Background In November 2006, the Denver Metro Health (STD) Clinic (DMHC) began offering Expedited Partner Therapy EPT) to heterosexual patients infected with Chlamydia trachomatis (Ct) or Neisseria gonorrhoeae (GC). Among those who accept EPT, the patient delivers treatment to his or her partner(s), removing the need for a clinic visit. We investigate demographic differences among patients who accepted EPT and examine re-infection rates among those who return to the clinic.
Methods Data were extracted from the electronic medical record (EMR) for 2644 eligible patients offered EPT between November 2006 and October 2010. Acceptance rates are compared across demographics and infection status. Rates of re-infection are examined among the 339 patients who returned for re-testing within 21 to 90 days of treatment. Dual infections are excluded.
Results Overall, 763 (28.3%) eligible patients accepted EPT. Women were more likely than men to accept EPT (35.9% vs 23.8%, p<0.01). Patients younger than 40 accepted EPT at a higher rate than those 40 or older (29.6% vs 20.0%, p<0.01). African Americans were least likely to accept EPT (23.0%), whereas approximately 30% of Hispanics and Whites accepted and those reporting multiple races accepted at the highest rate (43.6%) (p<0.01). Ct infected patients were significantly more likely to accept EPT than those infected with GC (32.7% vs 24.6%, p<0.01). Within 21 to 90 days of treatment initiation, 339 patients returned for re-testing (221 for Ct and 118 for GC). Overall, re-infection rates differed significantly by EPT acceptance at the initial visit with 11.1% re-testing positive among those who accepted EPT compared to 20.4% among those who refused (p=0.04) (Abstract O5-S3.01 table 1). When stratified by type of infection, the differences were no longer significant but the direction of the relationship remained. Among those originally Ct-infected, 9.1% of those who accepted EPT re-tested positive vs 15.3% among those who refused (p=0.19). Among those originally GC-infected, 16.1% of EPT acceptors re-tested positive compared to 28.7% of those who refused (p=0.17).
Conclusions In a busy inner-city STD clinic, EPT is more likely to be accepted by women, those who are younger and those infected with Ct. Re-infection rates among patients returning to the clinic suggest that EPT reduces the risk of re-infection, with the greatest benefit among those originally infected with GC.
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