The effectiveness of patient-delivered partner therapy and chlamydial and gonococcal reinfection in San Francisco.
BACKGROUND
Patient-delivered partner therapy (PDPT) has been evaluated in randomized trials. No analysis has examined the impact of PDPT once implemented programmatically.


METHODS
We examined the association between receiving PDPT and Chlamydia trachomatis and Neisseria gonorrhoeae reinfection within 1 year in patients diagnosed at San Francisco City Clinic between October 31, 2005 and March 31, 2008. Propensity score modeling was used to control for the difference between persons who did and did not receive PDPT.


RESULTS
There was no significant difference between patients who received PDPT and those that did not in the crude cumulative risk for repeat infection with C. trachomatis or N. gonorrhoeae. Using propensity score analysis, the adjusted relative risk was 0.99 (0.86-1.14) for chlamydial reinfection and 0.90 (0.72-1.11) for gonococcal reinfection. Further analysis looking at men who have sex with men, men who have sex with women, and females showed no significant reductions in relative risk of reinfection for C. trachomatis or N. gonorrhoeae in these sub populations.


CONCLUSIONS
Continued evaluation of PDPT on reinfection rates in real world settings as well as cost-effectiveness analyses of PDPT are needed to assess this alternative method of partner treatment.
Stephens
Sally C
SC
STD Prevention and Control Services, San Francisco Department of Public Health, San Francisco, CA 94114, USA. Sally.Stephens@sfdph.org
Bernstein
Kyle T
KT
Katz
Mitchell H
MH
Philip
Susan S
SS
Klausner
Jeffrey D
JD
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002689:Chlamydia / Q000302:isolation & purification; D002690:Chlamydia Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D012495:San Francisco / Q000453:epidemiology; D055502:Secondary Prevention; D012747:Sexual Partners; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents