Implementation of Expedited Partner Therapy in Southwest Alaska

Background: Sexually transmitted infections (STBBI) are a major problem in the Yukon Kuskokwim delta of southwestern Alaska.  The patients here suffer the highest rates of both chlamydia and gonorrhea in the United States and there is an ongoing epidemic since 2009.

Objectives: To describe the process of design and implementation of an EPT program at the Yukon-Kuskokwim Health Corporation (YKHC).  We are experiencing an ongoing epidemic of gonorrhea which started in 2009.

Methods: A task force was formed including members from YKHC, the State of Alaska Public Health Department and the Alaska Native Tribal Health Consortium to address this problem.  The Centers for Disease Control and Prevention (CDC) is also involved in the project.  A plan was then developed to roll out EPT first in our hub city of Bethel, followed by the surrounding 50 villages with a total population of approximately 25,000 people.

Results: Planning began in March 2011.  Policy changes, pharmacy changes and staff education required five months of planning and implementation.  We began EPT on 7 August 2011.  Within two months, an increase in the number of partner doses being dispensed increased sharply.  

Conclusions: EPT implementation is a challenging process, but it can be accomplished with teamwork and a medical staff dedicated to the health of the region.

Implications for Programs, Policy, and Research:  EPT can be implemented in a rural native health system when a group of motivated, caring professionals work together to solve the problems.