So, You Have Gonorrhea. Who Tells Your Ex?
In an effort to stop a spate of gonorrhea outbreaks, at least one public health department in the Pacific Northwest is offering a helpful service to infected patients: anonymous notification of former sexual partners.
That's right. A government worker will track down and contact each ex for you. Awkward for all concerned? Yes. But at a time when gonorrhea is becoming stubbornly drug-resistant, health officials see it as time â and embarrassment â well spent.
Anna Halloran, who works for Spokane Regional Health District in eastern Washington, is kind of like a private investigator. She tries to find people who don't know they might have a sexually transmitted disease, and get them treatment before they spread the infection.
"I feel a big sense of accomplishment when I've found somebody after I've been looking for them for weeks," she says. And it's not always easy.
"I try phone, I try the mail," Halloran says. She'll try texting, Facebook, even tracking people down in person. "You know, it's a really sensitive subject. And it's really hard news for people to get."
We're not able to listen in on one of her actual phone calls because of confidentiality issues. But I ask her to walk me through the process.
"So I'll ask, 'Is this Jessica?' " Halloran says. "And then I would ask your birthday, and if that matches what I have, I would say, 'I'm calling from the Spokane Regional Health District. And I'm calling to let you know that you may have been exposed to gonorrhea.'
"And then, I would pause for a little bit," says Halloran. "Then I would ask what the person I'm talking to knows about gonorrhea."
The STD is normally completely treatable with a single course of antibiotics. But it may produce very few symptoms for quite a while before blossoming into a serious health problem such as pelvic inflammatory disease or infertility.
"Some people cry, some people get really angry, some people don't want to talk to me at all," Halloran says. "A lot of people are really anxious to know who it was [who gave them the infection]. Of course, I can't say anything whatsoever that would identify that."
Now, you might be wondering: Shouldn't it be the patient's job to notify ex-partners?
"People don't necessarily do that," says Jocelyn Warren, a public health researcher at Oregon State University. Studies show that couples â especially young couples â don't communicate about their sexual histories. (Surprise, surprise!) And telling an ex about an STD infection can be especially "difficult," Warren says.
Public health departments just want to make sure the conversation happens. Partner notification by a third party is now standard practice in Washington and some other states to help curb the spread of syphilis and HIV. Warren says there's an incentive to add gonorrhea to the list: It may not always be easily curable.
Though the Washington cases can still be successfully treated with antibiotics if caught early enough, some parts of Europe and Asia are already seeing drug-resistant gonorrhea.
"Certainly there is an expectation that it's just a matter of time," Warren says. This fall, the U.S. Centers for Disease Control and Prevention released a report identifying a form of "super" gonorrhea as an urgent threat.
Five counties in Washington are in the midst of expanding outbreaks of the STD. Halloran says health officials are struggling to explain the rise.
"You know, I wait for the time when our numbers go down," Halloran says. "But I have to keep thinking of what the case rates would be like if we weren't doing this work."
Halloran sees the messy side of relationships â lies, infidelities. Occasionally she's even been asked to notify the current partner of someone who tested positive for gonorrhea. On the bright side, no one so far has asked her to dump their girlfriend or boyfriend for them. "I don't do breakups," Halloran says, with a laugh.
Halloran says that in her experience, most people want to do the right thing and make sure their sexual partners are notified â even if they're not quite brave enough to make the call themselves.
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Transcript
AUDIE CORNISH, HOST:
Public health officials in the Pacific Northwest are trying to stop a series of gonorrhea outbreaks, and for infected patients, health departments are offering anonymous notification of former sexual partners, as in a government worker will tell your exes for you. Awkward? Yes. But at a time when gonorrhea is becoming drug resistant, health officials see it as time well spent. Jessica Robinson of the Northwest News Network reports.
JESSICA ROBINSON, BYLINE: Anna Halloran is kind of like a private investigator.
ANNA HALLORAN: I feel a big sense of accomplishment when I've found somebody after I've been looking for them for weeks.
ROBINSON: And it's not always easy.
HALLORAN: I try phone. I try the mail.
ROBINSON: She'll try texting, Facebook, even tracking people down in person. Halloran works for the Spokane Regional Health District in eastern Washington state. She's trying to find people who don't know they might have an STD and get them treatment before they spread the infection.
HALLORAN: You know, it's a really sensitive subject and it's really hard news for people to get.
ROBINSON: So, we're not able to record one of your actual phone calls because of confidentiality issues. But I want you to walk me through this. Let's say that I'm one of the people that you're calling. And so you dial my number and then what do you say?
HALLORAN: So I'll ask, you know, is this Jessica? And then I would ask your birth date, and if that matches what I have then I would say: I'm calling from the Spokane Regional Health District. And I'm calling to let you know that you may have been exposed to gonorrhea. And then I would pause for a little bit and then I would ask what the person I'm talking to knows about gonorrhea.
ROBINSON: Gonorrhea is normally completely treatable with a single course of antibiotics. But it can have very few symptoms until it creates a serious health problem, like pelvic inflammatory disease or infertility. Patients diagnosed with the disease can opt to give Halloran a list of their recent sexual partners, and she'll break the news to them.
HALLORAN: Some people cry. Some people get really angry. Some people don't want to talk to me at all. A lot of people are really anxious to know who it was. Of course, I can't say anything whatsoever that would identify that.
ROBINSON: Now, you might be wondering: Isn't it the patient's job to notify ex-partners?
JOCELYN WARREN: People don't necessarily do that.
ROBINSON: Jocelyn Warren is a public health researcher at Oregon State University. She says studies show couples, especially young couples - surprise, surprise - don't communicate about their sexual histories. And telling an ex about an STD infection...
WARREN: These conversations can be very difficult to have.
ROBINSON: Public health departments have taken on the job to ensure the conversation happens. Partner notification is now standard practice for curbing the spread of syphilis and HIV. Warren says there's an incentive to add gonorrhea to the list: it may not always be easily curable.
WARREN: It does seem that gonorrhea evolves pretty rapidly to be resistant. It's not - we're not seeing drug-resistant gonorrhea now, but certainly there is an expectation that it's just a matter of time.
ROBINSON: Other countries in Europe and Asia are seeing drug-resistant gonorrhea. This fall, the U.S. Centers for Disease Control and Prevention released a report identifying a form of super gonorrhea as an urgent threat. That's not the case with the strain in Washington state. But still, five counties are the midst of a full on gonorrhea outbreak. These cases are treatable with drugs. But Anna Halloran, in Spokane County, says health officials are struggling to explain the rise.
HALLORAN: You know, I wait for the time when our numbers go down. But I have to keep thinking of what the case rates would be like if we weren't doing this work.
ROBINSON: Halloran sees the messy side of relationships - lies, infidelities. Occasionally, she's even asked to inform the current partner of someone who tested positive for gonorrhea. On the bright side, so far people haven't asked her to dump their girlfriend or boyfriend for them.
(LAUGHTER)
HALLORAN: No, that would be a first. I'll let you know when that happens.
ROBINSON: You don't do breakups?
(LAUGHTER)
HALLORAN: No, I don't do breakups.
(LAUGHTER)
ROBINSON: Halloran says most people want to do the right thing and make sure their sexual partners are notified, even if they're not quite brave enough to make the call themselves.
For NPR News, I'm Jessica Robinson in Spokane. Transcript provided by NPR, Copyright NPR.
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