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STIs in sex partners notified for chlamydia exposure: implications for expedited partner therapy
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  • John Saunders, Fiona Mapp, Sonali Wayal, Maria Pothoulaki and Claudia Estcourt
    Published on:
  • Published on:
    Response to van Aar et al.
    • John Saunders, Honorary Senior Lecturer and Consultant University College London
    • Other Contributors:
      • Fiona Mapp, Research Associate and Programme Manager
      • Sonali Wayal, Research Associate
      • Maria Pothoulaki, Research Fellow
      • Claudia Estcourt, Professor of Sexual Health and HIV

    Dear Editor,

    We read with interest the short report by van Aar et al. discussing potential implications of chlamydia expedited partner therapy (EPT) which entails patient delivered partner therapy.1 The authors highlight a number of factors which may influence the benefit-risk balance of providing EPT, many of which resonate with our experience of Accelerated Partner Therapy (APT).2 APT is an adaptation of EPT, which includes a telephone consultation between the sex partner and prescriber (to meet UK prescribing guidance), provision of a self-sampling kit for sexually transmitted infections (STIs) and HIV for a sex partner in addition to antibiotics and information on STIs and HIV. APT has been piloted among predominately heterosexual contacts of chlamydia and gonorrhoea.3

    The authors report a chlamydia positivity rate of 34.2% among chlamydia-notified partners in the Netherlands and proposed that the use of EPT for all contacts risks exposing the majority of contacts to potentially unnecessary antimicrobial therapy. Furthermore, just over 1% of these contacts also had gonorrhoea, accounting for about 10% of all gonorrhoea infections detected during the study time period, raising additional concerns about inadequate therapy and antimicrobial resistance.

    In England in 2016, chlamydia positivity among chlamydia contacts attending specialist sexual health services (SHS) was 40%, representing 19% of all chlamydia diagnoses made in SHS that year.4 This is...

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    Conflict of Interest:
    None declared.