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Background: The practice of Expedited Partner Therapy (EPT) allows partners to be treated for chlamydia or gonorrhea (CT/GC) without clinical evaluation, to augment traditional partner services. EPT in Washington State (WA) was initially implemented and promoted statewide by the University of Washington in collaboration with the WA Department of Health (DOH) as an evaluation study. Private and public medical providers received EPT education and access to free treatment packets at local pharmacies. After research funding ceased, the DOH maintained key aspects of the EPT program. This analysis examined the impact of transitioning EPT from research to routine public health activity.
Methods: Provider-identified plans for treating partners, including referrals to public health departments, were collected for all CT/GC cases between March 1, 2010 and October 31, 2013. Cases were randomly selected for interview and asked whether their provider offered EPT. Analyses were restricted to women and heterosexual men, 14 years and older at time of diagnosis, and stratified by research period (2010-2011) and program period (2012-2013). Statistical significance was calculated using chi-square tests.
Results: More EPT packets were available in 2012-2013 than in 2010-2011. Fewer CT/GC cases were referred to the health department for partner services in 2012-2013 (50.9%) than in 2010-2011 (51.5%) (p=.0024). In 2010-2011, 7,381 cases of CT/GC (17.1% of cases) were randomly selected for interview and 3,965 (8.4% of cases) were selected in 2012-2013. Of completed interviews (56.2%), the proportion of CT/GC cases that reported being offered EPT by providers decreased from 44.1% in 2010-2011 to 36.4% in 2012-2013 (p<.0001).
Conclusions: While declines in EPT use were observed, our findings suggest that providers continue to offer EPT to a substantial proportion of CT/GC cases even in the absence of ongoing promotion. Future analyses should include evaluation of reestablishing active provider education and other measures of EPT success.