Expedited Partner Therapy and Its Impact on Chlamydia and Gonorrhea Rates in LA County Hospitals [08A]

Abstract

INTRODUCTION: Rising rates of gonorrhea (GC) and chlamydia (CT) in Los Angeles County may be related to the inadequate notification/treatment of sexual partners, leading to cycles of treatment and reinfection. Expedited partner therapy (EPT) is a proposed solution that provides prescriptions/antibiotics directly to an affected patient's partner without a separate visit. EPT is approved in California for GC/CT treatment; however its distribution varies, warranting an examination of factors influencing partner notification and EPT distribution. METHODS: Institutional Review Board approval was obtained. Patients with positive GC/CT lab results from 1/2015 to 6/2017 were identified from LA County hospital electronic medical records. Documentation of the need to treat the patient's partner and/or EPT provision was identified, along with possible associated factors, e.g. the patient demographics, as well as the provider's specialty and training level. Descriptive statistics and bivariate comparisons identified correlations between receipt of EPT and possible factors. RESULTS: Of 319 GC/CT diagnoses, only 7.5% had EPT documented. More diagnoses occurred among female than male patients (63.6% vs. 36.4%) with males being less likely to be offered EPT (0.9% vs. 11.3%, P<.01). Patient age, race, and marital status were not associated with receiving EPT. Most diagnoses (60.2%) occurred in the emergency department, but those patients were least likely to receive EPT (3.7%, P<.01). Gynecologists were most likely to provide EPT (37.8%, P<.01). CONCLUSION: EPT was rarely offered to patients diagnosed with GC/CT, with provision least likely among male patients and in the emergency department setting. Gender-based and structural barriers may underlie low rates of EPT provision.