Posted on March 17, 2009
Chapter 577: Chlamydia, the most common sexually transmitted disease in New York State, is often asymptomatic. Thus, although it is the most frequently reported bacterial sexually transmitted disease in the United States, a substantial number of individuals with chlamydia are not aware of their infections and do not seek testing. Consequently left untreated, chlamydial infections can result in serious health problems, particularly in women. Indeed, up to 40% of women with untreated chlamydia suffer from pelvic inflammatory disease which, in turn, may cause permanent damage to the fallopian tubes, uterus and surrounding tissues. Such damage often progresses to chronic pelvic pain and may lead to infertility or ectopic pregnancy. Furthermore, women with chlamydia are up to five times more likely to become infected, if exposed to it, with HIV.
Reported rates of chlamydial infections in New York State have steadily increased, rising from 244.5 infections per 100,000 people in 2001 to 356.4 infections per 100,00 people in 2006. Nationally, over one million cases of chlamydia were reported in 2006. Fortunately, chlamydia is easily treated and can be cured with antibiotics. The risk of re-infection, however, particularly for women whose sex partners have not been treated, is high. Recognizing that having multiple infections increases the likelihood a woman will suffer serious reproductive health complications, this chapter authorizes the use of expedited partner therapy by a health care practitioner who diagnoses a sexually transmitted chlamydial infection in an individual patient.
Expedited partner therapy (EPT), the practice of treating the sex partners of persons with sexually transmitted diseases without an intervening medical evaluation, may prove an effective tool in breaking the cycle of chlamydial re-infection. Typically involving patient-delivered partner therapy, wherein a health care practitioner provides medication to the diagnosed individual for his or her partner, the Centers for Disease Control and Prevention (CDC) has concluded EPT should be available to clinicians as an option for partner management of chlamydial infections. The American Medical Association (AMA) has similarly recognized EPT as a valuable tool in promoting public health, observing that "[t]he appropriate use of EPT has resulted in more partner treatment than standard referral of patients among patients infected with [ ] chlamydia" (Report 6-A-08, Council of Ethical and Judicial Affairs, American Medical Association, available at www.ama-assn.org/ama1/pub/upload/mm/471/ceja6.doc). Acknowledging EPT represents a departure from the traditional patient-physician relationship, however, both the CDC and AMA recommend that clinicians employing EPT continue to consider standard patient referral strategies as treatment options.
Recognizing EPT is not intended as a replacement for standard patient referral strategies, and that it has only been proven successful in controlling select sexually transmitted diseases, particularly chlamydia, this legislation will sunset after five years. Signed by Governor Paterson on September 25, 2008, the provisions of this chapter become effective January 23, 2009. (S.6210-A/A.8730-C)
