Published in partnership with the National Coalition of STD Directors (NCSD).
April is Sexually Transmitted Disease (STD) Awareness Month, and we all have a role to play in preventing STDs. As state lawmakers, there is a lot we can do to advance policies that help keep communities healthy. One policy I am working on in my state is expedited partner therapy (EPT).
Expedited partner therapy is an option for treating the STDs chlamydia and gonorrhea. When patients test positive for an STD such as chlamydia they are usually treated with antibiotics by a health-care professional. However, treating the patient’s sexual partner(s) is also crucial to preventing reinfection of the patient. A health-care worker might tell a patient to encourage his or her partner(s) to get tested and treated, or the worker may contact the patient’s sexual partner(s) and refer them to testing. EPT simplifies the process of receiving treatment for STDs. EPT enables health-care professionals to provide patients with either antibiotics or prescriptions for antibiotics to their sexual partner(s) without a visit by the partner(s) to a health-care center.
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I’m working to advance EPT for a couple of reasons. First, scientific studies demonstrate the practice’s efficacy. One such study found that patients who receive EPT are far less likely to become reinfected with chlamydia or gonorrhea. These findings are not surprising. Patients who receive EPT can deliver antibiotics or written prescriptions to their sexual partner(s), increasing the likelihood that their partner’s STDs are treated and thus preventing the patient’s reinfection. By reducing reinfection rates, EPT may also help prevent HIV. For example, women with untreated chlamydia who are exposed to HIV are five times more likely to become infected with HIV than women without chlamydia. That’s because chlamydia changes the immune system in ways that make women more susceptible to HIV.
Getting STDs treated isn’t just good for HIV prevention; it is also good for reducing the strain on the health-care system. Untreated STDs can cause a myriad of poor health outcomes, including sterility and pregnancy complications in women. People with these types of complications require many health-care visits over a lifetime beyond simply getting treated for the initial STD. And the estimated 20 million STD incidences annually come with a total cost of $15.6 billion to the health-care system. EPT is not a panacea to eliminate the burden STDs place on the health-care system, but it could help make a serious dent.
EPT saves the health-care system’s scarce resources in another way: Because EPT reduces reinfection rates, fewer patients return to health-care providers for repeated treatment, and this minimizes the cost borne by the health-care system. Similarly, EPT essentially allows medical professionals to treat a patient’s infected sexual partner(s) without seeing them in a clinic or hospital, again reducing the financial strain on the health-care system. In addition, EPT can be more cost effective than other, more traditional methods of partner contact and treatment used by public health departments. To treat a patient’s sexual partner(s), health department personnel must often locate the patient’s sexual partner(s)—a sometimes laborious and expensive task—and then encourage the partner(s) to obtain treatment at a local health-care provider. EPT, however, allows the patient to deliver medications and obviates the need for health department staff to engage in costly partner location and contact.
Finally, EPT is safe. In 2001, California became the first state to legalize EPT. Over the past 12 years of use, the practice has become commonplace in California among physicians and nurses, with no adverse effects reported. Thirty-two states have followed in California’s footsteps by legalizing EPT. Now we just need to get the few remaining states to adopt the practice.
EPT is an important tool in the public health arsenal. And that’s why we’re working to make certain it’s legal in our state.
We need to do all we can to decrease our STD rates and improve sexual health. Our role as elected officials is to enact commonsense policies that help us do just that. Your role as citizens is to help keep us informed on sexual health issues and what policies keep our communities healthy. I hope you’ll feel free to contact us and legislators in other states. Together we will work to make STDs a thing of the past.
To find out more about EPT in your state, please visit CDC’s website.