The Effectiveness of Patient-Delivered Partner Therapy and Chlamydial and Gonococcal Reinfection in San Francisco

• Published in: Sexually transmitted diseases 2010-08, Vol.37 (8), p.525-529
• Main Authors: Stephens, Sally C., Bernstein, Kyle T., Katz, Mitchell H., Philip, Susan S., Klausner, Jeffrey D.
• Format: Article
• Language: English
• Subjects: Adult; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Bacterial diseases; Bacterial diseases of the genital system; Bacterial infections; Biological and medical sciences; Chlamydia; Chlamydia - isolation & purification; Chlamydia Infections - diagnosis; Chlamydia Infections - drug therapy; Chlamydia Infections - epidemiology; Chlamydia Infections - microbiology; Chlamydia trachomatis; Chlamydia trachomatis - isolation & purification; Drug therapy; Epidemiology. Vaccinations; Female; General aspects; Gonorrhea; Gonorrhea - diagnosis; Gonorrhea - drug therapy; Gonorrhea - epidemiology; Gonorrhea - microbiology; Human bacterial diseases; Human infectious diseases. Experimental studies and models; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Neisseria gonorrhoeae; Neisseria gonorrhoeae - isolation & purification; Original Study; Personal relationships; San Francisco - epidemiology; Secondary Prevention; Sexual Partners; Treatment Outcome; Young Adult
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/OLQ.0b013e3181d8920f

Background: Patient-delivered partner therapy (PDPT) has been evaluated in randomized trials. No analysis has examined the impact of PDPT once implemented programmatically. Methods: We examined the association between receiving PDPT and Chlamydia trachomatis and Neisseria gonorrhoeae reinfection within 1 year in patients diagnosed at San Francisco City Clinic between October 31, 2005 and March 31, 2008. Propensity score modeling was used to control for the difference between persons who did and did not receive PDPT. Results: There was no significant difference between patients who received PDPT and those that did not in the crude cumulative risk for repeat infection with C. trachomatis or N. gonorrhoeae. Using propensity score analysis, the adjusted relative risk was 0.99 (0.86-1.14) for chlamydial reinfection and 0.90 (0.72-1.11) for gonococcal reinfection. Further analysis looking at men who have sex with men, men who have sex with women, and females showed no significant reductions in relative risk of reinfection for C. trachomatis or N. gonorrhoeae in these sub populations. Conclusions: Continued evaluation of PDPT on reinfection rates in real world settings as well as cost-effectiveness analyses of PDPT are needed to assess this alternative method of partner treatment.