Patient Acceptance of Expedited Partner Therapy for Chlamydia Trachomatis in An Urban STD Clinic Setting, 2011

Schillinger, Julia

Thursday, March 15, 2012: 8:50 AM

Nicollet Grand Ballroom (C/D)

Tiffani Mulder, MPH, Division of Cancer Prevention and Control, Comprehensive Cancer Control Branch, Centers for Disease Control and Prevention, Atlanta, GA, Kimberly Johnson, MS, Bureau of STD Control and Prevention, New York City Department of Health and Mental Hygiene, Long Island City, NY, Meighan Rogers, MPH, Bureau of STD Control, New York City Department of Health and Mental Hygiene, New York, NY, Anne Lifflander, MD, MPH, Bureau of Sexually Transmitted Disease Control, New York City Department of Health and Mental Hygiene, Queens, NY, Mansi Mehta, MPH, Department of Infectious Diseases/ Bureau of Sexually Transmitted Diseases, New York City Department of Health and Mental Hygiene, Bureau of Sexually Transmitted Diseases, Queens, NY, Catherine Satterwhite, MSPH, MPH, Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, Sami L. Gottlieb, MD, MSPH, Division of STD Prevention, CDC, Atlanta, GA, Kelly Morrison Opdyke, MPH, Cicatelli Associates Inc, New York, NY, Melissa Kyriakos Nelson, MSc, Cicatelli Associates Inc, Region II Infertility Prevention Project, New York, NY, Susan Blank, MD, MPH, Bureau of STD Control and Prevention, NYC Department of Health & Mental Hygiene, Long Island City, NY and Julia Schillinger, MD, MSc, US Centers for Disease Control and Prevention, CDC Division of STD Prevention;, NYC DOHMH Bureau of STD,The New York City Department of Health and Mental Hygiene;, Long Island City, NY

Background: Expedited partner therapy (EPT) is the practice of treating sex partners of patients with a diagnosed STD without intervening medical evaluation. EPT is legal in New York State for Chlamydia trachomatis (CT) infections only. In 2011, New York City public STD clinics began offering EPT (medication or prescription) to heterosexual patients with laboratory-confirmed CT infection. Patients declining EPT were asked “main reason for refusal”.

Objectives: To identify factors associated with EPT acceptance.

Methods: We analyzed medical record data for clinic patients offered EPT during March–July 2011, and examined patient and provider characteristics associated with acceptance.

Results: Among 706 patients offered EPT, 57% (143/251) males and 62% (283/455) females accepted EPT in medication form; no prescriptions dispensed. Patients aged <20 years had a significantly lower acceptance rate, compared with patients aged ≥20 years (51% versus 65%; P < .01). Patients with previous clinic visits were more likely to accept EPT than patients without previous visits (63% versus 48%; P < .01), as were patients symptomatic on day of CT testing (70% versus 59%; P > .01). Patient acceptance differed by offering provider (range: 40%–80%; median, 62%). Patient race/ethnicity, number sex partners, history of condom use, history of STDs, and provider sex were not associated with acceptance. Among 125 patients with available data who refused EPT, reasons for refusal included “no longer with partner” (33%), “partner in clinic today” (21%), and “partner already treated” (20%).

Conclusions: A substantial proportion of clinic patients in our study did not accept EPT; however, many reported their sex partner had been treated. Patients aged <20 years had a lower acceptance rate.

Implications for Programs, Policy, and Research: Barriers to EPT acceptance among adolescents require exploration. Further examination of how providers present the option of EPT may elucidate bias in how EPT is offered.

D4.3 Patient Acceptance of Expedited Partner Therapy for Chlamydia Trachomatis in An Urban STD Clinic Setting, 2011