Patient-delivered partner therapy for chlamydia in Australia: can it become part of routine care?
Jane L. Goller
A K , Jacqueline Coombe A , Christopher Bourne B C , Deborah Bateson D , Meredith Temple-Smith E , Jane Tomnay F , Alaina Vaisey A , Marcus Y. Chen G H , Heather O’Donnell I , Anita Groos J , Lena Sanci E and Jane Hocking A
+ Author Affiliations
- Author Affiliations
A Melbourne School of Population & Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Vic. 3010, Australia.
B NSW STI Programs Unit, NSW Ministry of Health, NSW 2010, Australia.
C Sydney Sexual Health Centre, Sydney, NSW 2001, Australia.
D Family Planning NSW, Ashfield, NSW 2131, Australia.
E Department of General Practice, The University of Melbourne, Vic. 3010, Australia.
F Centre for Excellence in Rural Sexual Health, Department of Rural Health, The University of Melbourne, Vic. 3630, Australia.
G Central Clinical School, Monash University, Melbourne, Vic. 3004, Australia.
H Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, Vic. 3053, Australia.
I Victorian Government, Department of Health and Human Services, Vic. 3000, Australia.
J Communicable Diseases Branch, Queensland Department of Health, Brisbane, Qld 4006, Australia.
K Corresponding author. Email: jane.goller@unimelb.edu.au
Sexual Health 17(4) 321-329 https://doi.org/10.1071/SH20024
Submitted: 18 February 2020 Accepted: 13 May 2020 Published: 3 August 2020
Abstract
Background: Patient-delivered partner therapy (PDPT) is a method for an index patient to give treatment for genital chlamydia to their sexual partner(s) directly. In Australia, PDPT is considered suitable for heterosexual partners of men and women, but is not uniformly endorsed. We explored the policy environment for PDPT in Australia and considered how PDPT might become a routine option. Methods: Structured interviews were conducted with 10 key informants (KIs) representing six of eight Australian jurisdictions and documents relevant to PDPT were appraised. Interview transcripts and documents were analysed together, drawing on KIs’ understanding of their jurisdiction to explore our research topics, namely the current context for PDPT, challenges, and actions needed for PDPT to become routine. Results: PDPT was allowable in three jurisdictions (Victoria, New South Wales, Northern Territory) where State governments have formally supported PDPT. In three jurisdictions (Western Australia, Australian Capital Territory, Tasmania), KIs viewed PDPT as potentially allowable under relevant prescribing regulations; however, no guidance was available. Concern about antimicrobial stewardship precluded PDPT inclusion in the South Australian strategy. For Queensland, KIs viewed PDPT as not allowable under current prescribing regulations and, although a Medicine and Poisons Act was passed in 2019, it is unclear if PDPT will be possible under new regulations. Clarifying the doctor–partner treating relationship and clinical guidance within a care standard were viewed as crucial for PDPT uptake, irrespective of regulatory contexts. Conclusion: Endorsement and guidance are essential so doctors can confidently and routinely offer PDPT in respect to professional standards and regulatory requirements.
Additional keywords: contact tracing, expedited partner therapy, partner notification, policy, sexually transmissible infections.
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