Ohio House of Representatives
Health and Human Services Committee
HB 124
Testimony of Laura David, MD and Chair
American Congress of Obstetricians and Gynecologists, Ohio Section
Chair Gonzales, Vice Chair Huffman, and Ranking Member Antonio, I am Dr. Laura David, and I am an
Obstetrician- Gynecologist who has been in practice for over 30 years in the state of Ohio. Currently, I
am the Chair of the Ohio Section of the American Congress of Obstetricians and Gynecologists, and I
represent over 1500 Ohio ObGyn’s and the women patients they serve. I am grateful for this
opportunity to offer proponent testimony on their behalf for HB 124- Venereal Disease, Prescribe for
Sexual Partners, otherwise known as Expedited Partner Therapy (EPT).
The occurrence of sexually transmitted diseases has become epidemic in Ohio and in the entire nation.
In the year 2013, for which the most recent figures are available, Ohio ranked 20th in the incidence of
chlamydial infections, with a rate of 460 cases per 100,000 persons, for a total of over 53,300 cases
recorded in one year. For the other bacterial infection, gonorrhea, Ohio ranked # 8 in the nation in
incidence, (143 cases per 100,000) with over 16, 600 cases recorded in one year.
These infections disproportionately affect women, especially young women between the ages of 15 – 26
and unfortunately, the rate of becoming re-infected can be as high as 25 % in this age group. Infections
with chlamydia and gonorrhea in our women, especially our young women at peak reproductive age,
can lead to permanent pelvic organ scarring and inflammation, which is a major cause of infertility,
ectopic or tubal pregnancies, and acute and chronic abdominal and pelvic pain. An estimated $850
million is spent each year treating these two infections in the United States, and additional
complications from related infertility and pain places the cost at over $1 billion per year. Furthermore,
additional financial and emotional burden is incurred because the presence of these untreated
infections in pregnant women may increase the rate of premature labor and birth, neonatal eye and skin
infections and possible newborn blood, lung and nervous system infections.
A major reason for the high incidence of infection and re-infection in our female patients is the lack of
quick and efficient treatment of the male partners. This absence of completed antibiotic treatment for
the male partner is a story we know too well: male partners often do not have a common or
comfortable portal or access to care. Young men feel too old for the pediatricians’ office and have not
otherwise had reason already to become established with a primary care physician. Many males are
hesitant to discuss these issues with a physician. And others may refuse to seek medical attention for
fear that their privacy will no longer exist.
But HB 124 provides one avenue for reducing future infections and decreasing the perpetual
epidemic: Expedited Partner Therapy permits the dispensing of an antibiotic prescription for the
partner of our patient diagnosed with chlamydia, gonorrhea or trichomoniasis without direct
examination of that partner. Of course, our hope is as this bill urges- that the partner can be persuaded
by education and information to seek his own care with a medical provider. But reality has shown us
that this is often not accomplished. That is why Expedited Partner Therapy has been strongly endorsed
by many medical organizations, including our own American Congress of Obstetricians and
Gynecologists and the Centers for Disease Control and Prevention and others you will hear from today.
This practical and safe approach to interrupting a cycle of perpetual infections is so widely accepted that
it is legal in 37 states and presumptively permitted in another 9. Ohio is one of only 4 states in the U. S.
in which practitioners are legally excluded from this widely accepted course of action.
Expedited Partner Therapy involves well established protocols from The Centers for Disease Control and
Prevention with most regimens involving one or two doses of medication given in one day’s time. In
reviewing the experience of other states using these protocols, the incidence of allergic reactions is
virtually negligible. But safeguards of education and instructions and information are a central tenant of
HB 124. In fact, the ability to provide treatment for the partner presents a “Teachable Moment” in the
medical care of all involved.
Studies from other states, including a recent study from the State of Washington published this year
substantiates the success in reducing both chlamydial and gonorrheal infection rates among young
adults when Expedited Partner Therapy and the concomitant education and outreach are enacted.
We hope that Ohio will no longer lag the rest of the country in providing this opportunity for physicians
to act in the best interest of their patients with the best guidelines and protocols already widely
established by the other 46 states in our union.
I urge you to enact HB 124 and thank you for this opportunity to provide proponent testimony. I am
willing to answer any questions that you may have regarding Expedited Partner Therapy.