{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:35:38Z","timestamp":1768570538712,"version":"3.49.0"},"posted":{"date-parts":[[2025,1,3]]},"group-title":"Health Systems and Quality Improvement","reference-count":33,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,1,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sexually transmitted infections (STIs) disproportionately impact populations with higher social vulnerability. Expedited Partner Therapy (EPT), which allows the treatment of partners without requiring a medical visit, reduces STI reinfection rates and expands treatment access for underserved groups. However, EPT remains underutilized, particularly in the electronic prescription era, which introduces logistical complexities. Previous studies highlight low pharmacist awareness of EPT, but few have assessed its real world availability in pharmacies or how accessibility varies by socioeconomic subcomponent of the Social Vulnerability Index (SVI).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This study aimed to evaluate pharmacist awareness and willingness to dispense electronic, nameless EPT prescriptions in New York City (NYC) pharmacies and examine how these outcomes vary by the socioeconomic factors of the pharmacy\u2019s location.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Study Design<\/jats:title>\n                  <jats:p>A cross-sectional study of 347 randomly sampled NYC pharmacies was conducted using a telephone-based secret shopper approach. Research associates posed as patients seeking to fill hypothetical EPT prescriptions to assess pharmacist awareness, willingness to dispense, and insurance acceptability. Multivariable logistic regression models evaluated the association between EPT awareness and willingness with SVI, adjusting for pharmacy type, neighborhood location, and local chlamydia rates.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among surveyed pharmacies, 40% (134\/335) of pharmacists were aware of EPT, and only 30% (100\/333) were willing to fill nameless prescriptions. Non-chain pharmacies were significantly less likely to be aware of EPT compared to national chains (34% vs. 54%, p=0.02). The most common dispensing approach was filling prescriptions under the index patient\u2019s name (34%, 114\/335), with most pharmacies (86%, 179\/208) accepting insurance. Only 30% (100\/333) of pharmacists were willing to dispense nameless EPT prescriptions. Most pharmacists\u2019 methods of dispensing EPT prescriptions did not follow NY state EPT guidelines (54%, n=113). The most frequent reasons for refusal included unfamiliarity with EPT (62%, 66\/107) and the incorrect belief that patient names were legally required (28%, 30\/107). Adjusted regression showed increased odds of awareness of EPT in areas with the highest socioeconomic SVI quartile compared to the lowest quartile (odds ratio 3.7; 95% CI 1.4-10.8), though willingness to fill prescriptions did not differ by SVI (p=0.35).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Despite higher pharmacist awareness of EPT in more socioeconomically vulnerable areas, willingness to dispense nameless prescriptions remains low across NYC pharmacies. Independent pharmacies demonstrated particularly low awareness and engagement with EPT. These findings underscore the need for targeted pharmacist education, system-level interventions to streamline EPT dispensing, and enhanced training to ensure guideline adherence, particularly in high-need areas. Addressing these barriers could reduce STI disparities and improve public health outcomes.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2024.12.28.24319274","type":"posted-content","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T08:55:14Z","timestamp":1735894514000},"source":"Crossref","is-referenced-by-count":0,"title":["Neighborhood Social Vulnerability and Access to Expedited Partner Therapy Prescriptions: A Secret Shopper Audit Survey"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2565-5690","authenticated-orcid":false,"given":"Rachel E.","family":"Solnick","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen C.","family":"Vargas-Torres","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexis","family":"Guastello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marissa","family":"Seldes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelsey","family":"Simpson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia Mae","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Grant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ethan","family":"Cowan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025010713150693000_2024.12.28.24319274v1.1","unstructured":"CDC. National Overview of STIs in 2023 [Internet]. STI Statistics. 2024 [cited 2024 Dec 11]. Available from: https:\/\/www.cdc.gov\/sti-statistics\/annual\/summary.html"},{"key":"2025010713150693000_2024.12.28.24319274v1.2","unstructured":"National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division. Sexually Transmitted Infections: Adopting a Sexual Health Paradigm. National Academies Press; 2021."},{"issue":"1","key":"2025010713150693000_2024.12.28.24319274v1.3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/OLQ.0000000000001695","article-title":"The Importance of Structural Interventions for Advancing Sexual Health and Health Equity in the United States: A Review of the Evidence and Recommendations for Action on Sexually Transmitted Infections","volume":"50","year":"2023","journal-title":"Sex Transm Dis"},{"key":"2025010713150693000_2024.12.28.24319274v1.4","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e31818d3cad"},{"key":"2025010713150693000_2024.12.28.24319274v1.5","unstructured":"National Institute of Allergy and Infectious Diseases. Sexually Transmitted Diseases [Internet]. 2015. 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Strategies for partner notification for sexually transmitted infections, including HIV. Cochrane Database Syst Rev. 2013 Oct 3;(10):CD002843. PMCID: PMC7138045","DOI":"10.1002\/14651858.CD002843.pub2"},{"issue":"5","key":"2025010713150693000_2024.12.28.24319274v1.11","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1097\/OLQ.0000000000000751","article-title":"Expedited Partner Therapy: Pharmacist Refusal of Legal Prescriptions","volume":"45","year":"2018","journal-title":"Sex Transm Dis"},{"key":"2025010713150693000_2024.12.28.24319274v1.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.02.038"},{"key":"2025010713150693000_2024.12.28.24319274v1.13","unstructured":"CDC\/ATSDR Social Vulnerability Index [Internet]. 2022 [cited 2023 Jan 10]. 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Association Between Social Vulnerability and Rates of HIV Diagnoses Among Black Adults, by Selected Characteristics and Region of Residence\u2014United \u2026. and Mortality Weekly \u2026 [Internet]. ncbi.nlm.nih.gov; 2022; Available from: https:\/\/www-ncbi-nlm-nih-gov.proxy.lib.umich.edu\/pmc\/articles\/PMC8812837\/"},{"issue":"1","key":"2025010713150693000_2024.12.28.24319274v1.19","first-page":"226","article-title":"Secret shopper studies: an unorthodox design that measures inequities in healthcare access. Arch Public Health","volume":"80","year":"2022","journal-title":"Springer Science and Business Media LLC"},{"key":"2025010713150693000_2024.12.28.24319274v1.20","unstructured":"New York State Public Health Law \u00a72312 and 10 NYCRR \u00a723.5-Expedited partner therapy for chlamydia trachomatis infection [Internet]. [cited 2023 Jan 17]. 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