Background:
In order to improve upon consistently low treatment rates of
chlamydia-infected women discharged untreated from jail, a
field-delivered therapy (FDT) protocol was developed.


Objective:
To evaluate the feasibility of FDT as a chlamydia (CT) treatment option
for recently incarcerated females and their partners.

Method:
A case-worker trained in FDT found cases in the field and offered a
clinic referral for treatment or field therapy. Cases accepting FDT
were offered field therapy or patient-delivered partner therapy (PDPT)
for their partners. Case records from January-September 2005 were
reviewed to evaluate the pilot.

Result:
Of the 138 cases assigned to the case worker, 43 (31%) were
successfully treated through FDT. Of the remaining cases, 63 (46%)
could not be located, 8 (6%) refused treatment, 20 (14%) remain open and
4 (3%) were administratively closed. Of the women receiving FDT, 7
(16%) were incarcerated on prostitution charges. Of the 56 sexual
contacts named by FDT recipients, PDPT was accepted for 20 (36%), 5 (9%)
were treated by FDT, 11 (20%) received a clinic referral from the case
worker, and 2 (1%) were incarcerated. For the remaining 19 (34%), cases
chose to refer their partners for treatment. Cases characterized their
relationships with elicited partners as 68% steady, 23% casual, and the
remaining 9% were not characterized. FDT or PDPT was accepted for 53%
of steady and 23% of non-steady partnerships. Treatment could be
verified for 12 (21%) of contacts. No adverse reactions to medication
were noted in the women or their partners.

Conclusion:
FDT allowed for the treatment of almost one third of the CT infected
females assigned to the case worker and FDT/PDPT allowed for treatment
of just under half of all their named sexual contacts.

Implications:
FDT and PDPT are feasible strategies to ensure prompt treatment of a
proportion of hard-to-reach, high risk cases and their sexual contacts.