Preferred Strategies of Men and Women for Managing Chlamydial Infection

Abstract

Early identification and treatment of sexual partners of women with chalmydial infection is critical because of the high risk of reinfection primarily as a result of resumption of sex with an untreated partner. Management strategies used for identifying and testing sexual partners for possible infection include: (1) partner notification (patient referral) of the sexual partner to a clinic for testing and treatment; (2) patient-delivered partner medication (PDPM) which involves the delivery of antibiotics by the patient to sexual partners; and, (3) a postal testing kit which involves asking partners to mail a urine sample to a laboratory. To determine preference of patients and their sexual partners for one of these strategies, the investigators employed interviewer-conducted questionnaires in women and anonymous, self-administered questionnaires in men. The study subjects were women infected with chlamydia already participating in a study randomizing them to receive one of these strategies, and men attending genitourinary clinics, family planning clinics and hospital fracture clinics. The response rates for the women's questionnaire were 97% (174/180) at study entry and 81% (145/180) at 6-month follow up. For the men's questionnaire, the response rate was 81%. Over two-thirds of the women respondents (67%) preferred PDPM for their partner if given the choice; the majority (57%) also chose PDPM for themselves if a partner tested positive for Chlamydia. The most common reasons given by women for preference of PDPM were greater simplicity and convenience, and quicker treatment of partners. Ninety-three of 142 women (65%) reported that their partners were satisfied with whichever intervention they were randomized to receive. Of the 293 men who responded, 70% preferred patient referral for partners and 53% chose this intervention for themselves. PDPM was more likely to be the preference of men previously tested for Chlamydia (n = 22) compared to those never tested (n = 7) (P < 0.001). Less than 5% of women and 10% of men preferred postal testing kits for partners. The investigators conclude from these findings that PDPM appears to be more popular with women, and at least in theory, patient referral is more popular with men.