Article Text
Abstract
Background To examine the associations between social characteristics of US states and the presence of laws authorising expedited partner therapy (EPT).
Methods Data were collected from various sources for 2008–2010 on US state healthcare system characteristics (adult enrollment in Medicaid, number of physicians per 100,000), governmental characteristics (the size of state legislatures, percent of state residents in poverty, percent state financial contribution to state STD programme), and state STD morbidity (chlamydia rates per 100,000 among females age 15–24). Data were analysed in an adjusted logistic regression model in SAS.
Results Overall, 23 states have passed legislation authorising EPT as of February 2013. In adjusted analyses, the only healthcare system variable significantly associated with the presence of a state law authorising EPT was higher adult Medicaid enrollment (AOR = 7.871 [95% CI: 1.644, 37.685]), which may represent an increased willingness to authorise EPT where publicly-funded healthcare coverage is more widely available. The only other variable significantly associated with the presence of a law authorising EPT was lower chlamydia rates per 100,000 among females age 15–24 (AOR = 0.332 [95% CI: 0.122, 0.903]). The presence of a state law authorising EPT did not differ by the size of the state legislature, percent in poverty, percent state contribution to state STD programme, or number of physicians per 100,000.
Conclusions States with higher adult Medicaid enrollment and lower chlamydia rates among females 15–24 were more likely to have a law authorising EPT. Increased adult Medicaid enrollment may represent an increased willingness of a state to provide publicly-funded healthcare services to its residents; the legal acceptability of EPT may thus be associated with general willingness to provide publicly-funded healthcare within a jurisdiction. This may translate to increased social compatibility of laws authorising EPT in non-US jurisdictions characterised by high rates of publicly-funded healthcare.
- expedited partner therapy
- law
- policy