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Is Expedited Partner Therapy for STIs Legal in Your State?

EPT was determined to be legally permissible in 12 jurisdictions and probably prohibited in 13.

One approach to controlling sexually transmitted infections (STIs) is expedited partner therapy (EPT): giving a patient with an identified STI a prescription or medication for his or her sexual partner or partners. The CDC recommends this approach as an option in some situations. In implementing EPT, clinicians might be providing prescription medications for people whom they have never seen. Is this practice legally risky?

In an examination of existing and prospective legislation and regulations, judicial decisions, and administrative opinions by attorneys general, the authors assessed the legality of EPT in the 50 states, the District of Columbia, and Puerto Rico. They found EPT to be "legally permissible" in 12 jurisdictions that have statutory, regulatory, or administrative language specifically permitting the practice. EPT is "probably legally prohibited" in states with statutory, regulatory, or administrative mandates for a valid clinician–patient relationship prior to prescribing or distributing drugs. In the remaining states, the District of Columbia, and Puerto Rico, the authors concluded that EPT is "potentially allowable" because "inconsistent or ambiguous provisions" of statutes or regulations may be interpreted to permit it. For example, some states’ statutes adopted the CDC treatment guidelines although state legal provisions might need modification to clarify EPT status. The legality of EPT is listed by jurisdiction in Table 1.

Comment: Legal concerns affect practice more than most clinicians would like. Clinicians in states where EPT is "probably prohibited" might want to establish policies and procedures simplifying face-to-face encounters for partners of women with STIs (e.g., inviting women to bring partners with them or allowing partners to walk in for prompt treatment). However, clinicians who are uncomfortable with this model might want to establish a "partner referral" relationship with a local public health center or other practice. In addition, in states where the legality of EPT is in doubt, clinicians can work with their professional associations and elected officials to clarify or change state law.

— Diane E. Judge, APN/CNP

Published in Journal Watch Women's Health March 20, 2008

Citation(s):

Hodge JG Jr et al. Expedited partner therapy for sexually transmitted diseases: Assessing the legal environment. Am J Public Health 2008 Feb; 98:238.

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