The Legal Aspects of Expedited Partner Therapy Practice: Do Laws Really Matter?

Cramer, Ryan

Tuesday, March 13, 2012: 11:05 AM

Greenway Ballroom D/E

Ryan Cramer, JD¹, Jami Leichliter, PhD², Mark Stenger, MA³, Lenore Asbel, MD⁴, Kyle T. Bernstein, PhD, ScM⁵, Margaret Eaglin, MPH⁶, Tom Jaenicke, MPH⁷, Megan Jespersen, MPH⁸, Penny Loosier, PhD, MPH¹, Mukhtar Mohamed, MPH, MA⁹, Preeti Pathela, PhD¹⁰, Nancy Patrick-Dubose, MPH¹¹, Mary Reed, MPH¹², Lauren Slive¹, Jeff Stover, MPH¹³ and Jonathan Zenilman, MD¹⁴, 1Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 2CDC, Division of STD Prevention, Atlanta, GA, 3DSTDP/Epidemiology & Surveillance Branch, CDC, Atlanta, GA, 4STD Control Program, Philadelphia Department of Public Health, Philadelphia, PA, 5STD Prevention and Control Services, San Francisco Department of Public Health, San Francisco, CA, 6City of Chicago Department of Public Health, Chicago, IL, 7Infectious Disease & Reproductive Health Assessment Unit, Washington State Department of Health, Olympia, WA, 8STD/HIV program, Louisiana Office of Public Health, New Orleans, LA, 9STD Control Program, Connecticut Department of Public Health, Hartford, CT, 10Bureau of STD Control and Prevention, The New York City Department of Health and Mental Hygiene, Long Island City, NY, 11Disease Control-TB/STD, Jefferson County Health Department, Birmingham, AL, 12Colorado Dept. of Public Health and Environment, Denver, CO, 13Health informatics & Integrated Surveillance Systems, Virginia Department of Health - Division of Disease Prevention, Richmond, VA, 14Division of Infectious Diseases, Johns Hopkins Center for STI Research & Prevention, Baltimore, MD

Background: Significant resources have been devoted to implementing policies intended to facilitate the practice of expedited partner therapy (EPT); it is unclear whether these policies are effective.

Objectives: To examine the association between laws and policies authorizing EPT and receipt of EPT among reported gonorrhea (GC) cases across the US.

Methods: We used weighted data on interviewed GC cases from 12 sites in the STD Surveillance Network (SSuN) in 2010 (n=3,404; response rate=39%). Among the sample, 2,393 patients reported whether they had received EPT. Additionally, we compiled and coded state laws relevant to EPT, as well as CDC’s legal status determination of EPT in each site. We also coded policy variables which included medical and other board opinions. We used chi-squares to test for differences in receipt of EPT by legal/policy variables, demographics and sexual behaviors. Variables significant at p<.10 in bivariates were included in a logistic regression model.

Results: Overall, 8.9% of interviewed GC patients reported receiving EPT for their partners (range: 0-100% across sites). Receipt of EPT was significantly higher where laws and policies authorizing EPT existed. Where EPT laws for GC existed and CDC deemed EPT as permissible, 12.6% of patients reported receiving EPT 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 wasn’t permissible (p<.05). EPT was higher where state medical or other boards ruled that patients could be treated without examination (p<.001). Receipt of EPT did not differ by age, sexual orientation, or provider type. Findings held in adjusted analyses.

Conclusions: EPT laws and policies were associated with higher EPT uptake among reported GC cases; however, receipt of EPT remains low in many areas.

Implications for Programs, Policy, and Research: Findings can help states make more efficient use of their resources.

A6.6 The Legal Aspects of Expedited Partner Therapy Practice: Do Laws Really Matter?