Partner notification for sexually transmitted diseases in Peru: knowledge, attitudes, and practices in a high-risk community.

OBJECTIVES: Notification and treatment of sex partners after diagnosis of a sexually transmitted disease (STD) is essential to reduce reinfection and further transmission. GOAL: The goal of this study was to determine the prevalence of partner notification and subsequent health-seeking behavior in a high-risk population in Lima, Peru. STUDY DESIGN: STD-infected participants of an HIV/STD prevention trial completed a questionnaire concerning partner notification. RESULTS: Of the 502 STD-positive subjects, 287 completed the survey. Among survey participants, 65% informed their primary partner and 10.5% informed casual or anonymous partners. Reasons for failure to notify varied by partner type and included not understanding the importance of partner notification, embarrassment, fear of rejection, and inability to locate the partner. When notified, approximately one third of all partners sought medical attention. CONCLUSIONS: Partner notification in Peru is limited by relationship dynamics, social stigma, and limited contact information. Interventions could emphasize the importance of notification, improvement of communication skills, and introduce contact tracing programs (including Internet-based systems) and expedited partner therapy.

Syphilis treatment and HIV infection in a population-based study of persons at high risk for sexually transmitted disease/HIV infection in Lima, Peru.

OBJECTIVES: The objective of this study was to characterize syphilis epidemiology and the relationship of HIV status and initial rapid plasma reagin (RPR) titer to syphilis treatment in Lima, Peru. STUDY DESIGN: We screened 1,261 individuals at high risk for sexually transmitted diseases for syphilis and HIV infection. Syphilis was treated with penicillin injection or doxycycline; treatment was repeated in unresponsive cases. RESULTS: : The prevalence of syphilis was 7.7%, 1-year incidence rate was 4.7%, and reinfection rate was 42.7%. The treatment success rate was 93.4% (71 of 76); those with initial RPR titers or=1:16. HIV infection was associated with syphilis, prevalent in 15.6% and 3.7% of those with and without syphilis, respectively (P < 0.001), but did not affect treatment success (90.9% vs. 93.8%). CONCLUSIONS: Syphilis was common, associated with HIV infection, and less responsive to therapy in those with initial RPR titers