P88 Uptake of Expedited Partner Therapy (EPT) in An Inner-City STD Clinic

Wednesday, March 10, 2010
Pre-Function Lobby & Grand Ballroom D2/E (M4) (Omni Hotel)
Christie Mettenbrink, MSPH1, Theresa Mickiewicz, MSPH1 and Cornelis Rietmeijer, MD, PhD2, 1Public Health Informatics, Denver Public Health, Denver, CO, 2STD Control Program, Denver Public Health, Denver, CO
Uptake of Expedited Partner Therapy (EPT) in an Inner-City STD Clinic

Background: In 2006, the CDC issued guidelines for providing EPT to patients not identifying as men who have sex with men, who are diagnosed with Chlamydia and/or gonorrhea . EPT allows the infected patient to deliver treatment to his or her partner(s). In August 2006, the Denver Metro Health Clinic began offering EPT.

Objectives: Describe EPT uptake, patient characteristics and factors associated with uptake.

Methods: Eligible patients offered EPT between September 2006 and August 2009 were examined. Monthly “acceptance” rates are calculated and trends reported. Patient demographics and factors associated with EPT uptake are described, including self-reported reasons for refusal of EPT and provider characteristics.

Results: Among the 2159 CT+ and/or GC+ eligible patients, 2060 (95%) were offered EPT and of these, 438 (21%) accepted. Monthly acceptance rates increased over time, averaging 10% at program inception, stabilizing to 20% through 2008 and increasing to 50% in 2009. There were no significant demographic differences between those who accepted EPT and those who refused: overall, 52% female, mean age 25 (range: 14-65) and racial/ethnic composition of 43% Black, 31% Hispanic, 20% White and 6% other. Among the 427 patients who refused EPT since August 2008, 333 (78%) reported one or more reasons for refusal, including: partner had been notified (42%), partner had been treated (35%), or partner was anonymous (17%). Provider type was a significant factor in acceptance: nursing staff were 1.7 times more likely to prescribe EPT than non-nursing staff (95%CI: 1.4-2.2).

Conclusions: In a busy inner-city STD clinic, an increasing proportion of eligible patients are accepting EPT. Nursing staff are more likely to dispense EPT than non-nursing staff.

Implications for Programs, Policy, and/or Research: Regularly scheduled provider training could significantly increase acceptance rates, especially among non-nursing staff.

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