Individual counseling of patients with sexually transmitted diseases. A way to improve partner notification in a Zambian setting?

Sex Transm Dis. Jul-Aug 1996;23(4):289-92.

Abstract

Background: Sexually transmitted diseases (STD) are a major health problem in Zambia. Partner notification, which is a recommended strategy to decrease STD, must be improved.

Goal: To assess whether individual counseling of patients with STD, combined with contact slip(s), had any impact on the proportion of sex partners traced in an urban setting in Zambia.

Study design: A randomized trial comprised of 94 women and 302 men with STD.

Results: Women and men in the intervention group informed more partners than did those in the control group. In the intervention group, 1.8 partners per man was treated compared to 1.2 in the control group (P < 0.001). There was no difference between the two groups of women. There was a gradual decline from numbers of partners informed to numbers of partners treated according to the patient to number of contact slips filed.

Conclusions: Individual counseling of men with STD improved partner notification.

PIP: In Lusaka, Zambia at an urban health center, researchers randomly allocated 302 male sexually transmitted disease (STD) patients and 94 female STD patients to receive or not receive individual counseling combined with written information to sex partners (i.e., contact slips). They aimed to determine whether or not this intervention improved partner notification. This study was conducted during October 1992-March 1993. The most common STD for men was chancroid, followed by gonorrhea and syphilis. For women, it was syphilis, followed by gonorrhea. Men and women in the intervention group were more likely to bring at least one sex partner to the clinic than those in the control group (100% vs. 93% and 72% vs. 56%, respectively). Men in the intervention group brought more partners from the last three months to the clinic than those in the control group (1.8 vs. 1.2; p 0.001), while women in both groups brought the same number of partners (0.7). In the intervention group, more partners of the men received treatment based on contact slips than partners of the women (1.6 vs. 0.4). For both sexes, based on the number of contact slips filed, the numbers of partners informed fell gradually with the numbers of partners treated. Men in the intervention group were less likely than those in the control group not to tell all partners from the last three months to come for treatment (19% vs. 48%). Among controls, the reasons were health staff failed to tell them to bring more than one partner and the men could not afford the medicines for their partners. Among cases, the leading reason was that the partners were unknown or out of town. Quarrels that prevented partners from seeking treatment occurred equally in both groups of women. They occurred more often among male cases than male controls, however (p = 0.0008). Yet partners of male controls who had experienced quarrels were less likely to seek treatment than those of male cases (p = 0.0015). The quarrels-related findings suggest the need for counseling to emphasize partners' emotional reactions and how to deal with these reactions. Overall findings show that individual counseling of men improved STD partner notification.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Contact Tracing / methods*
  • Counseling / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Sex Factors
  • Sexual Partners
  • Sexually Transmitted Diseases / epidemiology
  • Sexually Transmitted Diseases / prevention & control*
  • Urban Health
  • Zambia