Expedited Partner Therapy (EPT) is a public health practice that allows a healthcare provider to give a patient a prescription or the actual medication to treat a sexual partner diagnosed with a sexually transmitted infection (STI). This practice allows the partner to receive presumptive treatment without requiring a separate medical examination or visit. The primary goal of EPT is to quickly treat exposed partners to prevent a cycle of re-infection for the original patient, often called the index patient. This intervention is a strategy to improve public health outcomes by reducing the overall spread of certain infections.
Understanding Expedited Partner Therapy (EPT)
EPT is an evidence-based strategy implemented to ensure timely treatment for sexual partners who may be unable or unlikely to seek clinical care on their own. Untreated partners can easily reinfect the index patient, leading to treatment failure. Studies have demonstrated that using EPT increases the proportion of partners treated and reduces reinfection rates among patients.
The infections EPT most commonly covers are Chlamydia and Gonorrhea, two of the most frequently reported bacterial STIs. These infections are typically treatable with simple, well-tolerated oral antibiotic regimens, making them suitable for this indirect treatment method. The Centers for Disease Control and Prevention (CDC) includes EPT as a useful option for partner management, particularly for heterosexual partners. Some states also permit EPT for Trichomoniasis, another common and easily treatable parasitic STI.
EPT is generally limited to these specific infections because they are easily diagnosed and have uncomplicated, highly effective treatment protocols. Infections like Syphilis, which requires a more complex diagnostic process and often involves injectable medication, are not suitable for EPT. Furthermore, the optimal treatment for Gonorrhea is often an intramuscular injection, which cannot be provided through EPT. Healthcare providers must use clinical judgment to determine if EPT is appropriate, especially considering the partner’s potential for complications or co-infection.
State-Specific Legal Status and Prescribing Methods
The ability to obtain STI medication for a partner depends heavily on the legal and regulatory framework of the specific state or jurisdiction. While EPT is recognized by the CDC, its implementation is governed by state law, creating significant variation across the country. EPT is explicitly authorized or potentially allowable in nearly all 50 states and the District of Columbia.
In states where EPT is permitted, the methods for prescribing and dispensing the medication generally fall into two categories.
Patient-Delivered Medication
The first method is patient-delivered medication, sometimes called “medication-in-hand.” Here, the prescriber dispenses the physical pills directly to the index patient. The patient then takes the medication and informational materials to their partner, offering the most immediate treatment.
Prescription Method
The second method involves issuing a prescription written in the partner’s name or a generic designation. In some states, the prescription may be written in the partner’s actual name without a prior clinical assessment. Other jurisdictions allow the prescription to be written with a placeholder name or simply marked “EPT.” The index patient then takes this prescription to a pharmacy for the partner to pick up the medication.
Many states have specific laws that protect healthcare professionals from liability when prescribing EPT, provided they follow established guidelines. The specific STIs covered and the exact prescribing protocols can differ based on state public health laws. Patients should always check with their healthcare provider or local health department regarding the specific EPT laws and requirements in their area.
Practical Steps for Obtaining and Delivering the Medication
The process of obtaining EPT begins with the index patient communicating directly with the prescribing healthcare provider or clinic. The patient should explicitly request EPT for recent sexual partners who are unlikely to seek timely medical evaluation. The provider will then determine the appropriate medication regimen and method of dispensing based on the diagnosis and state law.
Once the medication or prescription is obtained, the patient is responsible for delivering it to the partner(s) along with detailed information. The partner needs to be fully aware they have been exposed to an STI and are receiving presumptive treatment. The partner should be advised of the potential side effects of the antibiotic and the importance of taking the medication exactly as prescribed.
Crucially, the partner must be informed about potential medication allergies and contraindications, such as pregnancy. If the partner is pregnant or has a known severe allergy to the prescribed antibiotic, they must not take the medication and should instead seek an immediate clinical evaluation. To prevent reinfection, both the index patient and the partner must abstain from sexual activity for at least seven days after both parties have completed the full course of medication.
Providing the EPT medication does not replace comprehensive sexual health care for the partner. The partner should be strongly encouraged to seek follow-up care for testing for other STIs that EPT does not cover, such as HIV or Syphilis. If the partner’s symptoms persist after taking the medication, a clinical appointment is necessary to determine if a different infection is present or if the treatment failed. A full clinical evaluation remains the preferred approach for all exposed partners.