An amendment to the Texas Administrative Code, Chapter 22, Section 190.8 [Texas Secretary of State] adopted in June, 2009, by the Texas Medical Board expressly allows Expedited Partner Therapy (EPT). The exception created by this amendment acknowledges the serious impact of sexually transmitted diseases. Today, physicians are allowed to prescribe treatment for the sexual partner(s) of their established patients with sexually transmitted diseases, without establishing a professional relationship with the partner(s) first.
In 2011, 122,489 cases of Chlamydial infection and 30,493 case of Gonorrheal infection were reported in Texas. Most health care providers advise their patients with STDs to notify their sex partners. However, the CDC estimates the proportion of partners who seek evaluation and treatment in response to patient referral ranges from 29% to 59%. Studies have demonstrated re-infection of treated index subjects by untreated partners accounts for 14% to 30% of incident bacterial STDs.
Expedited Partner Therapy (EPT) is the clinical practice of treating partners of heterosexual patients diagnosed with gonorrhea or Chlamydia without an intervening medical evaluation or professional prevention counseling. The usual implementation of EPT is patient-delivered partner therapy (PDPT), where patients deliver medications or prescriptions to their sexual partner(s). Other potential means to achieve EPT include prescriptive arrangements with cooperating pharmacies, retrieval of medication by partners at public health clinics, or delivery of medication to partners in non-clinical settings by public health workers.
DSHS recommends that all physicians provide expedited partner therapy. In Texas, as of September 2012, oral cefixime is still acceptable for the treatment of gonorrhea. EPT can reduce the risk of re-infection among persons treated for STDs, prevent disease complications, and reduce transmission to un-infected persons. The benefits outweigh the few drawbacks of EPT.
An EPT fact sheet (PDF : 91 kb) and patient/partner education materials are available below.
Patient-Delivered Partner Therapy
The usual implementation of expedited partner therapy is patient-delivered partner therapy (PDPT), where patients deliver medications or prescriptions to their sexual partner(s). Several studies have shown that PDPT is an effective option for treating the sex partners of heterosexual patients, can prevent re-infection of an index patient, and can slow/stop the transmission of disease to other uninfected partners. In Texas, PDPT with oral cefixime is still permitted. PDPT is not an option for MSM.
Other EPT/PDPT Resources
HIV/STD Insider article on EPT course from June, 2012
Texas Board of Nursing letter to DSHS clarifying nursing duties related to EPT (PDF : 137 kb)
Why Screen for Chlamydia? [NCC] This resource provides the latest information and tools for healthcare providers to improve chlamydia screening and make it a part of routine medical practice. It also discusses providing confidential care to adolescents and offers tips for effectively taking a sexual history of both adolescent and adult patients.
CDC EPT Dear Colleague letter (PDF) [CDC]
CDC Expedited Partner Therapy in the Management of Sexually Transmitted Diseases (PDF) [CDC]