Efficacy of patient-delivered partner medication in the treatment of sexual partners in Uganda

Background: Patient-based partner referral (PBPR), which is the main method for treating sexual partners of patients with sexually transmitted diseases (STDs), has limited effectiveness. Goal: The authors compared the efficacy of PBPR with patient-delivered partner medication (PDPM) among patients attending the Mulago STD clinic in Kampala, Uganda. Study Design: A total of 383 patients (187 women, 196 men) with STDs were randomized to the PBPR or PDPM group. The proportion of sexual partners treated in either group was compared using the chi-square statistic by intention to treat for partners whose follow-up status was unknown. Results: The two groups had similar background characteristics. Of the 237 partners elicited, 176 (74%) were reported treated in the PDPM group. In the PBPR group, in which 234 partners were elicited, 79 (34%) were referred to the treatment clinic. This difference was statistically significant (risk ratio [RR], 2.44; 95% CI, 1.95-3.07; P < 0.001). Furthermore, PDPM was more effective than PBPR for women and for casual partners for whom PBPR is considered difficult, For women, 86 of 103 partners in the PDPM group were reported treated, compared with 23 of 104 partners in the PBPR group (RR, 4.55; 95% CI, 2.92-7.08; P < 0.001). For casual partners, 18 of 51 (34%) were reported treated in the PDPM group, compared with only three of 45 partners (7%) who were referred in the PBPR group (RR, 1.43; 95% CI, 1.40-2.65; P < 0.01). Conclusion: Patient-delivered partner medication is more effective than patient-based partner referral in the treatment of sexual partners.