59. PATIENT DELIVERED PARTNER THERAPY FOR CHLAMYDIAL INFECTION: WHAT WOULD BE MISSED?

Abstract

The number of contacts of STIs who are tested and treated is generally low. Patient delivered partner therapy ( PDPT) has been proposed in order to increase the number of sexual partners of the index case that are treated. PDPT does not require the contact to be clinically assessed and tested. We sought to determine whether PDPT for chlamydial infection would result in missed diagnoses of other STIs or of the complications of chlamydial infection.

The Sydney Sexual Health Centre database was accessed to identify patients who presented as contacts of chlamydia and chlamydia associated conditions and to determine whether other STIs were diagnosed at the time of presentation. Those who were contacts of more than one bacterial STI or HIV were excluded. In the 3 years from June 2003 to June 2006, 626 individuals presented as contacts of chlamydia, NGU or PID. Of these, 212 (34%) tested positive for Chlamydia trachomatis by PCR. Of the 442 heterosexual patients, 36% had chlamydial infection diagnosed. Of the 184 men who had sex with men (MSM), 29% had chlamydial infection diagnosed. Of the heterosexuals who presented as contacts, 13 were diagnosed with other bacterial STIs or complications of chlamydia. Of these, 2 women and 2 men had gonococcal infection (0.9%), 1 woman had syphilis of unknown duration, 6 women (3%) were diagnosed with PID and 2 men (0.8%) with epididymitis. Of the MSM, 9 (5%), were newly diagnosed with HIV infection, 15 (8%) with gonococcal infection and none with syphilis.

PDPT would result in a missed opportunity to diagnose other STIs in MSM. In heterosexuals a small number of cases of PID and epididymitis would be inadequately treated and a small number of gonococcal infections would be missed.