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Expedited Partner Therapy for Adolescents Diagnosed with Chlamydia or Gonorrhea: A Position Paper of the Society for Adolescent Medicine

2009; Elsevier BV; Volume: 45; Issue: 3 Linguagem: Inglês

10.1016/j.jadohealth.2009.05.010

1879-1972

Gale R. Burstein, Allison Eliscu, Kanti R. Ford, Matthew Hogben, Tonya Chaffee, Diane M. Straub, Taraneh Shafii, Jill S. Huppert,

Reproductive Health and Contraception

Adolescent gonorrhea and chlamydia rates continue to rise, whereas resources to prevent infection and reinfection are lacking. To interrupt the chain of transmission and to prevent reinfection after treatment, it is critical to treat the sex partners of STI-infected persons. Traditional partner notification strategies are fraught with resource and compliance challenges. EPT can improve providers' ability to treat hard-to-reach individuals who are now “falling through the cracks.” CDC [[6]Centers for Disease Control and Prevention. Expedited Partner Therapy in the Management of Sexually Transmitted Diseases. Atlanta, Georgia: US Department of Health and Human Services, 2006 [Online]. Available at http://www.cdc.gov/std/treatment/EPTFinalReport2006.pdf. Accessed December 3, 2008.Google Scholar] and AMA [3American Medical Association. Report of the Council on Ethical and Judicial Affairs: CEJA Report 6-A-08. Available at: http://www.ama-assn.org/ama1/pub/upload/mm/471/ceja6.doc. Accessed December 19, 2008.Google Scholar, 5American Medical Association. Report 7 of the Council on Science and Public Health (A-06): Expedited Partner Therapy (Patient-delivered Partner Therapy): An update. 2006. Available at: http://www.ama-assn.org/ama/pub/category/16410.html. Accessed December 3, 2008.Google Scholar] guidelines, endorsed by the American Bar Association [[34]American Bar Association. Recommendation 116A. Available at http://www.abanet.org/leadership/2007/annual/docs/hundredsixteena.doc. Accessed November 25, 2008.Google Scholar], recommend the use of EPT for the treatment of heterosexual partners of patients infected with gonorrhea or chlamydia when other partner management strategies using in-person evaluation and treatment are impractical or unsuccessful. However, similar to other mainstream public health interventions, multiple challenges to routine EPT implementation, such as legal concerns, administrative and cost issues, and missed opportunities for partner counseling and complete STI evaluation must be addressed. Providers who care for adolescents should practice EPT for chlamydia- or gonorrhea-infected heterosexual males and females whose partners are unlikely or unable to otherwise receive treatment. Providers should collaborate with policy makers through SAM and AAP chapters to remove EPT legal barriers and to facilitate reimbursement, and should collaborate with health departments for implementation assistance.