A4.2 Impact of a Chlamydia Trachomatis Diagnosis on Sex Partnership Patterns: Implications for Ongoing Transmission

Tuesday, March 13, 2012: 10:25 AM
Greenway Ballroom F/G
Linda Niccolai, PhD and Melinda Pettigrew, PhD, Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT

Background: Changes in sex partnership patterns after a diagnosis of Chlamydia trachomatis have implications for repeat infections and ongoing transmission at the population level.  This topic has received less attention than the role of partner treatment for ongoing transmission.

Objectives: To compare number of sex partners, proportion of sex partnerships that are new, partnership duration, and prevalence of concurrency prior to and after a C. trachomatis diagnosis among young women in a family planning setting.

Methods: A total of 188 women (mean age 21 years) with C. trachomatis were recruited at the time of their diagnosis and followed for an average of four months.  At baseline and follow-up visits, participants answered questions about sex partnerships in the previous 4 months using a series of partner-specific modules.

Results: The mean number of sex partners decreased after the diagnosis from 1.41 to 1.07 (p<.01).  The proportion of new sex partners decreased from 43.5% to 34.2% (p=.04).  The median duration of sex partnerships increased from 4.0 to 6.1 months but this difference was not statistically significant (p=.23).  The proportion of individuals reporting concurrent partnerships did not change between the pre- and post-diagnosis periods (21.4% and 18.2%, p=.43).

Conclusions: Decreases in overall numbers of sex partners and new partners after a diagnosis of C. trachomatis indicate that many women reduce risk factors for repeat infections and ongoing transmission.  The increased partnership duration suggests that many women continue with pre-diagnosis partnerships that, in conjunction with adequate partner treatment, may also reduce further infections through partnership stability.  However, the lack of reduction in partnership concurrency after a diagnosis suggests that some risks for ongoing transmission persist.

Implications for Programs, Policy, and Research: The time of a C. trachomatis diagnosis may be an important window of opportunity to educate patients about STI risk associated with concurrent partnerships.