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O11.1 Patient-delivered partner therapy (pdpt) increases the frequency of partner notification among msm in lima, peru: a randomised clinical trial
  1. Jesse L Clark1,
  2. Eddy R Segura1,
  3. Catherine Oldenburg2,
  4. Jessica Rios3,
  5. Silvia M Montano4,
  6. Javier Salvatierra3,
  7. Manuel Villaran3,
  8. Jorge Sanchez3,
  9. Thomas J Coates1,
  10. Javier R Lama3
  1. 1David Geffen School of Medicine, University of California, Los Angeles
  2. 2Harvard University School of Public Health
  3. 3Asociacion Civil Impacta Salud Y Educacion
  4. 4US Naval Medical Research Unit-6, Callao, Peru

Abstract

Background Patient-Delivered Partner Therapy (PDPT) improves treatment outcomes among sexual partners of individuals with curable STIs. Although use of PDPT with MSM has been questioned due to the high prevalence of undiagnosed HIV and syphilis in MSM networks, increasing partner notification (PN) through PDPT may promote testing and treatment of otherwise unidentified partners. We assessed the impact of PDPT on self-reported partner notification (PN) among Peruvian MSM with gonorrheal (GC) and/or chlamydial (CT) infection.

Methods We screened 898 MSM in Lima, Peru for GC and/or CT between 2012–2014. Screening included syndromic management of urethritis/proctitis and nucleic acid testing for GC/CT at urethral, pharyngeal, and rectal sites (Aptima Combo-2 TMA). Enrollment was limited to participants with symptomatic urethritis/proctitis (n = 44) and/or laboratory-diagnosed GC/CT infection (n = 263). 173 eligible participants were randomly assigned to receive either standard PN counselling (n = 84) or counselling and PDPT (Cefixime 400 mg/Azithromycin 1 g) for up to 5 recent partners (n = 89). Self-reported notification of recent partners was assessed by CASI with 155 participants who returned for 14-day follow-up.

Results The median age of all enrolled participants was 26 (IQR: 23–31), with a median of 3 (IQR: 2–4) partners reported during the previous 30-day period. Among all participants completing follow-up, 111/155 (71.6%) notified at least one partner, with a median of 1 partner notified per participant (IQR: 0–2). For participants randomised to receive PDPT, 69/83 (83.1%) reported notifying at least one partner, compared with 42/72 (58.3%) of participants in the control arm (p = 0.001). The proportion of all recent partners notified was significantly greater in the PDPT than the Control arm (53.5% vs. 36.4%; p = 0.004).

Conclusions Provision of PDPT led to significant increases in notification among Peruvian MSM diagnosed with GC/CT infection. Additional research is needed to assess the impact of PDPT on biological outcomes of HIV/STI transmission in MSM sexual networks.

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