The Legal Aspects of Expedited Partner Therapy Practice

Abstract

Background Expedited partner therapy (EPT) is a potential partner treatment strategy. Significant efforts have been devoted to policies intended to facilitate its practice. However, few studies have attempted to evaluate these policies. Methods We used data on interviewed gonorrhea cases from 12 sites in the STD Surveillance Network (SSuN) in 2010 (n=3,404). Patients reported whether they had received EPT. We coded state laws relevant to EPT for gonorrhea using Westlaw legal research database, and the general legal status of EPT in SSuN sites from CDC’s website in 2010. We also coded policy statements by medical and other boards. We used chi-squares to compare receipt of EPT by legal/policy variables, patient characteristics and provider type. Variables significant at p<.10 in bivariate analyses were included in a logistic regression model. Results Overall, 9.5% of 2,564 interviewed gonorrhea patients reported receiving EPT for their partners. Receipt of EPT was significantly higher where laws and policies authorizing EPT existed. Where EPT laws for GC existed and EPT was permissible, 13.3% of patients reported receiving EPT as compared to 5.4% where there were no EPT laws and EPT was permissible, and 1.0% where there were no EPT laws and EPT was potentially allowable (p<.01). EPT was higher where professional boards had policy statements supporting EPT (p<.01). Receipt of EPT did not differ by most patient characteristics or provider type. Policy-related findings were similar in adjusted analyses. Conclusions EPT laws and policies were associated with higher reports of receipt of EPT among interviewed gonorrhea cases.

Sexually Transmitted Disease Prevention Policies in the United States

“…For example, a multi-state study of the relationship between state-level EPT policies (e.g., laws and medical/pharmacy board statements) and gonorrhea patients receiving EPT found evidence that EPT use is higher in states with policies that are supportive to its use. [17] Additionally, an assessment of federally qualified health centers in New York City conducted in 2012 found that approximately half of governing organizations had written policies permitting EPT. [18] Of clinical sites examined, 80% provided EPT with slightly more use (86%) at sites whose governing organization had a written EPT policy.…”

Adolescents’ Attitudes Toward Expedited Partner Therapy for Sexually Transmitted Infections

“…Expedited partner therapy legal status 11 and its dynamic nature is caused by advocacy efforts to increase permissibility. 20,21 The Centers for Disease and Control Prevention presents each state's EPT legal status and offers a legal/policy toolkit at www.cdc.gov/std/ept/legal.…”

Expedited Partner Therapy for Sexually Transmitted Diseases—Are We There Yet?

“…So the legal barrier continues to deteriorate and it appears that legalizing EPT in all states is a winnable battle. A recent study by Cramer et al 9 found that if EPT was legal, providers were almost 2.5 times more likely to offer it, yet only 9.5% of interviewed patients with gonorrhea reported receiving EPT for their partners. EPT legality is, therefore, a necessary but not sufficient criterion for uptake.…”

“…4 Where policies by professional organizations supporting EPT exist, providers are more likely to use it. 9 Favorable policies, professional endorsement, legal status and funding are needed to persuade many providers to offer EPT.…”