California Department of Public Health-STD Control Branch, Richmond, CA 94804, USA.
Sex Transm Dis. 2012 Feb;39(2):122-7. doi: 10.1097/OLQ.0b013e318237b723.
Treatment of sex partners is a core strategy for the control of chlamydia. Innovations such as patient-delivered partner therapy (PDPT) are effective in preventing repeat chlamydial infections, but providers' practice and perceptions of PDPT have not been adequately evaluated. This evaluation describes family planning providers' practices, knowledge, attitudes, and barriers regarding PDPT and assesses factors associated with routine use.
A cross-sectional, self-administered, Internet-based survey of a convenience sample of family planning providers in California was conducted in 2007. Multivariate logistic regression was used to determine predictors associated with routine PDPT use.
Of the 286 respondents, 73% reported routinely using PDPT for chlamydia and 77% provided medication to clients for their partner(s). Providers were more likely to offer PDPT for female versus male clients (73% vs. 53%, P < 0.0001). More than 90% agreed that PDPT helped provide better care for clients, was well-received, and protected against reinfection. Common concerns about PDPT included missed counseling opportunities (51%) and incomplete care for partners (42%). Over one-third (41%) identified lack of reimbursement for PDPT as an important barrier to routine use. Independent predictors of routine PDPT use included affiliation with an agency that received free prepackaged single-dose medication for on-site PDPT dispensing (adjusted odds ratio = 2.66, 95% confidence interval: 1.39-5.10) and support of the clinic's medical director (adjusted odds ratio = 4.85, 95% confidence interval: 1.57-14.96).
A majority of providers in this sample reported routinely using PDPT for chlamydia-infected clients; provision of prepackaged medication to clinics facilitated use of PDPT.
治疗性伴侣是控制衣原体感染的核心策略。例如患者递药伴侣治疗(PDPT)等创新方法在预防重复衣原体感染方面非常有效,但提供者对 PDPT 的实践和看法尚未得到充分评估。本评价描述了计划生育提供者在 PDPT 方面的实践、知识、态度和障碍,并评估了与常规使用相关的因素。
2007 年,对加利福尼亚州的计划生育提供者进行了一项横断面、自我管理、基于互联网的便利样本调查。多变量逻辑回归用于确定与常规 PDPT 使用相关的预测因素。
在 286 名受访者中,73%的人报告常规使用 PDPT 治疗衣原体感染,77%的人向客户提供药物治疗其伴侣。与男性客户相比,提供者更愿意为女性客户提供 PDPT(73%对 53%,P < 0.0001)。超过 90%的人认为 PDPT 有助于为客户提供更好的护理,受到好评,并防止再次感染。关于 PDPT 的常见担忧包括错过咨询机会(51%)和对伴侣的护理不完整(42%)。超过三分之一(41%)的人认为缺乏对 PDPT 的报销是常规使用的一个重要障碍。常规使用 PDPT 的独立预测因素包括与接受免费预包装单剂量药物进行现场 PDPT 配药的机构有关(调整后的优势比=2.66,95%置信区间:1.39-5.10)和对诊所医疗主任的支持(调整后的优势比=4.85,95%置信区间:1.57-14.96)。
本样本中的大多数提供者报告常规使用 PDPT 治疗衣原体感染的客户;向诊所提供预包装药物促进了 PDPT 的使用。