It’s time to expand chlamydia treatment for gay and bisexual men

Abstract

Expedited partner therapy involves prescribing sexually transmitted infection (STI) treatment for a patient’s partner(s) without seeing the partner. It is approved for heterosexual partners of patients with chlamydia in most states. However, the Centers for Disease Control and Prevention recommends against expedited partner therapy in men-who-have-sex-with-men (MSM), citing lim-ited data in this population and concerns that expedited partner therapy could discourage comprehensive STI testing, thereby driving increased HIV transmis-sion. In this piece, we describe the case of a 33-year-old gay man on HIV pre-exposure prophylaxis (PrEP) whose cycle of chlamydia reinfection might have been prevented by expedited partner therapy. His case highlights how new HIV prevention strategies—including PrEP and Treatment as Prevention—challenge the assumption that all MSM with chlamydia are at risk for HIV. Until more data on expedited partner therapy in MSM are available, clinicians should incorporate characteristics of patients’ sexual networks in weighing the risks and benefits of expedited partner therapy.