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Comparison of In-Person Versus Telephone Interviews for Early Syphilis and Human Immunodeficiency Virus Partner Services in King County, Washington (2010–2014)

Heumann, Christine L. MD, MPH; Katz, David A. PhD, MPH; Dombrowski, Julia C. MD, MPH; Bennett, Amy B. MPH; Manhart, Lisa E. PhD, MPH; Golden, Matthew R. MD, MPH

Sexually Transmitted Diseases: April 2017 - Volume 44 - Issue 4 - p 249–254
doi: 10.1097/OLQ.0000000000000583
The Real World of STD Prevention

Background The relative effectiveness of in-person versus telephone interviews for human immunodeficiency virus (HIV)/sexually transmitted disease partner services (PS) is uncertain.

Methods We compared outcomes of in-person versus telephone PS interviews for early syphilis (ES) and newly diagnosed HIV in King County, Washington from 2010 to 2014. We used multivariable Poisson regression to evaluate indices (number of partners per original patient [OP]) for partners named, notified, tested, diagnosed, and treated (ES only). Analyses controlled for OP age, sex, race/ethnicity, sexual orientation, time to interview, place of diagnosis, and staff performing interviews.

Results For ES, 682 and 646 OPs underwent in-person and telephone interviews, respectively. In-person syphilis PS were associated with higher indices of partners named (in-person index [IPI], 3.43; telephone index [TI], 2.06; adjusted relative risk [aRR], 1.68; 95% confidence interval [CI], 1.55–1.82), notified (IPI, 1.70; TI, 1.13; aRR, 1.39; 95% CI, 1.24–1.56), tested (IPI, 1.15; TI, 0.72; aRR, 1.34; 95% CI, 1.16–1.54), and empirically treated (IPI, 1.03; TI, 0.74; aRR, 1.19; 95% CI, 1.03–1.37), but no difference in infected partners treated (IPI, 0.28; TI, 0.24; aRR, 0.93; 95% CI, 0.72–1.21). For HIV, 358 and 489 OPs underwent in-person and telephone interviews, respectively. In-person HIV PS were associated with higher indices of partners named (IPI, 1.87; TI, 1.28; aRR, 1.38; 95% CI, 1.18–1.62), notified (IPI, 1.38; TI, 0.92; aRR, 1.24; 95% CI, 1.03–1.50), and newly diagnosed with HIV (IPI, 0.10; TI, 0.05; aRR, 2.17; 95% CI, 1.04–4.50), but no difference in partners tested (IPI, 0.61; TI, 0.48; aRR, 1.15; 95% CI, 0.88–1.52).

Conclusions Although in-person syphilis PS were associated with some increased PS indices, they did not increase the treatment of infected partners. In contrast, in-person HIV PS resulted in increased HIV case finding. These data support prioritizing in-person PS for HIV and suggest that in-person PS for syphilis may not have major public health benefit.

A study comparing in-person versus telephone partner services in King County, Washington, found no difference in finding or treating syphilis cases but found increased human immunodeficiency virus case finding with in-person interviews.

From the *Department of Medicine, Division of Infectious Diseases, Wayne State University, Detroit, MI; †Department of Medicine, University of Washington; ‡Public Health-Seattle and King County HIV/STD Program; §Department of Medicine, Division of Allergy and Infectious Diseases, and ¶Departments of Epidemiology and Global Health, University of Washington, Seattle, WA

Conflicts of interest: L.E.M. receives kits and reagents from Hologic, Inc. For the remaining authors, no conflicts of interest were declared.

Sources of funding: C.H. worked on this project while being funded by a National Institutes of Health Host Defense Training in Allergy Infectious Diseases Grant (T32 AI007044-40).

Correspondence: Christine L. Heumann, MD, MPH, 50 East Canfield Street, Suite 101-S, Detroit, MI 48201. E-mail: cheumann@med.wayne.edu.

Received for publication October 16, 2016, and accepted December 16, 2016.

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