Patient-Reported Expedited Partner Therapy for Gonorrhea in the United States: Findings of the STD Surveillance Network 2010-2012.
Patient-Reported Expedited Partner Therapy for Gonorrhea in the United States: Findings of the STD Surveillance Network 2010-2012.
复制标题
美国患者报告的淋病快速合作伙伴治疗：2010-2012 年 STD 监测网络的调查结果。
DOI：
10.1097/olq.0000000000000329
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发表时间：
2015
影响因子：
3.1
通讯作者：
Golden,Matthew
中科院分区：
文献类型：
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作者：
Stenger,MarkR;Kerani,RoxanneP;Bauer,HeidiM;Burghardt,Nicole;Anschuetz,GretaL;Klingler,Ellen;Schumacher,ChristinaM;Simon,Julie;Golden,Matthew
加速伴侣治疗（EPT）已被证明可以预防淋病患者的再感染，并有可能降低发病率。疾病控制和预防中心推荐EPT作为治疗异性恋患者性伴侣的一种选择。目前，很少有研究调查这种有价值的干预措施的使用情况如何根据患者和提供者的特征以及美国多个司法管辖区的地理位置而有所不同。方法从参与性传播疾病（STD）监测网络的美国7个不同地区的报告病例中随机抽取病例和患者访谈数据。对这些数据进行加权，以代表7个研究地点报告的所有淋病病例。估计患者接受EPT的情况，并分别构建多变量模型，以检验异性恋者和男男性行为者接受EPT的相关因素。结果总体而言，5.4%的确诊和报告患有淋病的患者报告接受EPT治疗其性伴侣。异性恋患者比男男性行为者更有可能接受EPT治疗，分别为6.6%和2.6%。尽管在不同的医疗机构中观察到显著的差异，来自计划生育/生殖健康和性病诊所的患者更有可能报告接受EPT治疗，但两组接受EPT治疗的种族、西班牙裔或年龄没有显著差异。管辖区差异也被观察到，华盛顿州异性恋患者最可能（35.5%），而纽约市、康涅狄格州和费城的异性恋患者最不可能报告接受EPT（< 2%）。结论：除了性病监测网络中积极推广EPT使用的一个辖区外，整个网络中患者报告的干预接收情况仍不理想。要充分发挥这一有价值的淋病控制干预措施的全部潜力，需要进一步努力促进EPT，特别是对在私人提供者和医院环境中诊断的患者。患者报告的快速伴侣治疗（EPT）的收据因司法管辖区而异。在诊断提供者设置中也观察到显著差异。努力教育患者和提供者，减少EPT使用的法律和监管障碍，并实施广泛的公共卫生倡议，使EPT规模化，可能会增加这种有价值的性传播疾病控制干预措施的接受程度。
Background Expedited partner therapy (EPT) has been shown to prevent reinfection in persons with gonorrhea and to plausibly reduce incidence. The Centers for Disease Control and Prevention recommends EPT as an option for treating sex partners of heterosexual patients. Few studies that examine how the reported use of this valuable intervention differs by patient and provider characteristics and by geography across multiple jurisdictions in the United States are currently available.Methods Case and patient interview data were obtained for a random sample of reported cases from 7 geographically disparate US jurisdictions participating in the Sexually Transmitted Disease (STD) Surveillance Network. These data were weighted to be representative of all reported gonorrhea cases in the 7 study sites. Patient receipt of EPT was estimated, and multivariate models were constructed separately to examine factors associated with receipt of EPT for heterosexuals and for men who have sex with men.Results Overall, 5.4% of patients diagnosed and reported as having gonorrhea reported receiving EPT to treat their sex partners. Heterosexual patients were more likely to have received EPT than men who have sex with men at 6.6% and 2.6% of patients, respectively. Receipt of EPT did not vary significantly by race, Hispanic ethnicity, or age for either group, although significant variation was observed in different provider settings, with patients from family planning/reproductive health and STD clinic settings more likely to report receiving EPT. Jurisdiction variations were also observed with heterosexual patients in Washington State most likely (35.5%), and those in New York City, Connecticut, and Philadelphia least likely to report receiving EPT (< 2%).Conclusions With the exception of one jurisdiction in the STD Surveillance Network actively promoting EPT use, patient-reported receipt of the intervention remains suboptimal across the network. Additional efforts to promote EPT, especially for patients diagnosed in private provider and hospital settings, are needed to realize the full potential of this valuable gonorrhea control intervention.Patient-reported receipt of expedited partner therapy (EPT) varies widely by jurisdiction. Significant differences are also observed across diagnosing provider settings. Efforts to educate patients and providers, to reduce legal and regulatory barriers to EPT use, and to implement widespread promotion of public health initiatives to bring EPT to scale may increase the uptake of this valuable sexually transmitted disease control intervention.