Patient-Delivered Partner Therapy for Chlamydial Infections

Abstract

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.