The Effectiveness of Patient-Delivered Partner Therapy and Chlamydial and Gonococcal Reinfection in San Francisco

@article{Stephens2010TheEO,
  title={The Effectiveness of Patient-Delivered Partner Therapy and Chlamydial and Gonococcal Reinfection in San Francisco},
  author={Sally Stephens and Kyle T. Bernstein and Mitchell H. Katz and S Philip and Jeffrey D. Klausner},
  journal={Sexually Transmitted Diseases},
  year={2010},
  volume={37},
  pages={525-529}
}
Background: Patient-delivered partner therapy (PDPT) has been evaluated in randomized trials. No analysis has examined the impact of PDPT once implemented programmatically. Methods: We examined the association between receiving PDPT and Chlamydia trachomatis and Neisseria gonorrhoeae reinfection within 1 year in patients diagnosed at San Francisco City Clinic between October 31, 2005 and March 31, 2008. Propensity score modeling was used to control for the difference between persons who did and… 
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Citation Type

A Randomized, Controlled Trial of inSPOT and Patient-Delivered Partner Therapy for Gonorrhea and Chlamydial Infection Among Men Who Have Sex With Men
TLDR
PDPT may increase partner treatment among MSM and few MSM appear to be willing to use inSPOT to notify their sex partners, suggesting traditional randomized trials of partner notification strategies may not be feasible among MSM.
Uptake and Population-Level Impact of Expedited Partner Therapy (EPT) on Chlamydia trachomatis and Neisseria gonorrhoeae: The Washington State Community-Level Randomized Trial of EPT
TLDR
A public health intervention promoting the use of free PDPT substantially increased its use and may have resulted in decreased chlamydial and gonococcal infections at the population level.
Patient-Reported Expedited Partner Therapy for Gonorrhea in the United States: Findings of the STD Surveillance Network 2010–2012
TLDR
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.
Patient preference for patient-delivered partner therapy: exploratory findings from three sexually transmitted disease clinics.
TLDR
The results indicate that the concept of PDPT is not intuitive to STD clients, and programs will not be successful in the absence of patient education concerning this approach to partner treatment and the risks of reinfection.
Expedited partner therapy for sexually transmitted infections
TLDR
Clinicians should continue to be aware of the importance of partner managements for STD-infected patients, with EPT being an evidence-based intervention in that respect, and effective counseling models – enhanced patient referral – should be closely examined in case oral treatment for gonorrhea becomes infeasible.
Implementation and Effectiveness of an Expedited Partner Therapy Program in an Urban Clinic
TLDR
Expedited partner therapy at the DMHC was substantially enhanced by process changes in the clinic and may be associated with a decreased risk of reinfection.
Expedited Partner Therapy (EPT) increases the frequency of partner notification among MSM in Lima, Peru: a pilot randomized controlled trial
TLDR
Provision of EPT led to significant increases in notification among Peruvian MSM diagnosed with GC/CT infection, including persistent or recurrent infection, antimicrobial resistance, and HIV/STI transmission, in MSM sexual networks.
Rate of repeat diagnoses in men who have sex with men for Chlamydia trachomatis and Neisseria gonorrhoeae: a retrospective cohort study.
TLDR
It is suggested that approximately half of MSM who test positive for chlamydia or gonorrhoea within 90 days after an initial infection represent contact with either a previous sexual partner or member of the same sexual network, the remainder representing the particularly high STI risk for these MSM.
Retreatment Rates for Uncomplicated Gonorrhea Infection: Comparing Ceftriaxone and Azithromycin Versus Ceftriaxone and Doxycycline
TLDR
Gonorrhea retreatment was common, highlighting the need for rescreening and better partner therapies, and azithromycin may be preferable as the second agent to treat gonorrhea, although doxycycline seems to be a reasonable alternative.
Overcoming the Challenges of Studying Expedited Partner Therapy in the Real World.
TLDR
A systematic review of the growing body of literature examining the real-world effectiveness of EPT for chlamydia and gonorrhea infection, using recurrent infection in treated index patients as the outcome of interest.
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References

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TLDR
A public health program that promotes routine use of PDPT and referral of selected patients for partner notification assistance appears to have improved partner notification outcomes.
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TLDR
This study found that men who were provided with medication to give to their sex partners were more likely to report that their partners were treated and less likely to be infected 1 month after receipt of treatment, and substantially increases the available data on PDPT for patients with gonorrhea.
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TLDR
Patient-delivered partner treatment for prevention of repeated C trachomatis infection among women is comparable to self-referral and may be an appropriate option for some patients.
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TLDR
Among heterosexual men with urethritis, PDPT was better than standard partner referral for treatment of partners and prevention of recurrence of C. trachomatis or N. gonorrhoeae infection.
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TLDR
Expedited treatment of sex partners reduces the rates of persistent or recurrent gonorrhea or chlamydial infection and is significantly more likely than those assigned to standard referral of partners to report that all of their partners were treated and significantly less likely to report having sex with an untreated partner.
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TLDR
Patient-delivered therapy is a beneficial and feasible addition to partner notification in the management of chlamydia, and should be considered seriously in public health policy and clinical care.
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TLDR
Among women with TV, patient-delivered partner treatment (PDPT) did not result in more partners taking the medicine or lower follow-up rates than PR but was less costly.
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TLDR
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TLDR
It is determined that three fourths of states or territories either expressly permit EPT or do not expressly prohibit the practice, and recommends expressly endorsing EPT through laws, creating exceptions to existing prescription requirements, and increasing professional board or association support for EPT.
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