Sexually Transmitted Diseases  >  Expedited Partner Therapy  >  Legal Status  >  Introduction

Legal Status of EPT - Introduction

The information presented here is not legal advice, nor is it a comprehensive analysis of all the legal provisions that could implicate the legality of EPT in a given jurisdiction.

Assuring treatment of the sex partners of persons with sexually transmitted diseases (STD) has been a central component of prevention and control of bacterial STDs in the United States for decades. Traditional practices to inform, evaluate and treat sex partners of persons infected with STDs have relied upon patients or health care providers to notify partners of infected persons of their exposure to an STD. Initially developed to help control syphilis, partner management became widely recommended for gonorrhea, chlamydial infection and, most recently, human immunodeficiency virus (HIV) infection. However, for STDs other than syphilis, partner management based on provider referral is rarely assured, while patient referral has had only modest success in assuring partner treatment.

An alternative approach to assuring treatment of partners is expedited partner therapy (EPT). EPT is the delivery of medications or prescriptions by persons infected with an STD to their sex partners without clinical assessment of the partners. Clinicians (e.g., physicians, nurse practitioners, physician assistants, pharmacists, public health workers) provide patients with sufficient medications directly or via prescription for the patients and their partners. After evaluating multiple studies involving EPT, CDC concluded that EPT is a “useful option” to further partner treatment, particularly for male partners of women with chlamydia or gonorrhea . In August 2006, CDC recommended the practice of EPT for certain populations and specific conditions in its Sexually Transmitted Diseases Treatment Guidelines, 2006.

Throughout discussions of EPT, the legal status of the practice remained an area of uncertainty. To assist state and local STD programs in their efforts to implement EPT as an additional partner services tool, CDC collaborated with the Center for Law and the Public’s Health at Georgetown and Johns Hopkins Universities to assess the legal framework concerning EPT across all 50 states and other jurisdictions (the District of Columbia and Puerto Rico). The primary research objective was to conceptualize, frame, and identify legal provisions that implicate a clinician’s ability to provide a prescription for a patient’s sex partner, without prior evaluation of that partner, for purposes of treating an STD (specifically chlamydia or gonorrhea). The results of this research, with explanatory information for six key areas of inquiry and summary conclusions for each state are presented here.

The information presented here is not legal advice, nor is it a comprehensive analysis of all the legal provisions that could implicate the legality of EPT in a given jurisdiction. Rather, it provides a comparative snapshot of legal provisions that may highlight legislative, regulatory, judicial laws and policies concerning EPT based on currently available information. This snapshot is subject to change. Measuring the legal weight of non-binding legal sources, such as policy guidance documents or administrative decisions, must be done locally within the context of applicable statutes and regulations. The data and assessment are intended to be used as a tool to assist state and local health departments as they determine locally appropriate ways to control STDs. Assessment of local statutes was not undertaken, with the exception of the District of Columbia. Assessment of tribal laws for sovereign nations was also not undertaken.