Ann Arbor, MI—Since 2006, the CDC has recommended “expedited partner therapy,” in an effort to slow the epidemic of sexually transmitted diseases (STD).

In most states, physicians are permitted to write a prescription or provide medications for the partner, sight unseen, of a patients diagnosed with an STD, and pharmacists are allowed to distribute the drugs to their partners, according to a report in the American Journal of Public Health.

Yet, the article adds, most patients only receive treatment for their own infection. University of Michigan researchers explain why that occurs.

Lead investigator Cornelius Jamison, MD, MSPH, MSc, points out that this is one health issue where public policy is ahead of clinical practice. Even though many major medical societies have endorsed EPT based on evidence that it is cost-effective and safe, the practice remains under-used across the country.

“We need to make sure everyone in the medical and public health community has a basic understanding of what expedited partner therapy is, how it can work, and what it will take for it to reach widespread use,” Jamison said.

The article describes some of the barriers to more extensive use of EPT, including:
• Hesitancy to be tested, especially among teens and young adults
• Lack of insurance or way to pay for STD tests or treatment among sexual partners
• Underuse of EPT at the walk-in clinics where some patients are most likely to seek care

Those barriers could be overcome with a packet of EPT antibiotics provided by a partner who got tested and treated, as could a pre-written prescription, Jamison asserted. He added that drugs used to treat chlamydia and gonorrhea are often prescribed together, even if the patient only tested positive for one infection and that a single 1-gram dose of azithromycin and a single 400-milligram dose of cefixime taken together can clear both infections.

The report also points to guidelines recommending that all sexually active teens and young women be tested for chlamydia and gonorrhea every year but says those are inconsistently followed.

Study authors also discuss policy hurdles that remain, including that seven states and Puerto Rico lack precise laws that give clear legal status to EPT, while South Carolina and Kentucky do not allow EPT under current law.

In addition, they note, liability concerns can keep physicians and pharmacists from providing EPT even in states that allow it.

“Our review and conceptual model show the barrier that we as providers, researchers and policy makers face,” Jamison. Said. “But it also shows the importance of coming together to figure out how to do the right thing for patients.”

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