Stekler Joanne, Bachmann Laura, Brotman Rebecca M, Erbelding Emily J, Lloyd Laura V, Rietmeijer Cornelis A, Handsfield H Hunter, Holmes King K, Golden Matthew R
Department of Medicine, Division of Infectious Diseases, University of Washington, Seattle, WA, USA.
Clin Infect Dis. 2005 Mar 15;40(6):787-93. doi: 10.1086/428043. Epub 2005 Feb 21.
Patient-delivered partner therapy (PDPT) is the practice of providing disease-specific antimicrobial agents to patients for delivery to their sex partners. Some partners who receive PDPT may forgo clinical evaluation, resulting in missed opportunities for the diagnosis and treatment of comorbid conditions.
We conducted a review of electronic charts for 8623 individuals attending 4 sexually transmitted disease clinics who were sex partners of patients with selected sexually transmitted infections (STIs). We evaluated the concordance between STIs diagnosed in partners and their reported exposures for which they might have received PDPT.
Among 3503 female and 4647 heterosexual male partners, 19 (0.4%) of 4716 individuals tested were newly diagnosed with human immunodeficiency virus (HIV) infection, and 61 individuals (0.7%) had syphilis. Pelvic inflammatory disease was diagnosed in 133 women (3.8%). Seventy-two (3.2%) of 2226 female and heterosexual male partners reporting exposure to patients with chlamydial infection had gonorrhea diagnosed. Chlamydial infection or gonorrhea was diagnosed in 81 heterosexual male partners (10.3%) who reported contact with women with trichomoniasis. Among 473 men who have sex with men (MSM; including bisexual men), 13 (6.3%) of 207 tested were newly diagnosed with HIV infection, and 8 (1.7%) had syphilis. Six (6.1%) of 98 MSM reporting exposure to patients with chlamydial infection had gonorrhea diagnosed.
Infrequent coinfections in female and heterosexual male partners exposed to patients with chlamydial infection or gonorrhea would not preclude use of PDPT. However, PDPT for male partners of women with trichomoniasis and for MSM requires further study.
患者主导的性伴治疗(PDPT)是指为患者提供特定疾病抗菌药物,以便其分发给性伴的做法。一些接受PDPT的性伴可能会放弃临床评估,从而导致错过诊断和治疗合并症的机会。
我们对4家性传播疾病诊所的8623名个体的电子病历进行了回顾,这些个体是患有特定性传播感染(STIs)患者的性伴。我们评估了性伴中诊断出的性传播感染与其报告的可能接受PDPT的暴露情况之间的一致性。
在3503名女性和4647名异性恋男性性伴中,4716名接受检测的个体中有19人(0.4%)被新诊断出感染人类免疫缺陷病毒(HIV),61人(0.7%)患有梅毒。133名女性(3.8%)被诊断出患有盆腔炎。在报告接触衣原体感染患者的2226名女性和异性恋男性性伴中,72人(3.2%)被诊断出患有淋病。在报告与滴虫病女性接触的81名异性恋男性性伴中(10.3%),诊断出衣原体感染或淋病。在473名男男性行为者(MSM;包括双性恋男性)中,207名接受检测的个体中有13人(6.3%)被新诊断出感染HIV,8人(1.7%)患有梅毒。在98名报告接触衣原体感染患者的男男性行为者中,6人(6.1%)被诊断出患有淋病。
接触衣原体感染或淋病患者的女性和异性恋男性性伴中合并感染情况不常见,这并不妨碍使用PDPT。然而,针对滴虫病女性的男性性伴和男男性行为者的PDPT需要进一步研究。