Sexual contact tracing outcome in adolescent chlamydial and gonococcal cervicitis cases

Abstract

Treatment of sex partners is an essential part of sexually transmitted diseases (STD) control. This study examined the efficacy of contact tracing via patient self-referral in gonococcal and chlamydial cervicitis cases among adolescents, compared with the effectiveness of provider-referral. Adolescent females with culture-proven chlamydial or gonococcal cervicitis were the study subjects. This cohort study was done in an urban non-STD clinic setting. The subjects chose either provider-notification or self-notification method to inform their sex partner(s) in 2 months preceding the interview date. Two hundred and sixty-five eligible subjects (91% African-American, 9% white) were identified. One hundred and ninety-eight sex contacts were reported by 165 (62%) cases; no contact was elicited in the remaining 100 (38%). The follow-up data revealed that 129/198 (66%) contacts were informed: 63 contacts by 61 index cases, 54 contacts of 47 cases by the case manager, 9 by both methods, and 3 by unspecified means. History of treatment was obtained in 54 contacts, including 37% (23/63) of patient-notified contacts and 50% (27/54) of provider-notified contacts; these 54 contacts constituted 42% of informed contacts, or 27% of all named contacts. The mean number of sexual contacts treated per index case was 0.58 (27/47) for the provider-referral groups and 0.38 (23/61) for the self-referral groups. Successful contact tracing was documented in 19.3% (51/265) of all index cases, resulting in treatment of 54 contacts. This study demonstrates the need for more effective partner treatment strategies in adolescent STD cases.