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Effect of expedited treatment of sex partners on recurrent
or persistent gonorrhea or chlamydial infection.
New England Journal of Medicine 2005;352(7):676-685.
Golden MR, Whittington WLH, Handsfield HH, Hughes JP, Stamm WE, Hogben
M, Clark A, Malinski C, Larson J, Thomas KK, Holmes KK.
Abstract
BACKGROUND: Many sex partners of persons with gonorrhea or chlamydial infections
are not treated, which leads to frequent reinfections and further transmission.
METHODS: We randomly assigned women and heterosexual men with gonorrhea or
chlamydial infection to have their partners receive expedited treatment or
standard referral. Patients in the expedited-treatment group were offered
medication to give to their sex partners, or if they preferred, study staff
members contacted partners and provided them with medication without a clinical
examination. Patients assigned to standard partner referral were advised
to refer their partners for treatment and were offered assistance notifying
partners. The primary outcome was persistent or recurrent gonorrhea or chlamydial
infection in patients 3 to 19 weeks after treatment. RESULTS: Persistent
or recurrent gonorrhea or chlamydial infection occurred in 121 of 931 patients
(13 percent) assigned to standard partner referral and 92 of 929 (10 percent)
assigned to expedited treatment of sexual partners (relative risk, 0.76;
95 percent confidence interval, 0.59 to 0.98). Expedited treatment was more
effective than standard referral of partners in reducing persistent or recurrent
infection among patients with gonorrhea (3 percent vs. 11 percent, P=0.01)
than in those with chlamydial infection (11 percent vs. 13 percent, P=0.17)
(P=0.05 for the comparison of treatment effects) and remained independently
associated with a reduced risk of persistent or recurrent infection after
adjustment for other predictors of infection at follow-up (relative risk,
0.75; 95 percent confidence interval, 0.57 to 0.97). Patients assigned to
expedited treatment of sexual partners were significantly more likely than
those assigned to standard referral of partners to report that all of their
partners were treated and significantly less likely to report having sex
with an untreated partner. CONCLUSIONS: Expedited treatment of sex partners
reduces the rates of persistent or recurrent gonorrhea or chlamydial infection.
Copyright 2005 Massachusetts Medical Society.