Partner-Delivered Therapy Viable in Resource-Poor Areas

Article excerpt

In South Africa and Brazil, the Population Council has recently studied alternative methods of notifying partners of women with sexually transmitted infections (STIs) that they need treatment. These studies have verified that offering women with STIs the option of bringing medicines to their partners, rather than requiring partners to come to the clinic, results in high treatment rates.

Notifying partners of infection

Notifying people that their sexual partners have an STI is an important means of reducing the transmission of infection. The practice of partner-delivered medicine has been shown to increase the number of partners contacted and to decrease the rate of re-infection in resource-rich settings, but little work has been done to demonstrate its effectiveness in resource-poor settings. It is in these places, however, where the strategy might be most useful; partner notification methods that rely upon outreach by health professionals are difficult to maintain in resource-poor settings, which often have shortages of providers.

Population Council researchers Heidi E. Jones, Juan Diaz, and Sheri A. Lippman collaborated with colleagues from Santa Casa Medical School and the University of Cape Town to study partner-delivered treatment programs in Sao Paulo, Brazil and Gugulethu, Cape Town, South Africa. These investigations were part of two larger studies of home-based STI testing. The studies tested for the presence of trichomoniasis, chlamydia, and gonorrhea among participating women. These infections may increase the risk of HIV infection and contribute to infertility,, pelvic inflammatory disease, obstetric complications, and illness in newborns. Further, they can all be treated with a single dose of medication.

Sao Paulo

In Brazil, women who had trichomoniasis were offered three options for partner notification: notifying their partners themselves, having a health professional notify their partners, or bringing medication and instructions on use to their partners. Women with chlamydia or gonorrhea were offered only the first two options because study clinicians felt that direct counseling of the partners was a priority. Of the 787 women in the larger study, 108 had at least one of the three infections.

Twenty--eight women had trichomoniasis. Four of them reported no sexual partners in the last three months, so partner notification was not conducted. Eighty-one percent of the partners of the remaining women were treated, 91 percent receiving partner-delivered medicine.

Eighty-five women had gonorrhea and/or chlamydia, four of whom reported having no sex partners in the last three months. Forty-four percent of the partners of the remaining women came to the clinic for treatment, and 31 percent received partner-delivered medication. …