A Randomized Controlled Trial Comparing inSPOT and Patient-Delivered Partner Therapy to Standard Partner Notification Among MSM: The Good, the Bad, and the Ugly

Background:  The efficacy of patient-delivered partner therapy (PDPT) and inSPOT, a web-based partner notification service, in increasing partner treatment and/or notification among men who have sex with men (MSM) has not been evaluated.

Objectives:  To describe enrollment of MSM in a randomized trial of inSPOT and PDPT and to evaluate the use of inSPOT and PDPT among enrollees.

Methods:  We enrolled MSM with chlamydia and/or gonorrhea in a randomized, controlled trial with four arms: inSPOT alone, PDPT alone, inSPOT and PDPT combined (inSPOT/PDPT), and standard partner management.  Men were offered enrollment when contacted for partner management.  Participants completed short baseline and follow-up interviews approximately 2 weeks apart.  Participants could contact partners themselves or have study staff manage partners.

Results:  We attempted to offer enrollment to 551 men.  Seventy-eight (14%) enrolled, 155 (28%) were ineligible, 281 (51%) refused, and 37 (7%) were not contacted.  The study was halted early due to low enrollment.  Among the 78 enrollees, 53 (68%) completed baseline and follow-up interviews.  Of these 53 men, 13, 10, 17, and 13 were assigned to the PDPT, inSPOT, inSPOT/PDPT, and standard arms, respectively.  These 53 participants provided information about 193 partners.  Across all study arms, among partners notified by participants, most were notified in person (38%), by telephone (34%), or by email (22%).  Of the 27 men assigned to the inSPOT or inSPOT/PDPT arms, 1 (4%) used inSPOT to notify at least one partner.  Of the 30 men in the PDPT and inSPOT/PDPT arms, 24 (80%) reported giving PDPT to ≥1 partner. 

Conclusions:  Few MSM are willing to enroll in a randomized trial comparing partner notification methods.  PDPT is highly acceptable, but almost no MSM used inSPOT in our study. 

Implications for Programs, Policy, and/or Research:  Randomized trials of partner notification strategies may not be feasible in MSM