STD partner notification and referral in primary level health centers in Nairobi, Kenya.

ABSTRACT

PIP: In developing countries, patient referral is a more feasible means of notifying partners of sexually transmitted disease (STD) clients than the costly, labor-intensive provider referral approach. However, enhancement strategies such as education and counseling, contact cards, educational materials, follow-up, and monetary incentives may be necessary. To assess the impact of brief counseling on patient referral rates, a study was conducted at five primary health care centers in low-income areas of Nairobi, Kenya. All 254 STD patients who attended the clinic in a two-week period in 1992 were enrolled in the study. Subjects were given 5-10 minutes of counseling, asked to identify their sexual partners, and given a return appointment for the following week. Of the 93 patients who returned to the clinic and provided partner referral data, 63 (68%) reported they informed their partner of the need for STD treatment and 54 (58%) claimed that their partners had been treated. Multivariate analysis indicated that partner notification rates were highest for females, married individuals or those with regular partners, and maternal-child health/family planning clinic patients. Although 84% of unmarried men, 66% of unmarried women, and 47% of married men were infected by a casual sex partner, only 35% of those in the casual partner group attempted notification. Before the study, only 15% of partners presented to the clinics for treatment as a result of partner referral. This provides some evidence of the effectiveness of the counseling strategy, at least for married men and women, although more detailed guidelines on methods of partner notification are recommended.