Partner referral by patients with gonorrhea and chlamydial infection. Case-finding observations

To evaluate the outcomes of a partner referral program at the sexually transmitted disease (STD) clinic in Amsterdam that encourages gonorrhea and chlamydia patients to refer their own partners to medical examination.

355 patients with a confirmed infection cooperated in partner referral and gave specific details on their sexual contacts. Univariate and multivariate analyses were conducted to identify characteristics associated with the outcome of partner referral.

The outcome of partner referral, expressed as the proportion of sex partners brought to evaluation or treatment, was 40%: 580 sex partners were identified of whom 20% attended the STD clinic, and medical follow-up could be confirmed for another 20%. No information was available for the remaining 60%. Patients with chlamydial infection referred more sexual partners than gonorrhea patients; women referred more partners than men. Sixty-three percent of the female contacts and 30% of the male contacts were found to be infected with gonorrhea, chlamydia, or both. Steady partners were more often referred by index patients than casual partners, especially if these latter were non-Dutch partners, clients of commercial sex workers, contacts met in less private settings, and "one night stands."

Partner referral can be an effective strategy for reaching individuals at high risk for STD. The partner referral method was successful among certain populations but was inadequate for other groups. A mixed effort of provider referral in addition to partner referral may be appropriate to increase the efficacy of partner notification.