Healthcare providers and community perspectives on expedited partner therapy (EPT) for use with gay, bisexual and other men who have sex with men
Open accessAbstract
Objectives: Expedited partner therapy (EPT) is an effective strategy to reduce rates of chlamydia and gonorrhoea infection and ensure sexual partners are treated. Currently, EPT is provided to heterosexual patients; however, EPT is not routinely recommended for use with gay, bisexual and other men who have sex with men (GBMSM) because of concerns about HIV coinfection. The objective of the qualitative study was to understand provider and community views on the use of EPT with GBMSM. Methods: Using convenience sampling methods, we recruited a sample of 18 healthcare providers and 21 GBMSM to participate in in-depth, semistructured interviews. Interviews were conducted over the phone and included questions about knowledge, experiences and potential barriers and facilitators to the use of EPT with GBMSM. Results: Most providers wanted to provide EPT to GBMSM and believed that the potential barriers and concerns to EPT use were not unique to a patient’s sexual orientation. Several providers noted that they were currently providing EPT to GBMSM as part of HIV prevention services. Community members were generally unaware of EPT as a service and most indicated that they would only use EPT if they were in a committed relationship. Barriers included partner allergies and resistance, pharmacy protocols, structural concerns (eg, insurance coverage, pharmacists onsite and transportation) and potential disclosure issues. Facilitators included cultural humility and telemedicine with patients’ partners to overcome these barriers. Conclusions: Acceptability of EPT use for both chlamydia and gonorrhoea was high among providers and community members. Barriers to EPT use, including concerns about patients’ partners’ allergies and resistance, disclosure concerns and linkage to HIV prevention services can be overcome through cultural humility trainings and telemedicine. Changing EPT recommendations at the national level to be inclusive of GBMSM is critical to curtail the rising STI and HIV epidemic.
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Health workers indicated that to deliver services effectively they would need support, including training, data management tools, funding, more staff time, and supportive policies.
“Health workers also indicated that to deliver services effectively they would need support, including training, data management tools, funding, more staff time allocated to complete certain tasks, and supportive policies (124, 127, 132-139).”
From Updated recommendations for the treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum (syphilis) and new recommendations on syphilis testing and partner services (2024) · cites this paper as [134]
The Results (Barriers to EPT use in general; Knowledge and experience with EPT) describe providers’ concerns about pharmacists’ training, insurance coverage, and restrictive protocols. The Discussion also calls for cultural-humility training for physicians and nurses. The paper does not report providers requesting data-management tools, funding, or more staff time, so it supports only part of the list attributed to it. (LLM, conf=0.86)
Experimental — accuracy not yet measuredPatients noted that they were more likely to notify current partners.
“Patients noted that they were more likely to notify current partners (127, 134, 135, 141, 142, 147, 149-151, 159, 161, 165, 167).”
From Updated recommendations for the treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum (syphilis) and new recommendations on syphilis testing and partner services (2024) · cites this paper as [134]
The Results section (‘Concerns of EPT use with GBMSM’; page unavailable) says community members were more willing to use EPT in committed relationships than for one-night stands, and preferred notification services for casual partners. It does not report patients saying they were more likely to notify current partners; searches for that comparison found no supporting passage. (LLM, conf=0.73)
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Cited by
Sorted by citations
- Authors
- Gamarel, K. E., Mouzoon, R., Rivas, A., Stephenson, R., & Mmeje, O.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Gamarel, Kristi E
- Venue
- Sexually Transmitted Infections
- Publisher
- BMJ
- Published
- 2019-09-11
- Volume
- 96
- Issue
- 2
- Pages
- 101-105
- ISSN
- 0007-134X (ISSN-L)
- 1368-4973
- 1472-3263
- PMC
- PMC7031027
- OpenAlex
- W2972892704
- Cited by
- 6
- References
- 2
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 3 · 2020: 1
- FWCI
- 0.18
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Sexually Transmitted Infections (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Michigan Institute for Clinical & Health Research (UL1T3002240)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Keywords
- expedited partner therapy, men who have sex with men, chlamydia, gonorrhea, healthcare provider perspectives, community perspectives, HIV coinfection, barriers and facilitators, telemedicine, cultural humility, coming out
- MeSH terms
- Sexual and Gender Minorities, Adult, Attitude of Health Personnel, Attitude to Health, Bisexuality, Chlamydia Infections, Drug Hypersensitivity, Female, Gonorrhea, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Practice Patterns, Physicians', Sexual Partners, HIV Infections, Contact Tracing, Telemedicine, Homosexuality, Male, Insurance Coverage, Young Adult
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