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Background: In 2011, 321,849 cases of gonorrhea were reported in the United States (104.2 cases per 100,000 population). Partner notification (PN) is an important element of gonorrhea control: initiated through public health professionals (provider referral), patients (patient referral), or patient-delivered partner therapy (PDPT). We examine how patterns of notifying and treating partners of persons with gonorrhea differ by PN approach.
Methods: For provider referral estimates, we obtained 2010–2011 referral data for 1,959 patients (with 4,595 partners) seen in US STD clinics in 3 states. From the published literature (2005–2012), we extracted 10 estimates of patient referral data from 7 studies (3,853 patients, 7,490 partners) and 5 estimates of PDPT data from 5 studies (1,781 patients, 3,125 partners). We calculated the proportion of partners identified who were notified and who were treated. We also calculated notification and treatment ratios per 100 patients for each approach and made simple treatment cascades from the numbers of partners identified, notified and treated.
Results: With provider referral, 21% of all partners named by patients were notified and 19% were treated. With patient referral, 56% were notified and 34% were treated. With PDPT, 57% were notified and 46% were treated. Per 100 patients seen in the clinic, 50 partners were notified and 44 (88% of those notified) treated via provider referral; 96 partners were notified and 61 treated (64% of those notified) with patient referral; 90 were notified and 73 (81% of those notified) treated with PDPT.
Conclusions: Higher proportions of partners were treated through patient-based methods, but the highest proportion treated among those notified in provider referral. A mix of PN methods in a prevention program must be scalable and sustainable. The long-term goal of using a blend of notification strategies is to maximize reach to exposed persons in the population and provide some intervention for all.