Would targeting increase efficiency of syphilis partner services programs?--Data from New York City, Philadelphia, Texas, and Virginia.
BACKGROUND
Targeted partner notification (PN), or limiting PN to groups in which efforts are most successful, has been suggested as a potentially cost-effective alternative to providing PN for all syphilis case-patients. The purpose of this study was to identify index case characteristics associated with highest yield partner elicitation and subsequent case finding to determine whether some groups could be reasonably excluded from PN efforts.


METHODS
We examined index case characteristics and PN metrics from syphilis case management records of 4 sexually transmitted disease control programs--New York City, Philadelphia, Texas, and Virginia. Partner elicitation was considered successful when a case-patient named 1 or more partners during interview. Case finding was considered successful when a case-patient had 1 or more partners who were tested and had serologic evidence of syphilis exposure. Associations between case characteristics and proportion of pursued case-patients with successful partner elicitation and case finding were evaluated using χ2 tests.


RESULTS
Successful partner elicitation and new case finding was most likely for index case-patients who were younger and diagnosed at public sexually transmitted disease clinics. However, most characteristics of index case-patients were related to success at only a few sites, or varied in the direction of the relationship by site. Other than late latent case-patients, few demographic groups had a yield far below average.


CONCLUSIONS
If implemented, targeted PN will require site-specific data. Sites may consider eliminating PN for late latent case-patients. The lack of demographic groups with a below average yield suggests that sites should not exclude other groups from PN.
From the *Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA; †Epidemic Intelligence Service, Scientific Education and Professional Development Program Office, Division of Applied Sciences, Atlanta, GA; ‡Philadelphia Department of Public Health, Philadelphia, PA; §New York City Department of Health and Mental Hygiene, New York City, NY; ¶Texas Department of State Health Services, HIV/STD Prevention and Care Branch, Austin, TX; and ∥Virginia Department of Health, Division of Disease Prevention, Richmond, VA.
Brooke E
BE
Hoots
Felicia M T
FM
Lewis
Greta
G
Anschuetz
Julia A
JA
Schillinger
Susan
S
Blank
Tammy
T
Foskey
Jeffrey A
JA
Stover
Thomas A
TA
Peterman
D000293:Adolescent; D000328:Adult; D016358:Contact Tracing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015143:Philadelphia / Q000453:epidemiology; D015397:Program Evaluation; D011634:Public Health; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012747:Sexual Partners; D013587:Syphilis / Q000453:epidemiology* / Q000517:prevention & control; D013781:Texas / Q000453:epidemiology; D014768:Virginia / Q000453:epidemiology