NEW YORK Asking patients to deliver therapy for sexually transmitted diseases to their sex partners is paying off, with increases in the proportion of partners who are being treated, according to study data.
The Centers for Disease Control and Prevention advises that expedited partner therapy (EPT), or treating sexual partners without requiring that they first seek a medical evaluation, is an option when other strategies are impractical or unsuccessful.
In Washington state, public health officials advise that EPT should be given when treatment cannot otherwise be ensured, according to Dr. Matthew Golden, director of the STD Control Program for Public Health in Seattle/King County.
But EPT isn't a cure-all, Dr. Golden said at a joint conference of the American Sexually Transmitted Diseases Association and the British Association for Sexual Health and HIV. Some people will not get their partners treated, such as those with more than one sex partner or a partner they are unikely to have sex with again, men who have sex with men, and those who say outright they won't notify their partners.
So King County health officials developed a case report form that allows the diagnosing physician to check a box indicating that the health department should assume responsibility for partner notification, such as drawing on the services of a disease intervention specialist. Through the program, patients and their partners have free access to medications through large clinics and commercial pharmacies.
Use of the form has yielded encouraging results. A random sample of patients diagnosed with gonorrhea or chlamydia shows about 39% were classified as having all partners treated before the intervention, compared with 65% in the postintervention period (Sex. Transm. Dis. 2007;34:598-603).
If the results continue, the researchers estimate there would be about a 25% reduction in chlamydial prevalence in about 2 years' time and a 50% reduction in chlamydial prevalence in 4 years' time. A community-level, randomized controlled trial is being conducted throughout the state to establish whether EPT reduces the prevalence of chlamydial infection and the incidence of gonorrhea at a population level.