=532871">https://portaljuridic.gencat.cat/ca/pjur_ocults/pjur_resultats_fitxa?action=fitxa&documentId=532871</a> [accessed 21 October 2019]." ] ] ] 11 => array:3 [ "identificador" => "bib0160" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Ministerio de Sanidad del Gobierno de España. Llei 41/2002 bàsica reguladora de l’autonomia del pacient i de drets i obligacions en matèria d’informació i documentació clinica. Available from: <a target="_blank" href="https://www.boe.es/boe_catalan/dias/2002/12/02/pdfs/A03057-03062.pdf">https://www.boe.es/boe_catalan/dias/2002/12/02/pdfs/A03057-03062.pdf</a> [accessed 21 October 2019]." ] ] ] 12 => array:3 [ "identificador" => "bib0165" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Ministerio de Justicia. Real Decreto 1720/2007, de 21 de diciembre, por el que se aprueba el Reglamento de desarrollo de la Ley Orgánica 15/1999, de 13 de diciembre, de protección de datos de carácter personal. Available from: <a target="_blank" href="https://www.boe.es/buscar/doc.php?id=BOE-A-2008-979">https://www.boe.es/buscar/doc.php?id=BOE-A-2008-979</a> [accessed 21 October 2019]." ] ] ] 13 => array:3 [ "identificador" => "bib0170" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Reglamento de la Agencia Española de Protección de Datos. Available from: <a target="_blank" href="https://www.aepd.es/reglamento/derechos/index.html">https://www.aepd.es/reglamento/derechos/index.html</a> [accessed 21 October 2019]." ] ] ] 14 => array:3 [ "identificador" => "bib0175" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estudios de contactos para infecciones de transmisión sexual ¿Una actividad descuidada?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "X. Vallès" 1 => "D. Carnicer-Pont" 2 => "J. Casabona" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.gaceta.2010.12.003" "Revista" => array:6 [ "tituloSerie" => "Gac Sanit" "fecha" => "2011" "volumen" => "25" "paginaInicial" => "224" "paginaFinal" => "232" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21420203" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0180" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infecciones de transmisión sexual: epidemiología y control" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Díez" 1 => "A. Díaz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/S1575-06202011000200005" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Sanid Penit" "fecha" => "2011" "volumen" => "13" "paginaInicial" => "58" "paginaFinal" => "66" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21750856" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0185" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Addressing gaps in the management of <span class="elsevierStyleItalic">Chlamydia trachomatis</span> and <span class="elsevierStyleItalic">Neisseria gonorrhoeae</span> in primary care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.B. Rose" 1 => "S.M. Garrett" 2 => "D. Hutchings" 3 => "K. Lund" 4 => "J. Kennedy" 5 => "S.R.H. Pullon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/OLQ.0000000000001005" "Revista" => array:6 [ "tituloSerie" => "Sex Transm Dis" "fecha" => "2019" "volumen" => "46" "paginaInicial" => "480" "paginaFinal" => "486" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30950981" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0190" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A qualitative study of means to improve partner notification after an HIV diagnosis among men who have sex with men in Australia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.E. Tomnay" 1 => "A. Hulme-Chambers" 2 => "J. Bilardi" 3 => "C.K. Fairley" 4 => "S. Huffam" 5 => "M.Y. Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/apc.2017.0080" "Revista" => array:6 [ "tituloSerie" => "AIDS Patient Care STDS" "fecha" => "2017" "volumen" => "31" "paginaInicial" => "269" "paginaFinal" => "274" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28605227" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0195" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Changes in chlamydia prevalence and duration of infection estimated from testing and diagnosis rates in England: a model-based analysis using surveillance data, 2000–15" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Lewis" 1 => "P.J. White" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Lancet Public Heal" "fecha" => "2018" "volumen" => "3" "paginaInicial" => "271" "paginaFinal" => "278" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0200" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cribado y estudio de contactos de infecciones de transmisión sexual en Atención Primaria. Más allá del diagnóstico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Peinado Adiego" 1 => "S. Velilla Zancada" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actual Med Fam" "fecha" => "2018" "volumen" => "36" "paginaInicial" => "251" "paginaFinal" => "258" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack461296" "titulo" => "Acknowledgements" "texto" => "<p id="par0255" class="elsevierStylePara elsevierViewall">We wish to thank Drs. María Jesús Barberá and Maider Arando Lasagabaster (Drassanes-Vall d’Hebron Sexually Transmitted Infections Unit, Barcelona), as well as Dr. Carlos García Forero (Epidemiology and Public Health, International University of Catalonia).</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015400000009/v2_202005120646/S2387020620301108/v2_202005120646/en/main.assets" "Apartado" => array:4 [ "identificador" => "44145" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Special article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015400000009/v2_202005120646/S2387020620301108/v2_202005120646/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020620301108?idApp=UINPBA00004N" ]
Journal Information
Vol. 154. Issue 9.
Pages 366-369 (May 2020)
Share
Download PDF
More article options
Vol. 154. Issue 9.
Pages 366-369 (May 2020)
Special article
Data confidentiality, professional secret and contact research in sexually transmitted infections
Confidencialidad de datos, secreto profesional y búsqueda de contactos en infecciones de transmisión sexual
Visits
2
This item has received
Article information
These are the options to access the full texts of the publication Medicina Clínica (English Edition)
Subscriber
Subscribe
Purchase
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail