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Background: Expedited Partner Therapy (EPT) has been shown to reduce Chlamydia trachomatis(Ct) re-infection. In New York City (NYC) in 2014, only 28% of Ct-infected patients were estimated to have received EPT. Identifying factors associated with patient-receipt of EPT is critical to improving EPT uptake.
Methods: We analyzed electronic health record data on Ct nucleic acid amplification testing performed between April-December2014 among women attending two high-volume community healthcare organizations with 8 sites throughout NYC. Extracted variables included: patient age and race/ethnicity, insurance status, clinic location, dates of Ct specimen collection and treatment, and whether EPT was dispensed. Among Ct-positive cases, we compared index patient EPT receipt by patient and visit characteristics.
Results: A total of 24,750 unique female patients contributed 28,612 Ct testing visits. There were 1,063 unique patients with 1,123 lab-confirmed Ct infections, for an overall positivity of 3.9% (1,123/28,612); 6.3% (870/13,810) among patients aged ≤25 and 1.7% (253/14,802) among patients >25. The majority of visits were for family planning (94.3%, 26,989/28,612), and among Medicaid enrollees (52.8%; 15,102/28,612) and uninsured patients (26.0%; 7,452/28,612). EPT was dispensed to 482 of the 1,123 Ct cases (42.9%), among 471 unique female patients (11 patients received EPT twice). Rates of index patient receipt of EPT were significantly lower among presumptively treated patients (presumptively treated patients, 9.3% (4/43) vs. non-presumptively treated patients, 56.3% (444/789); p<0.001). Hispanic patients were more likely than non-Hispanic patients to receive EPT (Hispanic, 47.7% (227/476) vs. non-Hispanic, 39.2% (223/569); p=0.006).
Conclusions: Less than half of Ct-infected patients received EPT, and EPT receipt varied considerably according to time of Ct treatment. Presumptively treated patients were unlikely to receive EPT, suggesting that future efforts should focus on encouraging those presumptively treated to return for partner treatment.