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Background: In randomized controlled trials of expedited partner therapy (EPT), among patients in the EPT arm, the proportion of partners believed to have taken the medication ranged from 56% to 85%. Little is known about the content of successful and unsuccessful EPT negotiations between patients and their partners. The aim of this study was to describe how patients made decisions about EPT and what they did with the EPT medication packs dispensed to them., Methods: We performed a qualitative study at the Baltimore City Health Department sexually transmitted disease clinics, which instituted an EPT pilot program in 2007. In-depth interviews were conducted with 31 patients, 1 week to 3 months after they had accepted EPT to bring to their partners. Taped interviews were transcribed verbatim and coded using ATLAS.ti 6 qualitative software. Codes were further combined into more comprehensive themes that were mapped onto the study's main aim., Results: Participants were innovative about how to get medication to their partners and indicated a deep sense of concern and responsibility for their partners' health. On the other hand, participants reported of being anxious about the interaction and sometimes felt that they lacked the words to talk with their partners about EPT. Some participants used EPT in unexpected ways, such as giving it to people other than their sex partners or taking it themselves., Conclusions: Enhancing the counseling that accompanies EPT may improve patients' success in delivering it to their partners.

Background: Human immunodeficiency virus (HIV) RNA testing of pooled HIV antibody-negative specimens can identify acute HIV infection (AHI) and trigger interventions to reduce transmission during this highly infectious period., Methods: A Baltimore, MD program serving sexually transmitted disease clinics and other high-risk sites combined HIV testing by third-generation enzyme immunoassay (EIA) with RNA testing of pooled antibody-negative specimens. Laboratory and Disease Intervention Specialists' records were reviewed for program evaluation. A cost analysis was performed., Results: In 22 months, we tested 60,695 specimens for HIV. Of these, 1766 (2.9%) tested positive by EIA. Pooled HIV RNA testing of 58,925 EIA-negative specimens detected 7 cases of AHI (0.01%). Reflex HIV RNA testing of EIA-reactive, Western blot-indeterminate specimens confirmed 4 additional AHI cases (total AHI, 0.02%). Contact tracing detected no additional previously unknown cases of HIV infection., Conclusions: The utility of pooled HIV RNA testing may be limited by advances in HIV testing technology that reduce the seronegative window period and by characteristics of the local HIV epidemic.