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Medical Education, Pediatrics, Public Health, Sexual Health

Study shows STD-treatment gap in pediatricians' training

Study shows STD-treatment gap in pediatricians' training

New pediatricians in California need better training in treating sexually transmitted diseases among teens, according to a Stanford/Packard Children’s study published today in Pediatrics.

In the study (subscription required), researchers examined pediatric residents’ knowledge of state laws governing treatment of their patients’ sexual partners and found the physicians have spotty knowledge of an important method for preventing teens from suffering multiple bouts of STDs. The method, called “expedited partner therapy” (EPT) lets doctors prescribe antibiotics for the sexual partner of a gonorrhea or chlamydia patient without seeing the partner.

Even after receiving antibiotics to clear their infections, 40 percent of teenage gonorrhea and chlamydia patients are diagnosed with a second bout of the same illness within a year.

EPT, which has been legal in California since 2001 and is now permitted in more than 30 states, isn’t the only way that doctors can reach patients’ sexual partners for STD treatment. But prior research has shown that EPT improves the rate of STD treatment among partners in comparison with other methods. Our press release on the new study explains why treating teens’ sexual partners is so important:

“Unless you treat the partner, your patient gets re-infected,” said Neville Golden, MD, an adolescent medicine specialist at Packard Children’s and professor of pediatrics at Stanford. “We call this the ‘ping-pong effect.'”

Indeed, even after receiving antibiotics to clear their infections, 40 percent of teenage gonorrhea and chlamydia patients are diagnosed with a second bout of the same illness within a year. About half of all sexually transmitted infections in this country occur in teenagers.

The study by Golden and colleagues focused on young doctors completing specialty training in pediatrics in California and asked whether they knew about California’s expedited partner therapy law. Though about half of the pediatric residents had used EPT, 87 percent said their knowledge of the law was shaky and that this lack of knowledge was a barrier to their use of EPT. Less than a quarter of the residents had ever been educated about EPT, suggesting a large opportunity for teaching pediatricians about the practice.

EPT isn’t perfect, and the residents’ responses also reflected valid concerns with the method. For instance, 78 percent of respondents worried about missing opportunities to address the partners’ health care needs and 69 percent were concerned that partners would not take the medication as directed. But given how common STDs are among teenagers, and how useful EPT can be, the study’s authors conclude that it’s important to ensure new pediatricians are better informed about it.

Previously: Experts weigh in on recommendation that boys be given HPV vaccine; Only one-third of teenage girls get HPV vaccine to prevent cervical cancer.

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