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Healthcare providers and community perspectives on expedited partner therapy (EPT) for use with gay, bisexual and other men who have sex with men
  1. Kristi E Gamarel1,
  2. Raha Mouzoon1,
  3. Alejandro Rivas1,
  4. Rob Stephenson1,2,
  5. Okeoma Mmeje3
  1. 1Department of Health Education and Health Behavior, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
  2. 2Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
  3. 3Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Kristi E Gamarel, Health Education and Health Behavior, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; kgamarel{at}umich.edu

Abstract

Objectives Expedited partner therapy (EPT) is an effective strategy to reduce rates of chlamydia and gonorrhoea infection and ensure sexual partners are treated. Currently, EPT is provided to heterosexual patients; however, EPT is not routinely recommended for use with gay, bisexual and other men who have sex with men (GBMSM) because of concerns about HIV coinfection. The objective of the qualitative study was to understand provider and community views on the use of EPT with GBMSM.

Methods Using convenience sampling methods, we recruited a sample of 18 healthcare providers and 21 GBMSM to participate in in-depth, semistructured interviews. Interviews were conducted over the phone and included questions about knowledge, experiences and potential barriers and facilitators to the use of EPT with GBMSM.

Results Most providers wanted to provide EPT to GBMSM and believed that the potential barriers and concerns to EPT use were not unique to a patient’s sexual orientation. Several providers noted that they were currently providing EPT to GBMSM as part of HIV prevention services. Community members were generally unaware of EPT as a service and most indicated that they would only use EPT if they were in a committed relationship. Barriers included partner allergies and resistance, pharmacy protocols, structural concerns (eg, insurance coverage, pharmacists onsite and transportation) and potential disclosure issues. Facilitators included cultural humility and telemedicine with patients’ partners to overcome these barriers.

Conclusions Acceptability of EPT use for both chlamydia and gonorrhoea was high among providers and community members. Barriers to EPT use, including concerns about patients’ partners’ allergies and resistance, disclosure concerns and linkage to HIV prevention services can be overcome through cultural humility trainings and telemedicine. Changing EPT recommendations at the national level to be inclusive of GBMSM is critical to curtail the rising STI and HIV epidemic.

  • gonorrhoea
  • gay men
  • qualitative research
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Footnotes

  • Handling editor Claudia S Estcourt

  • Contributors KEG conceptualised the project, led all analyses and wrote the first draft of the manuscript. RM and KEG conducted interviews and RM and AR coded all transcripts and assisted with analyses and interpretation of study findings. RS and OM reviewed manuscript drafts and provided feedback. All authors contributed to and have approved the final manuscript.

  • Funding This project was funded by Michigan Institute for Clinical & Health Research (UL1T3002240).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement The de-identified data can be accessed by contacting the first author upon request.

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