Evaluation of partner services for treatment of chlamydia trachomatis in California family planning clinics

Background:
With approximately 100,000 cases of chlamydia reported among California women and >10% repeat infection rates in family planning (FP) settings, effective strategies for clinic-based partner management are crucial. The availability of sexual health services for men in FP clinics as well as legislation allowing patient-delivered partner therapy (PDPT) for chlamydial infections create unique opportunities to improve partner treatment in California.

Objective:
To evaluate use and effectiveness of partner management strategies offered to women with diagnosed chlamydia in FP clinics.

Method:
During January 2005–December 2006, women aged 16–35 years with laboratory-confirmed chlamydial infection attending eight FP clinics in California were interviewed by telephone after treatment. Data were collected regarding partner management strategies for as many as three partners. The outcome of interest was patients' reports of partners receiving medication.

Result:
We interviewed 744 women with diagnosed chlamydia; 957 male partners were named as contacts. Based on patient recall, partner management strategies suggested by clinics were patient referral (521/957, 54%), PDPT (193, 20%), bringing partner to treatment visit (131, 14%), and provider referral (1, 0.1%). Ninety-three partners received no referral and 18 had missing data. Overall, 509 (53%) partners reportedly received medications for chlamydia. By strategy, recommending partners be brought to the clinic for treatment resulted in 81% partners receiving medication (106 of 131 partners); PDPT, 79%; patient referral, 44%; and no reported referral, 6%.

Conclusion:
PDPT was as effective as instructing patients to bring their partners for treatment. PDPT was more effective than traditional patient referral, yet less commonly used by FP providers.

Implications:
FP clinics that use enhanced partner management strategies described here are successful in treating partners of women with chlamydia. More research is needed to identify barriers for adopting effective strategies in clinics where traditional patient referral is used.