National Clinician Scholars Program, the Department of Family Medicine, and the Institute for Healthcare Policy and Innovation, University of Michigan, Veterans Health Administration, Ann Arbor Healthcare System, the Department of Obstetrics and Gynecology, University of Michigan Medical School, and the Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan; and the Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland.
Obstet Gynecol. 2019 Mar;133(3):416-422. doi: 10.1097/AOG.0000000000003088.
Sexually transmitted infections (STI), including Chlamydia trachomatis and Neisseria gonorrhoeae, have reached record high rates in the United States. Sexually transmitted infections disproportionately affect reproductive-aged females aged 15-44 years, who account for 65% and 42% of the total reported C trachomatis and N gonorrhoeae cases, respectively. Undiagnosed STIs can result in serious health complications that put women at an increased risk for pelvic inflammatory disease, ectopic pregnancy, and tubal factor infertility. Many of these women are seen by physicians (eg, obstetrician-gynecologists, family medicine doctors, pediatricians) or other clinicians (eg, nurse practitioners, midwives, physician assistants) who care for women. These clinicians have the opportunity to help curb the continued increase in STI incidence rates with the implementation and use of expedited partner therapy. Expedited partner therapy is a proven effective health care practice that allows clinicians to give patients medications or prescriptions to distribute to their partners. Despite expedited partner therapy's proven effectiveness, there are barriers to its implementation that must be understood to enhance STI treatment and prevention efforts. In this commentary, we discuss these barriers, and appeal to women's health clinicians to implement or increase use of expedited partner therapy for the treatment of women with STIs and their sexual partners.
性传播感染(STI),包括沙眼衣原体和淋病奈瑟菌,在美国已达到创纪录的高发率。性传播感染不成比例地影响育龄期女性,年龄在 15-44 岁之间,分别占总报告的沙眼衣原体和淋病奈瑟菌病例的 65%和 42%。未经诊断的 STI 可导致严重的健康并发症,使女性患盆腔炎、异位妊娠和输卵管因素不孕的风险增加。许多这样的女性由医生(例如妇产科医生、家庭医生、儿科医生)或其他临床医生(例如执业护士、助产士、医师助理)就诊,这些医生负责照顾女性。这些临床医生有机会通过实施和使用加速性伴侣治疗来帮助遏制 STI 发病率的持续上升。加速性伴侣治疗是一种经过验证的有效医疗保健实践,允许临床医生为患者提供药物或处方,分发给他们的伴侣。尽管加速性伴侣治疗已被证明有效,但在实施过程中仍存在障碍,必须加以理解,以加强 STI 的治疗和预防工作。在这篇评论中,我们讨论了这些障碍,并呼吁妇女健康临床医生为治疗患有 STI 的女性及其性伴侣实施或增加加速性伴侣治疗的使用。