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Background: In New York City (NYC) expedited partner therapy (EPT) is legal for people with clinically-diagnosed Chlamydia trachomatis (Ct) infection, however, because only a minority of people presumptively treated for Ct (PreTxCt) turn out to have Ct, NYC STD clinics offer EPT only to heterosexuals with laboratory-confirmed Ct. PreTxCt rates are high in NYC STD clinics, and patients with laboratory-confirmed Ct are not called back to clinic if they have already been treated, with the result that many EPT-eligible patients are not offered EPT. We sought to expand EPT use among PreTxCt patients.
Methods: During 2013 STD clinic providers were asked to use an automated test result retrieval system to manually assign a phone/web-based message offering EPT to PreTxCt patients with laboratory-confirmed Ct if they call in for their test results and return within 30 days of their testing visit to pick up medication for their partners. We analyzed the number (and percentage) of PreTxCt patients who had a message assigned, retrieved their message, and received EPT within 30 days of testing visit.
Results: There were 4,168 EPT-eligible patients, of whom 2,779 (67%) were PreTxCt (87% male; 2030/2779). Overall, 1,099 people PreTxCt (40%) had an EPT message assigned; 32% (349/1,099) retrieved the message within 30 days of their Ct-positive test (76% (266/349) were male). Thirty-eight patients (34 male, 4 female) returned to clinic and received EPT (3.5% of those who had a message assigned, and 11% of those who retrieved it).
Conclusions: The majority of EPT-eligible patients in NYC STD clinics were PreTxCt. Our system provides a simple way to offer EPT to PreTxCt patients, however only a small minority of these patients retrieved their EPT message and picked up medication for their partners. Further work is needed to expand EPT to eligible patients.