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Healthcare providers and community perspectives on expedited partner therapy (EPT) for use with gay, bisexual and other men who have sex with men.

Abstract

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.

Authors+Show Affiliations

Department of Health Education and Health Behavior, University of Michigan School of Public Health, Ann Arbor, Michigan, USA kgamarel@umich.edu.Department of Health Education and Health Behavior, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.Department of Health Education and Health Behavior, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.Department of Health Education and Health Behavior, University of Michigan School of Public Health, Ann Arbor, Michigan, USA. Department of Systems, Populations and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan, USA.Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31511394

Citation

Gamarel, Kristi E., et al. "Healthcare Providers and Community Perspectives On Expedited Partner Therapy (EPT) for Use With Gay, Bisexual and Other Men Who Have Sex With Men." Sexually Transmitted Infections, 2019.
Gamarel KE, Mouzoon R, Rivas A, et al. Healthcare providers and community perspectives on expedited partner therapy (EPT) for use with gay, bisexual and other men who have sex with men. Sex Transm Infect. 2019.
Gamarel, K. E., Mouzoon, R., Rivas, A., Stephenson, R., & Mmeje, O. (2019). Healthcare providers and community perspectives on expedited partner therapy (EPT) for use with gay, bisexual and other men who have sex with men. Sexually Transmitted Infections, doi:10.1136/sextrans-2019-054156.
Gamarel KE, et al. Healthcare Providers and Community Perspectives On Expedited Partner Therapy (EPT) for Use With Gay, Bisexual and Other Men Who Have Sex With Men. Sex Transm Infect. 2019 Sep 11; PubMed PMID: 31511394.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Healthcare providers and community perspectives on expedited partner therapy (EPT) for use with gay, bisexual and other men who have sex with men. AU - Gamarel,Kristi E, AU - Mouzoon,Raha, AU - Rivas,Alejandro, AU - Stephenson,Rob, AU - Mmeje,Okeoma, Y1 - 2019/09/11/ PY - 2019/06/10/received PY - 2019/08/26/revised PY - 2019/09/01/accepted PY - 2019/9/13/entrez KW - gay men KW - gonorrhoea KW - qualitative research JF - Sexually transmitted infections JO - Sex Transm Infect N2 - 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. SN - 1472-3263 UR - https://www.unboundmedicine.com/medline/citation/31511394/Healthcare_providers_and_community_perspectives_on_expedited_partner_therapy_(EPT)_for_use_with_gay,_bisexual_and_other_men_who_have_sex_with_men L2 - http://sti.bmj.com/cgi/pmidlookup?view=long&pmid=31511394 DB - PRIME DP - Unbound Medicine ER -