BACKGROUND: As the number of reported sexually transmitted diseases (STD) continue to increase in Washington State (WA), low intensity interventions for local health jurisdictions (LHJs) are vital to control the disease. Expedited Partner Therapy (EPT), the practice of providing medication or prescription to the original patient to give to their partners without medical evaluation, is an effective intervention requiring little time of the LHJ. EPT is recommended for heterosexual chlamydia and gonorrhea (GC) cases. The purpose of this analysis was to identify and describe GC cases being offered EPT for their sexual partners in WA.
METHODS: Using enhanced interview data from the STD Surveillance Network (SSuN), we identified GC cases eligible for and offered EPT from July 2014-June 2016. A case eligible for EPT was defined as provider or self-report of heterosexual behavior. Characteristics of those eligible for and offered EPT, including sex, age, race/ethnicity and county of residence, were compared to those were not offered EPT. Statistical significance was calculated using chi-square tests and odds ratios.
RESULTS: From July 2014-June 2016, 1,144 WA GC cases with an enhanced SSuN interview. Of these GC cases, 64.8% (n=741) were identified as heterosexual and therefore eligible for EPT. Approximately 27% of eligible cases were offered EPT by their provider and 13.8% not eligible for EPT were offered it. Those eligible for and offered EPT were more likely to be female (72.0% offered verses 50.1% not offered, p<0.001), live in Eastern Washington of the state (80.5% offered verses 70.0% not offered, p=0.0019) and less likely to be black, non-Hispanic (15.5% offered verses 27.2% not offered, p=0.0065) compared to those not offered EPT. Approximately half (n=103) of those offered accepted EPT. Reasons for not accepting EPT included partner(s) already treated (11.5%) and wanting partner(s) to see a medical provider (10.0%).
CONCLUSIONS: We found only a quarter of those eligible for EPT were offered it by their provider. LHJs should work with their local providers to identify barriers to offering EPT to eligible, especially to non-Hispanic blacks and providers in Western Washington. Increasing the uptake of EPT may assist with controlling the spread of GC among heterosexuals and allow LHJs to focus more directly on cases with higher risk.