PARTNER NOTIFICATION FOR SYPHILIS - A RANDOMIZED, CONTROLLED TRIAL OF3 APPROACHES

Objective: To determine the cost and effectiveness of three approaches to partner notification for infectious syphilis, Study Design: People with syphilis were randomly assigned to: (1) notification of partners by patients themselves within 2 days or disease intervention speciali sts would notify them; (2) immediate notification by intervention spec ialist; or (3) immediate notification by intervention specialists, who had the option of drawing blood in the field, Costs of intervention s pecialists' time, travel, and overhead were measured, Intention-to-tre at analysis measured outcomes per randomized index patient, Results: F rom December, 1990 through March, 1993, 1,966 index patients with syph ilis (primary 9%; secondary 18%; and early latent 73%) were randomized in Broward County (Ft, Lauderdale), Florida (1,191); Tampa, Florida ( 569); and Paterson, New Jersey (206), Index patients reported 11,272 p otentially exposed partners and sufficient information to initiate inv estigations for 2,761, Of these, 2,236 were located, 367 had newly ide ntified infections, and 870 others received preventive treatment, The three partner notification approaches had similar success locating par tners (1.1-1.2 per index patient) and treating partners (0.61-0.67 per index), The cost was $317 to $362 per partner treated; the optimal st rategy differed by study site, Conclusions: Partner notification ident ified many infected and potentially infected people, The cost and effe ctiveness of the three types of provider notification were similar. Al ternative approaches are needed to reach infected partners who could n ot be notified.