With expedited partner therapy, researchers forecast lower rates of sexually transmitted infections

October 24, 2019

Sexually-transmitted infections (STI) have risen dramatically in the past decade, according to the U.S. Centers for Disease Control and Prevention (CDC). New results from researchers from Emory University’s Rollins School of Public Health have shown that using an existing intervention that targets therapy to partners of men who have sex with men (MSM) has the potential to decrease the number of new gonorrhea and chlamydia infections. The findings were recently published in the journal Sexually Transmitted Diseases.

Expedited partner therapy (EPT) involves providing oral antibiotics to partners of persons who were recently diagnosed with an STI, without requiring testing first to confirm that the partner has contracted the STI, thus alleviating a potential barrier to treatment for partners.

Recommended by the CDC for heterosexual couples, EPT is not often used for same-sex couples. However, a mathematical model to forecast the future impact of EPT developed by Rollins researchers has shown that if EPT were used in 20 percent of eligible MSM, STI incidence could decrease by 27 percent. 

“Given the low rates of regular STI screening currently, we found that EPT could substantially reduce STI incidence by targeting MSM with a high likelihood of infection,” says senior author Samuel M. Jenness, PhD, assistant professor of epidemiology at Rollins.

But the strategy also has potential drawbacks as the study also found: EPT used for MSM could result in missed opportunities for HIV screening of partners and overuse of antibiotics if partners are not truly infected with an STI. 

“We estimated that the proportion of partners given medication who had no current STI ranged from 52 to 63 percent. The proportion of partners given medication with undiagnosed HIV infection was approximately 4 percent across scenarios,” Jenness says. “Future clinical trials should evaluate the promises and potential perils of EPT for MSM, who face a high and rapidly increasing burden of new sexually transmitted infections.”

Kevin Weiss, MPH, now a medical student at Icahn School of Medicine at Mount Sinai, is first author of the study.

Contributing authors include Jeb Jones and Kimberly Workowski from Emory, David Katz from the University of Washington, Eli Rosenberg from the University of Albany, and Thomas Gift and Kyle Bernstein from the Division of STD Prevention at the CDC.