Thibault Christina S, Golden Matthew R, Barbee Lindley A, Spellman Dawn, Soge Olusegun O, Kerani Roxanne P
From the HIV/STD Program, Public Health-Seattle & King County.
Sex Transm Dis. 2021 Dec 1;48(12S Suppl 2):S137-S143. doi: 10.1097/OLQ.0000000000001531.
Partner notification services (PS) are often used to control sexually transmitted infections, but their effectiveness is limited by patients' reluctance to name sex partners. We hypothesized that being notified of having antimicrobial-resistant Neisseria gonorrhoeae (ARGC) would make patients more likely to provide named partner information.
We used King County, Washington STD surveillance and Strengthening the US Response to Resistant Gonorrhea data to identify gonorrhea cases. Using log-binomial regression, we computed unadjusted and adjusted prevalence ratios for factors associated with naming any partners during routine PS interview vs. interview after ARGC diagnosis. Among those who completed a standard PS interview and later a reinterview after ARGC diagnosis, we compared mean numbers of reported and contactable partners at initial interview and reinterview using the Wilcoxon rank sum test.
From July 2018 to October 2020, 1588 gonorrhea cases were interviewed; 103 (6%) had ARGC. After adjusting for sexual exposure, age, year, disease intervention specialist, reinterview, and diagnosing clinic, being interviewed after ARGC diagnosis remained predictive of naming ≥1 partner relative to routine PS (prevalence ratio, 2.2; 95% confidence interval, 1.6-2.9). Among 40 cases who completed a standard PS interview and later a reinterview after ARGC diagnosis, there was a modest increase in mean partners named at initial versus reinterview (1.4 vs. 1.9 per case, P = 0.09).
Cases interviewed after ARGC diagnosis named more contactable partners than did those undergoing routine PS. Reinterviewing patients after ARGC diagnosis provides only a modest increase in contactable partners but may be useful to limit transmission of this potentially challenging infection.
性伴通知服务(PS)常用于控制性传播感染,但其效果因患者不愿说出性伴姓名而受到限制。我们推测,被告知感染耐抗菌药物淋病奈瑟菌(ARGC)会使患者更有可能提供指名性伴信息。
我们利用华盛顿州金县性传播疾病监测数据以及强化美国应对耐药淋病数据来识别淋病病例。采用对数二项回归,我们计算了在常规PS访谈与ARGC诊断后访谈期间,与说出任何性伴相关因素的未调整和调整患病率比。在完成标准PS访谈且之后在ARGC诊断后又接受重新访谈的患者中,我们使用Wilcoxon秩和检验比较了初次访谈和重新访谈时报告的和可联系的性伴平均数。
2018年7月至2020年10月,对1588例淋病病例进行了访谈;其中103例(6%)感染ARGC。在调整了性接触、年龄、年份、疾病干预专家、重新访谈和诊断诊所等因素后,与常规PS相比,ARGC诊断后接受访谈仍可预测说出≥1名性伴的情况(患病率比为2.2;95%置信区间为1.6 - 2.�)。在40例完成标准PS访谈且之后在ARGC诊断后又接受重新访谈的病例中,初次访谈与重新访谈时说出的性伴平均数有适度增加(每例分别为1.4名和1.9名,P = 0.09)。
ARGC诊断后接受访谈的病例说出的可联系性伴比接受常规PS访谈的病例更多。ARGC诊断后对患者进行重新访谈仅使可联系性伴数量适度增加,但可能有助于限制这种潜在具有挑战性的感染的传播。