Impact of a single session of counseling on partner referral for sexually transmitted disease treatment, Harare, Zimbabwe

Counseling patients with sexually transmitted diseases (STD) to refer their partners to treatment is considered a means of preventing reinfection and controlling the spread of STD and is standard practice throughout the world. We conducted a randomized controlled trial to assess the impact of an enhanced counseling session on partner referral in Harare, Zimbabwe. The intervention consisted of an individualized confidential session with a trained counselor; standard care (control) relied on the treating clinician to discuss partner referral. A consecutive sample of 272 patients (135 men, 137 women) was randomly assigned to the intervention or control group; 137 (50%) completed follow-up. By intent-to-treat analysis, persons in the intervention arm were more likely to report notifying any partner compared to controls (92% vs. 67%, adjusted odds ratio 4.1, 95% confidence interval 1.3-13.2, p < .001). Across both study arms, women and married persons were more likely to notify partners, particularly spouses. Few persons notified casual partners. Qualitative data at follow-up identified diverse motivating factors and barriers to partner referral. A short, low-cost counseling session may increase the number of spouses referred to STD treatment in resource-poor, high-morbidity areas of sub-Saharan Africa. New methods of treating or notifying casual partners need to be evaluated.