Patient-delivered partner therapy for chlamydia: health practitioner views on updated guidance in Victoria, Australia
Chloe Warda![https://orcid.org/0009-0008-1571-8767](/media/client/orcid_16x16.png)
![https://orcid.org/0000-0002-5768-3223](/media/client/orcid_16x16.png)
![https://orcid.org/0000-0002-9520-5724](/media/client/orcid_16x16.png)
![https://orcid.org/0000-0001-9329-8501](/media/client/orcid_16x16.png)
![https://orcid.org/0000-0001-5580-360X](/media/client/orcid_16x16.png)
A
B
Abstract
Patient-delivered partner therapy (PDPT) involves providing a prescription or medication to a patient diagnosed with chlamydia to pass to their sexual partner/s. Barriers to PDPT include uncertainty about its integration into clinical practice and permissibility. In Victoria, Australia, the Department of Health provides clinical guidance for PDPT (updated in 2022). We explored health practitioner views on the usefulness of the updated guidance for providing PDPT.
We conducted an online survey (12 December 2022 to 2 May 2023) of health practitioners who primarily work in Victoria and can prescribe to treat chlamydia. The survey displayed excerpts from the guidance, and asked closed and free-text questions about its ability to address barriers to PDPT. Quantitative data were descriptively analysed, complemented by conventional content analysis of qualitative data.
Of a total of 49 respondents (66.7% general practitioners), 74.5% were aware of PDPT, and 66.7% had previously offered PDPT. After viewing excerpts of the guidance, >80% agreed it could support them to identify patients eligible/ineligible for PDPT, and 66.7% indicated they would be comfortable to offer PDPT. The guidance was viewed as helpful to address some barriers, including complicated documentation (87.7%) and medico-legal concerns (66.7%). Qualitative data highlighted medico-legal concerns by a minority of respondents. Some raised concerns that the guidance recommended prescribing azithromycin, despite doxycycline being first-line chlamydia treatment.
The guidance was largely viewed as supportive for PDPT decision-making. There is scope for further refinements and clarifications, and wider dissemination of the guidance.
Keywords: accelerated partner therapy, Australia, chlamydia, expedited partner therapy, general practitioner, health practitioner, partner notification, patient-delivered partner therapy, PDPT, primary care, STI management.
References
1 Ferreira A, Young T, Mathews C, Zunza M, Low N. Strategies for partner notification for sexually transmitted infections, including HIV. Cochrane Database Syst Rev 2013; 2013(10): Cd002843.
| Crossref | Google Scholar |
2 Estcourt CS, Stirrup O, Copas A, Low N, Mapp F, Saunders J, et al. Accelerated partner therapy contact tracing for people with chlamydia (LUSTRUM): a crossover cluster-randomised controlled trial. Lancet Public Health 2022; 7(10): e853-e65.
| Crossref | Google Scholar | PubMed |
3 Goller JL, Coombe J, Bourne C, Bateson D, Temple-Smith M, Tomnay J, et al. Patient-delivered partner therapy for chlamydia in Australia: can it become part of routine care? Sex Health 2020; 17(4): 321-9.
| Crossref | Google Scholar | PubMed |
4 Coombe J, Goller J, Bittleston H, Bateson D, Bourne C, O’Donnell H, et al. Patient-delivered partner therapy: one option for management of sexual partner(s) of a patient diagnosed with a chlamydia infection. Aust J Gen Pract 2022; 51: 425-9.
| Crossref | Google Scholar | PubMed |
5 Estcourt CS, Sutcliffe LJ, Copas AJ, Mercer CH, Roberts TE, Jacksone L, Symonds M, et al. Developing and testing accelerated partner therapy for partner notification for people with genital Chlamydia trachomatis diagnosed in primary care: a pilot randomised controlled trial. Sex Transm Infect 2015; 91: 548-54.
| Crossref | Google Scholar |
6 Pavlin NL, Parker RM, Piggin AK, Hopkins CA, Temple-Smith MJ, Fairley CK, et al. Better than nothing? Patient-delivered partner therapy and partner notification for chlamydia: the views of Australian general practitioners. BMC Infect Dis 2010; 10: 274.
| Crossref | Google Scholar |
7 Goller JL, Coombe J, Bittleston H, Bourne C, Bateson D, Vaisey A, et al. Patient delivered partner therapy for chlamydia infection is used by some general practitioners, but more support is needed to increase uptake: findings from a mixed-methods study. Sex Transm Infect 2022; 98(4): 298-301.
| Crossref | Google Scholar | PubMed |
8 Cramer R, Hogben M, Handsfield HH. A historical note on the association between the legal status of expedited partner therapy and physician practice. Sex Transm Dis 2013; 40(5): 349-51.
| Crossref | Google Scholar | PubMed |
9 Drugs, Poisons and Controlled Substances Regulations; 2017. Available at https://www.legislation.vic.gov.au/in-force/statutory-rules/drugs-poisons-and-controlled-substances-regulations-2017/007
10 Department of Health. Patient delivered partner therapy (PDPT) for chlamydia – clinical guidance and FAQs. Melbourne: State Government Victoria, Department of Health; 2022. Available at https://www.health.vic.gov.au/publications/patient-delivered-partner-therapy-pdpt-for-chlamydia
11 Layton E, Goller JL, Coombe J, Temple-Smith M, Tomnay J, Vaisey A, Hocking J. ‘It’s literally giving them a solution in their hands’: the views of young Australians towards patient-delivered partner therapy for treating chlamydia. Sex Transm Infect 2021; 97: 256-260.
| Crossref | Google Scholar |
12 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. Sex Health 2019; 16(4): 332-9.
| Crossref | Google Scholar | PubMed |
13 Ballard A, Cardwell T, Young A. Fraud detection protocol for web-based research among men who have sex with men: development and descriptive evaluation. JMIR Public Health Surveill 2019; 5(1): e12344.
| Crossref | Google Scholar | PubMed |
14 Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res 2005; 15(9): 1277-1288.
| Crossref | Google Scholar | PubMed |
15 Victoria State Government. All reasonable steps (and other key terms). Information for health practitioners. In: Department of Health, editor. Victoria State Government; 2023. Available at https://www.health.vic.gov.au/publications/all-reasonable-steps-and-other-key-terms-requirements-for-health-practitioners
16 Woodward SC, Tyson HA, Martin S. An observational study of the acceptability of patient-delivered partner therapy for management of chlamydia. Sex Health 2020; 17(4): 381-3.
| Crossref | Google Scholar | PubMed |
17 Burstein GR, Eliscu E, Ford K, Hogben M, Chaffee T, Straub D, et al. Expedited partner therapy for adolescents diagnosed with chlamydia or gonorrhea: a position paper of the society for adolescent medicine. J Adolesc Health 2009; 45(3): 303-309.
| Crossref | Google Scholar |
19 Australasian Sexual Health Alliance. Australian STI Management Guidelines, for use in primary care. Australian Society for HIV Medicine; 2024. Available at https://sti.guidelines.org.au/
20 Australasian Society for HIV Viral Hepatitis and Sexual Health Medicine. Australasian Contact Tracing Guidelines. ASHM; 2022. Available at https://contacttracing.ashm.org.au/
21 North Western Melbourne Primary Health Network. Victorian HIV and hepatitis integrated training and learning (VHHITAL). Melbourne: NWMPHN; 2024. Available at https://nwmphn.org.au/about/partnerships-collaborations/vhhital/