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Patient delivered partner therapy (PDPT)

It is preferable that partners are encouraged to attend for testing. In general, Patient delivered partner therapy (PDPT) is best suited to situations when other means of contact tracing have failed or are considered likely to fail. For example, PDPT would be appropriate for situations where partner(s) are unable or unwilling to attend a health service in a timely manner or for patients with repeat infections whose partner(s) have not been treated. PDPT should generally not be used for patients diagnosed with more than one STI, patients whose partners are pregnant, patients at risk of partner violence, or partner(s) at high risk of HIV infection such as men who have sex with men.

Patient delivered partner therapy is the practice of providing a prescription or medication to a patient diagnosed with an STI to give to their sexual partner(s) without that partner being directly consulted by the health care provider. PDPT with a single 1 gram dose of azithromycin for chlamydia has been shown to be effective in treating partners who may not have otherwise accessed treatment, thereby preventing re-infections and treating more partners per index patient than patient-initiated notification.1-4 PDPT may also reduce complications and further transmission of infection in the community. Further, there have been no major adverse drug reactions reported from azithromycin associated with PDPT.1,4,5 Evaluations of PDPT in Australian sexual health and family planning clinics have found PDPT for chlamydia to be highly acceptable to patients and partners. Of index patients offered PDPT, 79% accepted the offer in one study6 and in another, 92% of partner(s) took the antibiotics on the same day as the index case.7

In Australia, PDPT guidance allowing the prescription or supply of azithromycin for partners of patients diagnosed with uncomplicated genital Chlamydia trachomatis infection is available in Victoria,8 New South Wales9 and the Northern Territory.10 GPs and other Primary Care Providers in other States and Territories should contact their local Health Department for PDPT advice.

References

1.Trelle S, Shang A, Nartey L, Cassell J, N. L. Improved effectiveness of partner notification for patients with sexually transmitted infections: systematic review. British Medical Journal. 2007;334(7589):354-7.

2.Kissinger P, Hogben M. Expedited partner treatment for sexually transmitted infections: an update. Curr Infect Dis Rep 2011;13:188-95

3.Althaus C, Turner K, Mercer C, Auguste P, Roberts T, Bell G, et al. Effectiveness and cost-effectiveness of traditional and new partner notification technologies for curable sexually transmitted infections: observational study, systematic reviews and mathematical modelling. . Health Technol Assess. 2014;18(2):1-100, vii-viii.

4.Golden MR, Kerani RP, Stenger M, Hughes J, Aubin M, Malinski C, et al. Uptake and population-level impact of expedited partner therapy (EPT) on Chlamydia trachomatis and Neisseria gonorrhoeae: the Washington State community-level randomized trial of EPT. Plos One. 2015;12(1).

5.Schillinger JA, Kissinger P, Calvet H, Whittington WL, Ransom RL, Sternberg MR, et al. Patient-delivered partner treatment with azithromycin to prevent repeated Chlamydia trachomatis infection among women: a randomized, controlled trial. Sex Transm Dis 2003; 30: 49–56. doi:10.1097/00007435-200301000-00011

6.Lorch R, Bourne C, Burton L, Lewis L, Brown K, Bateson D, et al. ADOPTing a new method of partner management for genital chlamydia in New South Wales: findings from a pilot implementation program of patient-delivered partner therapy. Sexual Health. 2019;16(4):332-9.

7.Woodward S, Tyson H, Martin S. An observational study of the acceptability of patient-delivered partner therapy for management of chlamydia. Sexual Health. 2020;17(4):381-3

8.Department of Health and Human Services. Patient delivered partner therapy clinical guidelines. Melbourne: State Government of Victoria; 2015. Available online at: https://www2.health.vic.gov.au/about/publications/policiesandguidelines/pdpt-clinical-guidelines

9.NSW STI Programs Unit. Patient delivered partner therapy for treatment of chlamydia in eligible patients: clinic pathway in publicly funded sexual health services. Sydney: NSW Government; 2017. Available online at: https://stipu.nsw.gov.au/gp/hiv-and-sticlinical-management/patient-delivered-partner-therapy/

10.Northern Territory Government, Department of Health. Medicines & Poisons Control Information Sheet No. 320.8. Darwin: Northern Territory Government; 2015. Available online at: https://digitallibrary.health.nt.gov.au/prodjspui/handle/10137/895

 

 Page last updated April 2021

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