Proposed Legislation to Expand Sexually Transmitted Disease Control: Patient Delivered Partner Therapy Perspectives of County Health Department Professionals, New York State 2007

Background: The Centers for Disease Control and Prevention encourages states to legalize patient-delivered partner therapy (PDPT) for Chlamydia and gonorrhea, that is, allow physicians/providers to give their patients medication or a prescription intended for their sexual partners without the partner having a medical encounter.

Objective: To assess current sexually transmitted disease (STD) control practices in New York State counties, and gather perspectives on PDPT and alternative treatment methods.

Methods: A cross-sectional study reviewed county health department websites to assess information provided to residents regarding STD treatment, including clinic location and hours. County officials were interviewed from January to March 2007 by telephone, to determine available treatments, current partner notification practices and PDPT perspectives. Descriptive statistics included frequencies and proportions.

Results: County officials were split about legalizing PDPT, with 45% for, 45% against, and 10% undecided. Reasons for support included treating more infected individuals (61%) and improving STD control (29%). Reasons for lack of support included contraindication/side effects (28%), fear of medication not reaching partners (28%) and malpractice concerns (20%). Analysis by STD caseload showed that 67% of counties with high case loads (400-5525 Chlamydia and gonorrhea cases annually) were against the legalization. About half of professionals interviewed supported expanding disease control efforts through distribution of educational materials (45%) and express care for partners in STD clinics (67%).

Discussion: County officials' perspectives are polarized, reflecting the difficulty of negotiating less than optimal options for STD control. The role of epidemiologists in STD policy formation will be discussed.