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Background: Expedited partner therapy (EPT) is a partner management strategy whereby providers give index patients infected with Chlamydia trachomatis(Ct) medication to deliver to sex partners as treatment. In research settings, EPT reduces repeat infection among index patients provided with medication to deliver to their sex partner(s) (Medication-EPT), however, in real-world settings EPT is often provided by prescription (Prescription-EPT). We compared partner treatment outcomes for Medication-EPT versus Prescription-EPT.
Methods: We conducted telephone interviews from October 2014-October 2015 with a population-based random sample of women aged 15-25 recently diagnosed with Ct (excluding those diagnosed in public STD clinics). Interview questions included: patient-demographics, patient-treatment, type of EPT given, and report of partner treatment. The main outcomes were: proportion of women receiving EPT, proportion of Prescription-EPT versus Medication-EPT, and proportion of partners reported as treated. We used chi-square and Fisher exact tests for analysis.
Results: Overall, 84.8% (357/421) of interviewed women reported being treated for their own chlamydial infection; 30.5% (109/357) were given EPT for >1 partner. Women receiving prescription (vs. medication) for their own treatment were slightly more likely to receive EPT (OR: 1.57, p=0.05) and were more likely to receive Prescription-EPT than Medication-EPT (OR=6.85, p<0.0001). Prescription-EPT was provided for 52.2% (48/92) of patients who received EPT for their most recent partner. There was no difference by EPT type in the proportion of index patients reporting partner treatment: 77.1% (37/48) for Prescription-EPT vs. 79.5% (35/44) for Medication-EPT (p=0.77).
Conclusions: EPT is a common partner management strategy for young women in NYC, and Prescription-EPT is a common form of EPT provision. Prescription-EPT does not appear to result in lower rates of partner treatment than Medication-EPT. Further research is needed to assess the effects of Prescription-EPT on partner treatment, particularly among adolescents, in other geographic regions, and in the context of electronic prescribing mechanisms.