Expedited Partner Therapy (EPT)/Patient Deliver Partner Therapy (PDPT) David Johnson STD Disparities Coordinator, Office of Health Equity Division of STD Prevention National Center for HIV, Viral Hepatitis, STD, & TB Prevention Council of State Governments December 3, 2010 State of Rhode Island and Providence Plantations
Objectives Describe the terms Expedited partner therapy (EPT) and patient delivery partner therapy (PDPT) Provide a national overview of the legal status for EPT Highlight the limitations associated with health department partner management Describe the benefits associated with EPT/PDPT Identify training resources for providers and patients
EPT and PDPT? Expedited Partner Therapy is the practice of treating the sex partners of persons with sexually transmitted diseases (STDs) without any intervening medical evaluation or professional prevention counseling. Patient Delivered Partner Therapy is based on the patient s willingness to deliver medicine (patient-delivery) and the partner s willingness to take it (partner-use).
Where is EPT Legal? Connecticut(?), Maine(?), Massachusetts(?), New Hampshire(?), New Jersey(?), New York(?), Pennsylvania(?), Puerto Rico(?), Rhode Island(?), Vermont(?)
Expedited Partner Therapy Legal Status as of Nov 2010 AK WA OR NV CA ID AZ UT MT WY CO NM ND SD NE KS OK TX MN WI IA IL MO AR MS LA VT NY MI PA IN OH WV VA KY NC TN SC AL GA ME NH MA RI CT NJ DE MD (Baltimore only) FL DC HI EPT is Permissible EPT is Likely Prohibited EPT is Potentially Allowable Legislation Introduced
Limitations with Health Department Partner Management U.S. health departments provide partner notification services to fewer than 20 percent of people diagnosed with gonorrhea or chlamydial infection Traditional public health partner services were ineffective when provided outside of the STD clinic setting Outside of STD clinics, health departments have no resources to help clinicians ensure that their patients' partners are treated Approximately one-half of potentially exposed partners receive treatment
Benefits to EPT or PDPT Limited access to care does not allow for everyone to be seen by a physician Health departments and private providers do not have the resources to follow-up on every partner that have been exposed to an STI Allows for partners to work together Potentially increases the proportion of partners treated
Training for EPT/PDPT No single repository of training and support tools for EPT/PDPT Subject-matter experts, CDC personnel, and practitioners created a web-based portal www.partnercare.org For providers, a real-world, interactive, implementation video case, documents the PDPT process For patients/partners, model patient-partner interactions and short-animated informational segments on key PDPT topics
References Golden MR, Hogben M, Handsfield HH, St Lawrence JS, Potterat JJ, Holmes KK. Partner notification for HIV and STD in the United States: low coverage for gonorrhea, chlamydial infection, and HIV. Sex Transm Dis. 2003,30(6):490-496. Golden MR, Faxelid E, Low N. Partner notification for sexually transmitted infections including HIV infection: an evidence-based assessment. In: Holmes KK, Sparling PF, Stamm WE, et al., eds. Sexually Transmitted Diseases. 4th ed. New York, NY: McGraw Hill; 2008. Goldsworthy RC, Fortenberry DJ. Patterns and determinants of patient-delivered therapy uptake among healthcare consumers. Sex Transm Dis. 2009 Jan;36(1):25-32. Goldsworthy RC. Getting Better, Faster: Expedited Partner Services, Partner Treatment, and the Control of STI. Social Justice APHA 138 Annual Meeting & Expo, November 2010. Low N, McCarthy A, Roberts TE, et al. Partner notification of chlamydia infection in primary care: randomised controlled trial and analysis of resource use. BMJ. 2006;332(7532):14-19. Minnesota Department of Health. Expedited Partner Therapy (EPT) for Chlamydia trachomatis and Neisseria gonorrhoeae: Guidance for Medical Providers in Minnesota. IDEPC Division, STD and HIV Section of the Minnesota Department of Health.
Resources Patientcare http://partnercare.org/ 138 th APHA Annual Meeting & Expo http://apha.confex.com/apha/138am/webprogram/paper221377.html
For More Information About How You Can Get Involved Please Contact: Your Local Health Department CDC s Division of STD Prevention www.cdc.gov/std or me at dbj1@cdc.gov American Social Health Society www.ashastd.org Block Island
The findings and conclusions in this presentation have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.