Partner notification and treatment of chlamydia and gonorrhea in African American adolescent women

Awarded 2012
Complex Family Planning Fellowship Research
Anna Buchsbaum, MD, MPH
Emory University

African American adolescent women in the Southern United States carry a disproportionately high burden of Chlamydia and gonorrhea infections when compared to women of the same age but of different race/ethnicity or geographic location. Additionally, Chlamydia and gonorrhea re-infection rates are 1.7 times higher in adolescents than in older women. Successfully reducing re-infection rates may lead to lower overall prevalence of disease. However, decreasing re-infection rates is contingent on successful partner notification and partner treatment. Therefore, understanding the factors that influence partner notification and treatment is critical.
This study aimed to 1) describe preferences for different partner notification and treatment strategies; 2) identify the individual, relationship, and other psychosocial factors associated with high self-efficacy for partner notification; 3) describe the proportion of adolescents in this high risk population who are re-infected with a sexually transmitted infection (STI) and; 4) identify the factors associated with whether an infected patient notified her partner of a positive STI diagnosis.
This was a nested prospective cohort study. 350 participants were enrolled in a cross sectional study investigation of dual protection. For this study, participants were asked about preferences for partner notification, 85.1% (297) would prefer telling their partner about an STI diagnosis themselves versus having a health care provider tell their partner. Seventy-one percent (247) would prefer to bring their partner to the clinic for treatment instead of giving him pills or a prescription to fill. Factors associated with high self-efficacy for partner notification included older age, fewer lifetime sexual partners, and being in a serious relationship at the time of enrollment.
Ninety-three (26.7%) were diagnosed with an STI at baseline and were eligible to participate in the follow up survey, 55 participated. 42 (76.4%) reported telling their partner about their positive STI diagnosis. This was associated with a prior history of being told of a positive STI diagnosis and high self-efficacy for notifying a partner of an STI diagnosis. At follow-up the proportion of participants with a positive repeat STI test was 23.9%.
The proportion of STI re-infection in this sample of young African American adolescent women was high. Relying on patient referral for partner notification and treatment may not be adequate in this population. Therefore, alternative strategies for partner notification and treatment, like offering male partners concurrent clinic appointments, may improve partner treatment rates and decrease reinfection.