According to a recent study, places that allow doctors to treat a patient's sexual partner without an in-person visit may find more success lowering rates of sexually transmitted diseases.
In some U.S. states, patients who test positive for chlamydia or gonorrhea leave the clinic with not only a prescription for themselves, but also one for their sexual partner, who was not seen by a doctor.
Thirty-eight states allow this public health measure known as expedited partner therapy or EPT, which advocates say goes a long way in preventing sexually transmitted infections (STIs).
And states with the most permissible EPT laws may have the most success treating and preventing STIs, suggested the new University of Michigan study.
Researchers analyzed reported chlamydia cases from 2000 to 2013 and found that, on average, disease incidence in states with prohibitive EPT legislation grew significantly faster than in states where EPT was allowed.
"We know that to most effectively treat and prevent STDs, we have to consider both the infected patient and his or her partners," said lead author Okeoma Mmeje.
"There are many barriers preventing people from making an office visit, from transportation and inconvenience to access to a free clinic," she noted. "Allowing doctors to treat both patients and their partners in this way has proven to be effective at preventing reinfection and the spread of infections such as chlamydia and gonorrhea. Long term, there are many societal benefits both in health and cost."
Researchers found that in states where is EPT is prohibited, the average increase in the incidence of chlamydia infection is 17.5 cases per 100,000 per year, compared with 14.1 cases in states where EPT is permissible.
The benefits of expanded treatment access
National health organizations such as the Centers for Disease Control and Prevention and the American Congress of Obstetricians and Gynecologists have endorsed EPT, but it remains underused, Mmeje added.
Many insurers don't cover medication costs for partners, and some doctors are hesitant to treat patients without an exam, citing liability concerns. The U-M team is researching barriers to practicing EPT in Michigan, where it is allowed.
Mmeje continued that in states like Michigan, there are several steps in place to learn about a patient's partner's allergies before prescribing medication. Laws also protect against liability.
"The rate of sexually transmitted diseases in our country, particularly among youth, continues to be a significant public health concern," Mmeje said. "EPT helps circumvent some of the most common barriers to patients receiving the care they need. Our findings provide strong reasons to re-examine policies that make it difficult to access a public health measure that we know can help treat and prevent sexually transmitted diseases."
The study appears in the journal Sexually Transmitted Infections.