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Review
. 2020 Dec;47(12):811-818.
doi: 10.1097/OLQ.0000000000001269.

Unnamed Partners From Syphilis Partner Services Interviews, 7 Jurisdictions

Anna Barry Cope, Kyle Bernstein  1 , James Matthias, Mohammad Rahman, Jill Diesel, River A Pugsley, Julia A Schillinger, Rilene A Chew Ng, Darpun Sachdev  2 , Rebecca Shaw  2 , Trang Quyen Nguyen  2 , Ellen J Klingler  3 , Victoria L Mobley  4 , Erika Samoff  4 , Thomas A Peterman  1
Affiliations
Review

Unnamed Partners From Syphilis Partner Services Interviews, 7 Jurisdictions

Anna Barry Cope et al. Sex Transm Dis. 2020 Dec.

Abstract

Background: Reducing transmission depends on the percentage of infected partners treated; if many are missed, impact on transmission will be low. Traditional partner services metrics evaluate the number of partners found and treated. We estimated the proportion of partners of syphilis patients not locatable for intervention.

Methods: We reviewed records of early syphilis cases (primary, secondary, early latent) reported in 2015 to 2017 in 7 jurisdictions (Florida, Louisiana, Michigan, North Carolina, Virginia, New York City, and San Francisco). Among interviewed syphilis patients, we determined the proportion who reported named partners (with locating information), reported unnamed partners (no locating information), and did not report partners. For patients with no reported partners, we estimated their range of unreported partners to be between one and the average number of partners for patients who reported partners.

Results: Among 29,719 syphilis patients, 23,613 (80%) were interviewed and 18,581 (63%) reported 84,224 sex partners (average, 4.5; 20,853 [25%] named and 63,371 [75%] unnamed). An estimated 11,138 to 54,521 partners were unreported. Thus, 74,509 to 117,892 (of 95,362-138,745) partners were not reached by partner services (78%-85%). Among interviewed patients, 71% reported ≥1 unnamed partner or reported no partners; this proportion was higher for men who reported sex with men (75%) compared with men who reported sex with women only (65%) and women (44%).

Conclusions: Approximately 80% of sex partners were either unnamed or unreported. Partner services may be less successful at interrupting transmission in networks for men who reported sex with men where a higher proportion of partners are unnamed or unreported.

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Figures

Figure 1.
Figure 1.. Number of reported named, reported unnamed, and estimated unreported partners from syphilis partner services in 7 US jurisdictions
1. Unreported partners=For patients who did not report ≥1 named or unnamed partner, we estimated the number of unreported partners to be between 1 to the average number of partners reported by patients who did report ≥1 partner in the patient’s jurisdiction (range per jurisdiction 2.1 to 11.2; Table 2). We could not calculate the number of unreported partners for patients who reported ≥1 partner.
Figure 2.
Figure 2.. Proportion of total, MSM, MSW, and female interviewed early syphilis patients1 who reported only named partners, reported named & unnamed partners, reported only unnamed partners, and did not report any partners in 7 US jurisdictions, 2015-2016
1. MSM=Men who reported sex with men; MSW Only=Men who reported only sex with women. Men who we could not classify as either MSM or MSW are included in the “Total” column, but not in any other column of each chart.
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