Article Text
Abstract
Background Despite increasing rates of HIV and other STIs among men who have sex with men (MSM) and transgender women (TW), expedited partner therapy (EPT) is not routinely offered to these priority populations. The goal of this study was to understand healthcare providers’ (HCP) views and opinions regarding the use of EPT with MSM and TW.
Methods Between May and October 2018, 18 HCP in Michigan completed semi-structured interviews. The interviews covered questions about knowledge, attitudes, experiences with, and barriers and strategies for delivering EPT to MSM and TW.
Results HCP (Meanage =47.4) included MDs (33%), NPs (61%), RNs (5%), and a Pharmacist (1%). The majority of HCP (94.5%) were willing to prescribe EPT for chlamydia and gonorrhea to MSM and TW. Several HCP in community health clinics were currently prescribing EPT to MSM and TW, whereas others followed CDC guidelines. Some HCP expressed concerns about the provision of EPT for individuals with multiple sexual partners, persistent/recurrent infection, and potential antimicrobial resistance; however, none of the HCP believed there was a difference in efficacy based on a client’s sexual preferences or gender identity. HCP who provided EPT described strategies to overcome these barriers, such as capitalizing on pharmacies and phone calls or videoconference calls with patients’ partners to discuss potential allergies, treatment regimens, and ensuring linkage to HIV testing. HCP described how telemedicine and the use of peer health navigators could help overcome systemic barriers to regular STI testing (e.g., transportation, delayed appointment times) and potentially overcome medical mistrust around HIV prevention and care.
Conclusion The provision of EPT represents an overlooked yet important strategy to curb increasing STI rates among MSM and TW. Changing EPT legislation and CDC guidelines to include MSM and TW represents a promising avenue to link these communities to HIV and other STI prevention services.
Disclosure No significant relationships.