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D4.2 Provision of Patient-Delivered Partner Therapy (PDPT) by Providers in a Community-Level Randomized Trial of Expedited Partner Therapy in Washington State

Thursday, March 15, 2012: 8:40 AM
Nicollet Grand Ballroom (C/D)
Roxanne Kerani, PhD, HIV/STD Control Program, Public Health - Seattle and King County, Seattle, WA, Mark Stenger, MA, Infectious Disease & Reproductive Health, Assessment Unit, Washington State Department of Health, Olympia, WA, Mark Aubin, BA, STD Services Section, Washington State Department of Health, Olympia, WA, James Hughes, PhD, Biostatitics, University of Washington, Seattle, WA, King Holmes, MD, PhD, Global Health, University of Washington, Seattle, WA and Matthew Golden, MD, MPH, Center for AIDS and STD, University of Washington, Seattle, WA

     

Background:  Most studies suggest that <20% of persons diagnosed with chlamydia or gonorrhea (CT/GC) receive PDPT.

Objectives:  To estimate the percentage of heterosexuals with CT/GC receiving PDPT from clinicians, and identify correlates of PDPT use, in areas of Washington State participating in a program providing free PDPT.

Methods: Heterosexual cases of CT/GC reported during the intervention phase of a community-level trial of EPT were randomly selected for interviews measuring PDPT use.  Partner services (PS) guidelines instructed providers to refer patients for PS if patients had >2 partners in the 60 days preceding diagnosis, were unable to contact partners, or did not anticipate having sex with a partner again.  We used log regression to identify characteristics associated with PDPT use. 

Results: Of 41,164 cases reported 2008-2011, 8,779 (19%) were randomly selected for interview; 4,927 (56%) had complete data collected.  Overall, 1,538 (31%) cases received PDPT from a provider.  Factors associated with receiving PDPT included: female gender (36% vs. 15% in males, adjusted prevalence ratio [APR]=1.81, 95% CI:1.58-2.07); diagnosis in family planning clinics (52%, APR=1.15, CI:1.07-1.24), women’s health clinics (45%, APR=1.16, CI:1.07-1.26), emergency rooms (9%, APR=0.66, CI:0.50-0.88), or military settings (12%, APR=0.42, CI:0.32-0.55) versus through private providers (27%); having >2 partners in the 60 days preceding diagnosis (15% vs. 35%, APR=0.82, CI:0.72-0.93); and not being referred for PS (55% vs. 10%, APR=2.82, CI:2.50-3.17).  Patients who reported having untreated partners at interview had received PDPT less frequently than those with only treated partners (11% vs. 56%, APR=0.21, CI: 0.18-0.25).  A subset of cases was asked if their clinician offered them PDPT; 1,796/3,562 (50%) responded affirmatively; 1,145 (64%) used PDPT.

Conclusions: Approximately one-third of Washington heterosexuals diagnosed with chlamydia or gonorrhea receive PDPT, and half are offered it.  PDPT use is associated with increased partner treatment. 

Implications for Programs, Policy, and Research:  Public health programs promoting free PDPT can help assure high levels of use.     

See more of: Physician, Heal Thy Patient’s Partner: Partner Services and STD Prevention
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