Background In 2009, African American women 15 to 19 years of age had the highest rate of chlamydia of any population in San Francisco (10 762.13 cases per 100 000 residents per year). Screening and education efforts had not succeeded in lowering rates in this population. Previous research suggests that adolescents may have fewer partners and fewer anonymous encounters than other patients with whom we conduct partner notification. We evaluated a pilot program of contact tracing aimed at male partners of adolescents women diagnosed with chlamydia living in selected neighbourhoods.
Methods Residential addresses for all reported females under 20 years of age reported with a Chlamydia infection were geocoded. Cases residing in neighbourhoods with the highest rates of Chlamydia in 2009 were assigned to a health worker for partner notification. Cases were interviewed at least two weeks after being tested in order to give providers time to disclose the results. Names of male partners during the previous three months were collected along with locating information. The total number of partners for each woman (including unnamed partners) was also recorded. Male partners were contacted by the health worker; if partners had not been tested or prophylactic ally treated, they were tested for Chlamydia and treated if positive.
Results Between 1 June 2010 and 31 December 2010, 296 Chlamydia cases were reported among women under 20 years of age. Of these, 106 (35.8%) resided in the priority neighbourhoods. Only 64 cases (60.4%) were located and interviewed; all but one of the remaining cases were not locatable. The cases claimed a total of 96 male partners, with 66% claiming just one partner in the previous 3 months, and only two cases claiming more than three partners. However, only 39 partners (40%) were named, including 11 partners residing out of jurisdiction, and 4 who had already been treated by the time they were located. Eleven (11) male partners were tested, and only 2 were positive for Chlamydia. The greatest barrier to contacting the cases and their male partners was cell phones numbers that were disconnected by the time we needed to use them.
Conclusion While women in this population have fewer anonymous encounters than other populations targeted using partner notification, few cases among male partners were brought to treatment. Partner notification for adolescent females will likely have minimal impact on chlamydia transmission.
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