Novel interventions to reduce re-infection in women with chlamydia: a randomized controlled trial.

BACKGROUND The aim of this study was to determine whether postal testing kits (PTKs) or patient-delivered partner therapy (PDPT) for partners of women with Chlamydia trachomatis reduce re-infection rates in women, compared with partner notification by patient referral. METHODS Three hundred and thirty women testing positive for chlamydia, at clinics for genitourinary medicine, family planning and termination of pregnancy in Edinburgh, were randomized to one of three partner interventions: patient referral, PTK (partners post urine for testing) or PDPT (1 g azithromycin for partners). Women submitted urine for chlamydia testing every 3 months. The primary outcome was re-infection assessed as time to first positive result by the Cox proportional hazard regression. The proportion of partners tested or treated with each intervention was determined. RESULTS Out of 330 women, 215 (65%) were retested over 12 months. There were 32 of 215 women (15%) who retested positive (7, 15 and 10 women from the patient referral, PTK and PDPT groups, respectively). There was no significant difference in re-infection between PDPT versus patient referral (HR 1.32, 95% CI 0.50-3.56), PTK versus patient referral (HR 2.35, 95% CI 0.94-5.88) or PDPT versus PTK (HR 0.55, 95% CI 0.24-1.24). There was no significant difference in the proportion of partners confirmed tested/treated between the patient referral (34%) and PTK (41%, P = 0.32) or PDPT (42%, P = 0.28) groups. CONCLUSIONS PTK and PDPT do not reduce re-infection rates in women with chlamydia compared with patient referral. However, PDPT may offer other advantages such as simplicity and cost compared with patient referral.