State lawmakers have amended a bill so that it no longer excludes homosexuals from a treatment option for certain sexually transmitted diseases.

Expedited partner therapy, a practice that’s growing nationally, lets doctors treat the partners of patients who have chlamydia or gonorrhea without first examining them. Advocates say this could help reduce Hawaii’s high rates of both diseases, particularly among women.

Senate Bill 655, as initially introduced in January by Sen. Josh Green, would have opened up this treatment option to anyone. But last month the Senate Commerce and Consumer Protection Committee, chaired by Sen. Roz Baker, restricted it to heterosexuals.

The House Consumer Protection and Judiciary committees last week undid the Senate’s limiting language by deleting “heterosexual” in references to partners. They also broadened it to include other sexually transmitted diseases that are or may be recommended by the CDC.

Rep. Karl Rhoads, who chairs the House Judiciary Committee, could not be reached for comment Monday.

The Senate committee’s decision to restrict expedited partner therapy was based on a 2006 report by the Centers for Disease Control and Prevention that recommends it only as a last resort for same-sex couples due to the high risk of coexisting infections, especially undiagnosed HIV.

That report hasn’t stopped other states, such as Iowa, from keeping their statutes open to all patients regardless of sexual orientation. They rely on doctors’ discretion to prescribe the oral treatment as they see fit until more studies are done on the effectiveness of expedited partner therapy for same-sex couples.

The CDC says these studies may be a particularly high priority in view of resurgent sexual risks and STD rates and the poor outcomes of standard partner management practices. The University of California, Los Angeles, has sponsored an ongoing study in Peru that is expected to provide pilot data on expedited partner therapy for gay men in Latin America.

Pills and Needles

Part of the challenge in expedited partner therapy has been the nature of the treatments.

Expedited partner therapy relies on oral treatments because they don’t require a doctor or nurse to administer them like shots typically do.

In Hawaii, treatment of chlamydia is only by oral medication for all populations, according to Peter Whiticar, chief of the state Department of Health STD/AIDS Prevention Branch.

“Gonorrhea, on the other hand, is becoming increasingly difficult to treat due to the emergence of resistant strains which may not respond to the previously standard oral regimens,” he told Civil Beat Monday. “Therefore, intermuscular injections are the recommended treatment regimen for gonorrhea.”

Nationwide, an estimated $850 billion is spent treating chlamydia and gonorrhea infections, according to the American Congress of Obstetricians and Gynecologists. Advocates, including ACOG, say SB 655’s passage could help reduce infection rates and, in turn, the overall cost.

The most recent CDC data ranks Hawaii 22nd in the nation for reported chlamydia infection rates, peaking among 15- to 24-year-olds. It’s relatively easy to cure with antibiotics, but particularly dangerous if untreated — especially for pregnant women.

Green said the law would decrease the number of people who get chlamydia or gonorrhea in Hawaii.

“My single priority is to make as many people healthy as possible,” he said Monday.

The full House will vote on the bill Tuesday.

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