Committee opinion no. 506. Obstet Gynecol. 2011;118:761-766.
The American College of Obstetricians and Gynecologists
issued a new committee opinion supporting the use of “expedited partner
therapy” in accordance with CDC guidelines as a method for the prevention
of reinfection of sexually transmitted infections when partners are unable or
unwilling to otherwise seek medical care.
“The 12-month reinfection rate of chlamydia among
adolescents and young women is as high as 26%, often due to an untreated sexual
partner,” according to background information in the committee opinion
Expedited partner therapy (EPT) practice encourages
physicians to prescribe treatment for the sexual partners of patients
diagnosed with STIs, without examining the partner
“Evidence indicates that EPT can decrease
reinfection rates compared to standard partner referrals for examination and
treatment,” Diane F. Merritt, MD, chair of the American College of
Obstetricians and Gynecologists’ (ACOG) Committee on Adolescent Health
Care, said in a press release. “Of course, it’s preferable that a
physician examines a patient in person before prescribing medication, but the
benefits of EPT among individuals whose partners are otherwise unlikely to seek
care in preventing chlamydia and gonorrhea reinfections
outweigh the risks to the partners.”
Merritt said many people with STIs are not aware they
are infected and, in turn, pass the infection on to their partners.
“The legality of [EPT] is ambiguous in some states
and overt legal impediments exist in others; analysis suggests that the
practice is permissible in 27 states,” according to the paper.
“Clinicians practicing in states where [EPT] is legal should use it for
eligible patients. In states, territories and other jurisdictions where [EPT]
is not legal or the legal status of [EPT] is unclear or ambiguous, clinicians
are encouraged to advocate for its legality and implementation and work with
their health departments to develop protocols for the use of [EPT].”