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Uzoeshi Anukam MSII Center for AIDS & STD, University of WA Howard University College of Medicine

Legal Status of Patient Delivered Partner Therapy (PDPT) in the U.S.: a National Survey of State Pharmacy Boards and Boards of Medical Examiners. Uzoeshi Anukam MSII Center for AIDS & STD, University of WA Howard University College of Medicine. Background.

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Uzoeshi Anukam MSII Center for AIDS & STD, University of WA Howard University College of Medicine

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  1. Legal Status of Patient Delivered Partner Therapy (PDPT) in the U.S.: a National Survey of State Pharmacy Boards and Boards of Medical Examiners Uzoeshi Anukam MSII Center for AIDS & STD, University of WA Howard University College of Medicine

  2. Background • Patient delivered partner therapy (PDPT) is the practice of giving patients diagnosed with a curable STD medication to give to their sex partner(s) • Approximately 50% of clinicians in the U.S. report having given a patient with gonorrhea or chlamydial infection medication for a partner • PDPT has been shown to decrease reinfection rates in persons with gonorrhea in a RCT, and two RCTs have observed trends toward lower rates of recurrent or persistent CT in persons given PDPT • The legal status of PDPT in the U.S. is ill-defined

  3. Objective & Methods • Objective: To define whether PDPT is legal in the U.S. • Survey of directors of state boards of medicine and pharmacy • in 50 states & the District of Columbia • 5 questions: • Is PDPT legal? • Has the issue ever been addressed? • What organization is responsible for deciding if PDPT is • legal? • Would a new law be required to make PDPT legal? • Would the board take disciplinary action against a provider • who employed PDPT?

  4. Response rate Any response 39 (76) 44 (86) 49 (96) Data 34 (67) 41 (80) 47 (92) Medical Board Pharmacy Board Either medical or pharmacy board

  5. Is PDPT Legal? Pharmacy Board N (%) 4 (10) 20 (49) 6 (15) 11 (27) 6 (15) 21 (51) 14 (34) Medical Board N (%) 5 (15) 14 (41) 5 (15) 10 (29) 7 (21) 16 (47) 11 (32) Legal Yes No Law is vague Don’t Know Ever addressed Yes No Don’t know

  6. Legality of PDPT Legal Illegal Unknown White = No response Disagreement med & pharm boards

  7. Frequency of whether the issue of PDPT had ever been addressed by medical or pharmacy boards by perceived legal status Pharmacy Board (n=41) N (%) 2 (50) 4 (20) 0 0 Medical Board (n=34) N (%) 4 (80) 1 (7) 1 (20) 1 (10) Legal in state Yes No Law is vague Don’t Know

  8. Agency responsible for deciding if PDPT is legal among areas in which practice was not considered legal Pharmacy Board (n=37)* N (%) 21 (57) 8 (22) 7 (19) 1 (3) 2 (5) 3 (8) Medical Board (n=29)* N (%) 15 (51) 9 (31) 3 (10) 3 (10) 0 6 (20) Agency Medical board Pharm board Dept. Health Attorney general State legislature Don’t know * 5 pharmacy boards and 7 medical boards indicated more than one agency would share responsibility

  9. Would a new law be required? Percent

  10. Would enforcement action be taken? Percent

  11. Summary • PDPT is clearly defined as being legal in 4 states (CA, WA, CO, TN). • Two (CA, TN) have specific laws on PDPT, and 2 (CO, WA) have written ruling on the issue without specific laws. • The legal status of PDPT in most other areas is ill-defined • Many boards of pharmacy & medicine regard PDPT as illegal, though most have never addressed the issue. • Some believe persons prescribing PDPT could be subject to legal action • Most boards of pharmacy & medicine believe new laws would be required to clearly establish the practice as being lawful.

  12. Conclusions • Although PDPT is common throughout the U.S. and several studies suggest the practice can improve partner notification outcomes, the legal status of PDPT is ill-defined and the practice if often considered unlawful. • If PDPT is to be promoted nationally, it will need to be explicitly defined as being legal. • This will likely require new laws or written rulings from relevant professional, legal or public health agencies.

  13. Contributors & Support Center for AIDS & STD, UW Matthew R. Golden H. Hunter Handsfield WA State Pharmacy Board Donald Williams Support UW NIH STD CRC AI31448 NIAID K23 AI01846-02.

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