Patients’ Partners Treated without Doctor’s Visit to Curb STD Rise

According to a press release from the Centers for Disease Control and Prevention (CDC) that was published in August, 2018, there has been a steep increase in STDs in the United States over the past few years. In 2017, close to 2.3 million cases of syphilis, gonorrhea and chlamydia were diagnosed, which is a big jump compared to the previous year which had roughly 2.1 million cases. What’s concerning is that this has been the fourth consecutive year that the US has seen a sharp increase in sexually-transmitted diseases. Jonathan Mermin, who is the director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, felt that they were sliding backwards, saying, “It is evident the systems that identify, treat, and ultimately prevent STDs are strained to near-breaking point.”

One of the ways in which the CDC has suggested could help in curbing the rise in STD cases is by advising physicians to use a practice known as expedited partner therapy (EPT), which means that physicians are allowed to prescribe medication to the partners of their patients without any prior medical examination.

The biggest challenge that doctors face in treating STDs is that despite advising them against having any sex until both partners have been completely treated, they ignore the advice and decide not to wait. At this point, the partner becomes infected before the patient gets completely treated, and so they continue to pass the infection back and forth. The CDC believes that by allowing physicians to use expedited partner therapy, this could help greatly in reducing the cases of re-infection amongst partners because they don’t have to wait until they go to the doctor’s office just to get the antibiotics.

However, there is a large group of physicians that firmly disagree with this practice as they feel it is unethical and can create legal problems. There are other concerns that this form of treatment could lead to irresponsible practices of prescribing antibiotics when they might not be needed, making the bacteria become more resistant to them. In fact, the CDC expresses the concerns on the possible threat of antibiotic resistant gonorrhea. In the release, the CDC stated the following, “Over the years, gonorrhea has become resistant to nearly every class of antibiotics used to treat it, except to ceftriaxone, the only remaining highly effective antibiotic to treat gonorrhea in the United States.”

While the CDC does advise physicians to practice expedited partner therapy on patients diagnosed with treatable STDs, there are some states that still don’t permit it. Currently, there are five states which potentially allow EPT (Alabama, Kansas, New Jersey, Oklahoma and South Dakota), and two that completely prohibits this practice (Kentucky and South Carolina). The rest of the states have embraced EPT, leaving it up to the physician to make the final decision.

In 2014, a study was carried out on the effects of expedited partner therapy for STDs. The study revealed that close to 29% of patients had a less likelihood of being re-infected when physicians used EPT as a practice. Also, the partners of these patients showed a higher likelihood of taking the medication when the patients gave it to them compared to those that were referred to see a doctor instead.

One thing is clear is that the sharp rates of STD in the US has to be curbed in some way or other. While expedited partner therapy does seem like a workable solution for now, medical experts unanimously agree that it is important to find more effective ways of lowering the cases of sexual transmitted diseases.

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