Alternative Approaches to Partner Notification, Diagnosis, and Treatment: Perspectives of New York County Health Departments, 2007

Abstract

The Centers for Disease Control and Prevention is encouraging states to consider patient-delivered partner therapy (PDPT) as a treatment option for Chlamydia and gonorrhea. We sought to assess current sexually transmitted disease (STD) control practices in New York State county health departments, and gather their perspectives on PDPT and alternative interventions. A cross-sectional study reviewed county websites to assess STD service information provided. County STD programs were surveyed from January to March 2007 by telephone to determine conditions diagnosed and treated, current partner notification practices, and to assess perspectives on PDPT and alternative interventions. Descriptive statistics were computed. County officials were divided about legalizing PDPT, with 45% for, 45% against, and 10% undecided. Reasons for support included the perception PDPT would result in more infections treated (61%) and improved STD control (29%). Reasons for lack of support included potential contraindication/side effects (28%), potential for medication not reaching partners (28%), and malpractice risk (20%). Stratified analysis by STD morbidity levels showed high morbidity counties were against legalization (67%). PDPT with health department follow-up of partners was the most preferred strategy, followed by patient distribution of educational materials and express care for partners in STD clinics; PDPT alone was the least preferred. New York State County officials' perspectives on PDPT are polarized along lines of program size and morbidity. Further research on alternative partner intervention strategies and discussion of PDPT is necessary to develop a forward-thinking strategic plan for STD control in the state.