Patient-Reported Expedited Partner Therapy for Gonorrhea in the United States: Findings of the STD Surveillance Network 2010-2012.
BACKGROUND
Expedited partner therapy (EPT) has been shown to prevent reinfection in persons with gonorrhea and to plausibly reduce incidence. The Centers for Disease Control and Prevention recommends EPT as an option for treating sex partners of heterosexual patients. Few studies that examine how the reported use of this valuable intervention differs by patient and provider characteristics and by geography across multiple jurisdictions in the United States are currently available.


METHODS
Case and patient interview data were obtained for a random sample of reported cases from 7 geographically disparate US jurisdictions participating in the Sexually Transmitted Disease (STD) Surveillance Network. These data were weighted to be representative of all reported gonorrhea cases in the 7 study sites. Patient receipt of EPT was estimated, and multivariate models were constructed separately to examine factors associated with receipt of EPT for heterosexuals and for men who have sex with men.


RESULTS
Overall, 5.4% of patients diagnosed and reported as having gonorrhea reported receiving EPT to treat their sex partners. Heterosexual patients were more likely to have received EPT than men who have sex with men at 6.6% and 2.6% of patients, respectively. Receipt of EPT did not vary significantly by race, Hispanic ethnicity, or age for either group, although significant variation was observed in different provider settings, with patients from family planning/reproductive health and STD clinic settings more likely to report receiving EPT. Jurisdiction variations were also observed with heterosexual patients in Washington State most likely (35.5%), and those in New York City, Connecticut, and Philadelphia least likely to report receiving EPT (<2%).


CONCLUSIONS
With the exception of one jurisdiction in the STD Surveillance Network actively promoting EPT use, patient-reported receipt of the intervention remains suboptimal across the network. Additional efforts to promote EPT, especially for patients diagnosed in private provider and hospital settings, are needed to realize the full potential of this valuable gonorrhea control intervention.
From the *Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA; †University of Washington School of Medicine/Public Health-Seattle and King County, Seattle, WA; ‡California Department of Public Health, Sacramento, CA; §Philadelphia Department of Public Health, Philadelphia, PA; ¶New York City Department of Health and Mental Hygiene, New York, NY; ∥Johns Hopkins University School of Medicine/Baltimore City Health Department, Baltimore, MD; and **Washington State Department of Health, Olympia, WA.
Mark R
MR
Stenger
Roxanne P
RP
Kerani
Heidi M
HM
Bauer
Nicole
N
Burghardt
Greta L
GL
Anschuetz
Ellen
E
Klingler
Christina M
CM
Schumacher
Julie
J
Simon
Matthew
M
Golden
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016358:Contact Tracing / Q000706:statistics & numerical data*; D062665:Epidemiological Monitoring; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D057566:Self Report; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D055815:Young Adult