A REVIEW OF AND COMMENT ON PATIENT-DELIVERED PARTNER THERAPY FOR SEXUALLY TRANSMITTED DISEASES IN THE UNITED STATES

Abstract
Interest in patient-delivered partner therapy (PDPT) for sexually transmitted diseases is growing among public health professionals in the United States. Until recently, there were few data with which to judge the relative efficacy of this approach to partner treatment, but, beginning with a randomized, controlled trial in the mid 1990s, the body of data has grown substantially. In that trial, which compared rates of chlamydial reinfection among women randomized to receive PDPT to those managed with standard partner management, the investigators found a 20% reduction in chlamydial reinfection among participants randomized to PDPT (12% reinfection), compared with participants randomized to standard partner management (15%). In this paper we describe the initial RCT conducted to evaluate PDPT in detail, reference several newly-completed trials of PDPT; discuss current practices of PDPT in the state of California - where a law was passed to explicitly permit PDPT for chlamydial infection - and describe PDPT practices for chlamydial infection and gonorrhea reported in a national survey of US physicians in private and public practice settings. Finally, we comment on issues requiring further evaluation to improve our understanding of all aspects of PDPT.

Key words
Sexually transmitted disease, infection control

Bibliografía del artículo

1. Oxman AD, Scott EAF, Sellors JW, et al. Partner notification for sexually transmitted diseases: An overview of the evidence. Can J Public Health 1994; 85 (supp 1):S41-S47.
2. Macke B, Maher J. Partner notification in the United States: An evidence-based review. Am J Prev Med 1999; 17:230-242.
3. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2002. Atlanta, GA: U.S. Department of Health and Human Services, 2003.
4. Alexander LL, Cates JR, Herndon N, Ratcliffe JF (eds). Sexually transmitted diseases in America: how many cases and at what cost American Social Health Association: Research Triangle Park, NC, 1998.
5. Weinstock H, Berman S, Cates W Jr. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health 2004; 36(1):6-10.
6. Golden MR, Hogben M, Handsfield HH, et al. Partner notification for HIV and STD in the United States: Low coverage for gonorrhea, chlamydial infection and HIV. Sex Transm Dis 2003; 30:490-496.
7. Brackbill R, Sternberg M, Fishbein M. Where do people go for treatment of sexually transmitted diseases Fam Plann Perspect 1999; 31(1):10-15.
8. Kissinger P, Brown R, Reed K, et al. Effectiveness of patient delivered partner medication for preventing recurrent chlamydia trachomatis. Sex Transm Inf 1998; 74:331-333.
9. Schillinger JA, Kissinger P, Calvet H, et al. Patient-delivered partner treatment with azithromycin to prevent repeated chlamydia trachomatis infection among women. Sex Transm Dis 2003; 30:49-56.
10. Pocock J. Clinical trials: A practical approach. New York: Wiley, 1983.
11. Golden MR, Whittington WLH, Handsfield HH, et al. Partner management for gonococcal and chlamydial infection: Expansion of public health services to a private sector and expedited sex partner treatment through a partnership with commercial pharmacies. Sex Transm Dis 2001; 28:658-665.
12. Golden MR, Whittington WL, Handsfield HH, et al. Impact of expedited sex partner treatment on recurrent or persistent gonorrhea or chlamydial infection: A randomized controlled trial. Paper presented at the National STD Conference, Philadelphia, 2004.
13. Kissinger P, Richardson-Alston G, Leichliter J, et al. A comparison of three different strategies to treat partners of men with urethritis. Paper presented at the National STD Conference, Philadelphia, 2004.
14. California Department of Health Services. Patient-delivered therapy of antibiotics for chlamydia trachomatis: Guidance for medical providers on California. Author: Sacramento, CA, 2004.
15. Klausner JD, Chaw JK. Patient-delivered therapy for chlamydia: Putting research into practice. Sex Transm Dis 2003; 30:509-511.
16. Klausner JD, Engelman J, Lukehart SA, et al. Brief report: Azithromycin treatment failures in syphilis infections – San Francisco, California, 2002 – 2003. Morb Mort Wkly Rep 2004; 53:197-198.
17. Hammet TM, Kaufman JA, Faulkner A, et al. Sexually transmitted disease prevention in the United States: Integrated evaluation of public and private sector disease reporting and service delivery. CDC 200-93-0633, Phase I Final Report, 1997.
18. St. Lawrence JS, Montano DE, Kasprzyk D, et al. National survey of US physicians’ STD screening, testing, case reporting, clinical management, and partner notification practices. Am J Public Health 2002; 92:1784-88.
19. Hogben M, St. Lawrence JS, Montano D, et al. Physician opinions of three forms of STD partner notification: Responses from a national survey. Sex Transm Inf 2004; 80:30-34.
20. Hogben M, McCree DH, Golden MR. Patient-delivered partner therapy for sexually transmitted diseases as practiced by U.S. physicians. Sex Transm Dis. In press.
21. Golden MR, Whittington WL, Gorbach PM, et al. Partner notification for chlamydial infections among private sector clinicians in Seattle-King County: a clinician and patient survey. Sex Transm Dis. 1999; 26:543-547.
22. Packel L, Guerry S, Bauer H, et al. Patient-delivered partner therapy for chlamydia infections: Attitudes and practices of California physicians and nurse practitioners. Paper presented at the National STD Conference, Philadelphia, 2004.
23. McCree DH, Oh J, Hogben M. The role of pharmacists in patient-delivered partner therapy for STD control - A commentary. Am J Health-Systems Pharm. In press.

Autoevaluación