Expedited Partner Therapy: Legal considerations and policy efforts regarding implementation

Background: Traditional STD partner notification requires patients or providers to notify sex partners of patients of their exposure and encourage them to seek evaluation. Expedited partner therapy (EPT) is a strategy wherein medications or prescriptions for the partner are delivered to the sex partner, usually by the patient who has been diagnosed and treated, and prior to clinical evaluation. Although CDC has recommended EPT as a useful option for cases of chlamydia or gonorrhea, uncertainty about the legality of the practice remains.

Methods: Research was conducted in three areas: 1) medical licensing practices for health care practitioners; 2) public health and safety laws; and 3) pharmaceutical practices. We examined statutes, bills, administrative regulations and opinions, and judicial cases using legal research engines (Westlaw, Lexis) and publicly-available websites. Results are presented in a comprehensive and searchable web-based tool organized by jurisdiction and legal area.

Results: EPT is legally permissible in 11 jurisdictions because laws or other legal authorities expressly permit the practice; EPT is likely prohibited in 13 jurisdictions because interpretations of legal authorities suggest as much; EPT is neither clearly permitted nor prohibited in 28 jurisdictions because legal authorities present inconsistent provisions or are subject to interpretation. See www.cdc.gov/std/ept.

Conclusions: Results provide a starting point for local public health practitioners interested in implementing EPT in their jurisdictions. Recommendations based on these analyses are that jurisdictions enact: 1) laws expressly permitting EPT; 2) specific exceptions to prescription requirements; and that jurisdictions seek: 3) professional society endorsements.