California Department of Public Health, Center for Infectious Diseases, Division of Communicable Disease Control, Sexually Transmitted Disease Control Branch, Richmond, CA 94804, USA.
Sex Transm Dis. 2011 Oct;38(10):913-8. doi: 10.1097/OLQ.0b013e3182240366.
Prompt treatment of exposed partners is critical for preventing further transmission of chlamydia, reinfection, and sequelae among females. Patient-delivered partner therapy (PDPT) has been allowable in California since 2001; however, few data are available regarding PDPT use and treatment outcomes.
Eight family planning clinics participated in a partner services evaluation from 2005 to 2006. Females aged 16 to 35 years with chlamydia were interviewed to determine the partner service received and partner treatment outcomes; a subset of partners was also interviewed. Determinants of reported partner treatment were assessed using multivariate logistic regression. Selected medical records were reviewed to assess reinfection rates.
Overall, 743 female patients disclosed 952 partners; 58% of whom were identified as steady partners. Reported partner services included concurrent patient-partner treatment visits (15% of partners), PDPT (19%), patient referral (55%), health department referral (0.1%), and no partner management (11%). On the basis of patient report, 82% of partners were notified and 54% received treatment. Of the 166 (17%) partners interviewed, 139 (84%) reported that they had received treatment, which correlated well with patient report. Reported partner treatment was higher for concurrent treatment visits and PDPT (79% and 80%, respectively) compared to patient referral (44%, P < 0.0001). Adjusted for clinic and relationship status, partners managed with concurrent treatment visits or PDPT were more likely to receive treatment compared with partners managed with patient referral (adjusted odds ratios, 3.5; 95% confidence interval, 2.1-5.8 and adjusted odds ratios, 4.3; 95% confidence interval, 2.6-7.2, respectively). Among the patients retested within 6 months after treatment, 18% were reinfected; reinfection rates did not differ by type of partner service.
Although overall rates of reported partner treatment were low, concurrent patient-partner treatment visits and PDPT were associated with significantly higher rates of partner treatment. However, these methods may be underutilized in California family planning settings.
及时治疗暴露的性伴侣对于预防衣原体在女性中进一步传播、再次感染和后遗症至关重要。自 2001 年以来，加利福尼亚州已经允许患者自行提供性伴侣治疗（PDPT）；然而，关于 PDPT 的使用和治疗结果的数据很少。
2005 年至 2006 年，8 家计划生育诊所参与了一项伴侣服务评估。对年龄在 16 至 35 岁之间的衣原体感染女性进行了访谈，以确定所接受的伴侣服务和伴侣治疗结果；还对一部分伴侣进行了访谈。使用多变量逻辑回归评估报告的伴侣治疗的决定因素。对选定的病历进行了回顾，以评估再感染率。
总体而言，743 名女性患者共披露了 952 名性伴侣；其中 58%为稳定伴侣。报告的伴侣服务包括同时进行的患者-伴侣治疗就诊（15%的伴侣）、PDPT（19%）、患者转诊（55%）、卫生部门转诊（0.1%）和无伴侣管理（11%）。根据患者报告，82%的伴侣被通知，54%接受了治疗。在接受采访的 166 名（17%）伴侣中，有 139 名（84%）报告说他们接受了治疗，这与患者报告相符。与患者转诊（44%）相比，同时治疗就诊和 PDPT 的伴侣治疗报告率更高（分别为 79%和 80%，P<0.0001）。调整诊所和关系状况后，与患者转诊相比，同时进行治疗就诊或 PDPT 管理的伴侣更有可能接受治疗（调整后的优势比，3.5；95%置信区间，2.1-5.8 和调整后的优势比，4.3；95%置信区间，2.6-7.2）。在治疗后 6 个月内重新检测的患者中，18%再次感染；不同类型的伴侣服务的再感染率没有差异。
尽管报告的伴侣治疗总体比率较低，但同时进行的患者-伴侣治疗就诊和 PDPT 与伴侣治疗的比率显著提高相关。然而，在加利福尼亚州的计划生育环境中，这些方法可能未得到充分利用。
