Wednesday, March 12, 2008
Partner notification (PN) is not a useful tool to assure care for partners of HPV-infected women or to prevent further transmission. HPV infection is highly prevalent in the general population, usually transient, and rarely associated with disease. Diagnostic or treatment options for HPV infection in men are lacking.
To determine whether providers recommend PN and partner referral for women with an abnormal Pap test or with a positive HPV test.
In 2004, we conducted a nationally representative survey of clinicians in specialties that provide cervical cancer screening. Providers were asked about their counseling messages for women with HPV infection, including their recommendations for the notification of the partner(s) and whether they encourage these women to tell their partner(s) to see a clinician.
Obstetrician gynecologists (51%) and certified nurse midwives (48%) were significantly less likely than providers in other specialties (61-73%) to encourage women with either an abnormal Pap test or a positive HPV test to tell their partner(s) to see a clinician. Providers in all specialties were significantly more likely to recommend that patients inform their partner(s) of test results if an HPV test was positive than if it was negative, both among providers performing reflex HPV testing (66-83% vs. 29-50%) and providers performing adjunct HPV testing (72-92% vs. 30-52%).
Most providers advise their female patients with cervical cancer screening test results suggestive of HPV infection to notify their partners of the infection and to see a clinician.
Education is needed to inform providers that clinical evaluation of male partners is not useful, and that PN has a limited role in the control of HPV transmission. While women may benefit from discussing HPV with their partners, they should not feel pressured to disclose their HPV results to partners.