**6. Treatment of adolescents patients and their partners**

Treating the partners of STI-positive patients is another important factor in STI reduction. Ideally, partners of STI-positive patients would seek health care for evaluation, treatment, and counseling in person. This can prove to be a challenge in all ages, especially in adolescents and unfortunately, rates of reinfection in adolescents and young adults are high. A 2008 study by Gaydos et al. reported up to 26% of

adolescent and young adult women were reinfected with their STI within 12 months [46]. The AAP has endorsed a position paper by the Society for Adolescent Health and Medicine supporting the use of expedited partner therapy (EPT) as a treatment option for heterosexual sex partners of adolescents with gonorrhea and chlamydia when other partner treatment methods are impractical or unsuccessful [47].

EPT is a management technique in which medications or prescriptions are provided for the partner of a patient who tests positive for gonorrhea and/or chlamydia without physical examination of that partner. It involves prescribing the medication (it is acceptable to write "Expedited Partner Therapy" in place of the partner's name; no date of birth needed). It should also include treatment instructions, warnings about the medications, general health counseling, and a statement that advises the partner to seek medical evaluation in the setting of symptoms.

This technique has proven to be beneficial [48–50]. In a 2005 study by Golden et al., EPT was more effective than standard referral of partners in reducing persistent or recurrent infection among patients with gonorrhea (3% vs. 11%, P = 0.01) [50]. It is currently not recommended, however, for men who have sex with men or women with trichomoniasis because of increased risk of coinfections and lack of supporting evidence in these populations.

Optimal STI control requires more than testing and treatment to disrupt transmission; the CDC urges us to counsel these patients on partner treatment and safer sex practices. In adolescents especially, communication is key. Talking with adolescents about their risks of reinfection, both surrounding their acute infection as well as in the future unless they change their behaviors, is of paramount importance.
