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Assessing Different Partner Notification Methods for Assuring Partner Treatment for Gonorrhea: Looking for the Best Mix of Options

Fleming, Eleanor PhD, DDS, MPH; Hogben, Matthew PhD

Journal of Public Health Management & Practice: May/June 2017 - Volume 23 - Issue 3 - p 247–254
doi: 10.1097/PHH.0000000000000458
Research Articles

Context: Partner notification for gonorrhea is intended to interrupt transmission and to bring people exposed to infection to care. Partner notification may be initiated through public health professionals (disease intervention specialist: DIS referral) or patients (patient referral). In some cases, patients may carry medications or prescriptions for partners (patient-delivered partner therapy: PDPT).

Objective: To examine how patterns of notifying and treating partners of persons with gonorrhea differ by partner notification approach.

Design: From published literature (2005-2012), we extracted 10 estimates of patient referral data from 7 studies (3853 patients, 7490 partners) and 5 estimates of PDPT data from 5 studies (1781 patients, 3125 partners). For DIS referral estimates, we obtained 2010-2012 data from 14 program settings (4581 patients interviewed, 8301 partners). For each approach, we calculated treatment cascades based on the proportion of partners who were notified and treated. We also calculated cascades based on partners notified and treated per patient diagnosed.

Results: Proportions of partners notified and treated were, for patient referral, 56% and 34%; for PDPT, 57% and 46%; for DIS referral, 25% and 22%. Notification and treatment estimates for patient referral and PDPT were significantly higher than for DIS referral, but DIS referral was more efficacious than the other methods in assuring treatment among those notified (all Ps < .001). The notification and treatment ratios per patient seen were, for patient referral, 0.96 and 0.61; for PDPT, 0.90 and 0.73; for DIS referral, 0.45 and 0.40.

Conclusion: Patient-based methods had higher proportions of partners treated overall, but provider referral had the highest proportion treated among those notified. These data may assist programs to align the most efficacious strategies with the most epidemiologically or clinically important cases while assuring the best scalable standard of care for others.

US Public Health Service, Washington, District of Columbia (LCDR Fleming); National Center for Health Statistics, Hyattsville, Maryland (LCDR Fleming); and Social and Behavioral Research and Evaluation Branch, Division of STD Prevention of the National Center for HIV, Viral Hepatitis, STD and TB Prevention Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Hogben).

Correspondence: LCDR Eleanor Fleming, PhD, DDS, MPH, National Center for Health Statistics, 3311 Toledo Rd, Hyattsville, MD 20782 (vid4@cdc.gov; efleming07@email.mmc.edu).

The authors appreciate the programs that shared data for this project.

The authors have no conflicts or conflicts of interest, and no funding was given for the work of the authors.

The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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