A randomized, controlled trial of inSPOT and patient-delivered partner therapy for gonorrhea and chlamydial infection among men who have sex with men

Abstract

Background: The efficacy of patient-delivered partner therapy (PDPT) and inSPOT, a web-based partner notification service, in increasing partner treatment and/or notification among men who have sex with men (MSM) has not been evaluated.

Methods: We enrolled MSM with chlamydia and/or gonorrhea in a randomized, controlled trial with the following 4 arms: inSPOT, PDPT, combined inSPOT and PDPT (inSPOT/PDPT), and standard partner management. Men were offered enrollment when contacted for partner services. Participants completed baseline and follow-up interviews approximately 2 weeks apart.

Results: We offered enrollment to 393 eligible MSM, of whom 75 (19%) enrolled and 318 (81%) declined enrollment. The study was halted early due to low enrollment. Among the 75 enrollees, 53 (71%) completed baseline and follow-up interviews. Of these 53 men, 13, 10, 17, and 13 were assigned to the PDPT, inSPOT, inSPOT/PDPT, and standard arms, respectively; participants provided information about 186 partners. The number of partners treated per original patient was 2.33 in the PDPT arm and 1.52 in the non-PDPT arms. PDPT assignment increased the mean number of partners treated per original patient by 54% (ratio of means = 1.54, 95% confidence interval: 1.01-2.34), after adjustment for inSPOT assignment. Among 27 men assigned to inSPOT or inSPOT/PDPT, 1 (4%) used inSPOT to notify ≥ 1 partner. inSPOT did not affect partner notification, but decreased partner human immunodeficiency virus testing (ratio of means: 0.42, 95% confidence interval: 0.18-0.99).

Conclusions: PDPT may increase partner treatment among MSM. Few MSM appear to be willing to use inSPOT to notify their sex partners. Traditional randomized trials of partner notification strategies may not be feasible among MSM.