Highlights from key sexual health policies across state legislatures.
January 25, 2024
Expedited Partner Therapy
Oklahoma State Senator Brenda Stanley (R-Midwest City) pre-filed legislation (SB1491) that would codify expedited partner therapy (EPT) into law; Oklahoma is currently one of only four states in the U.S. in which EPT is not explicitly permissible. EPT is a clinical practice that allows health care providers to treat partner(s) of patients diagnosed with an STI without examining them first. Broadly speaking, EPT benefits partners who are unwilling or unable to access care on their own.
SB1491 stipulates that EPT is allowable if the patient can contact and identify the partner. Because people have sex with partners they meet through dating apps or anonymous networks, this requirement is not always realistic and may sometimes render EPT impossible (or in other cases, unsafe due to intimate partner violence concerns).
Finally, the legislation protects providers from civil damages or disciplinary action for dispensing STI treatment to unexamined partners. Such language is sometimes included in EPT laws because while EPT expands prescribing authority for providers, many are not willing to use it without clear liability exemptions. The bill’s first reading is scheduled for February 5.
After legislative review, Nevada’s Board of Health adopted new regulations in December 2023 that change state requirements around sex workers and STI testing. Previous rules mandated that sex workers must “cease employment” if they tested positive for an STI. In the new regulation (NV – 7186), they will be issued a warning instead. The rule also emphasizes that STI treatment cannot be required for a person who tests positive, although treatment options must be provided and the STI must be reported. Nevada is the only state in the U.S. with any type of legal sex work (permitted in 10 out of 17 counties).
Adolescent Health and Gender-Affirming Care
Last year’s unprecedented bill activity on gender-affirming care bans for LGBTQ+ adolescents has spilled over into 2024, with several lawmakers drafting and introducing fresh bills on the topic.
In Oklahoma, State Senator Dana Prieto (R-Owasso) introduced SB1563, which would require schools to notify parents when new pronouns or names of a child are used by personnel. Transgender advocates and professional clinical associations have decried “forced outing” efforts as harmful practices that put LGBTQ+ youth in a vulnerable position.
In Ohio, debates around gender-affirming care resulted in a series of unexpected twists and turns. Ohio’s Republican-controlled legislature secured enough votes to override their governor’s veto of HB68, which bans gender-affirming care for minors and girls’ sports participation for young transgender women. Governor Mike DeWine, also a Republican, rejected the legislation late last year after meeting with transgender minors and their parents who emphasized that gender-affirming care was lifesaving; the bill now becomes law in 90 days.
In addition, despite vetoing HB68, Gov. DeWine surprised many of the same families he met with by signing an “emergency” executive order on January 5 that immediately bans gender-affirming surgeries for anyone under 18 years of age. While narrower in scope, LGBTQ+ advocates have argued the executive order is equally restrictive by requiring providers to report new “gender-related” conditions and care plans of any patient—including adults—within 30 days.
HIV Prevention Medication and Pharmacies
Maryland policymakers are trying again this year to expand access to HIV prevention drugs in pharmacies with a seemingly different approach. Last year, SB64 never made it out of committee. The bill would have authorized pharmacists to prescribe both pre-exposure and non-occupational post-exposure prophylactic medications (PrEP and nPEP, respectively), while further eliminating cost-sharing and prior authorizations for either HIV prevention treatment.
This year, Democrat Joseline A. Pena-Melnyk, who chairs the Health and Government Operations Committee, proposed legislation that would allow pharmacists to prescribe just nPEP through a standing order; there is no language around prior authorization or cost-sharing. NCSD will continue to monitor HB127 to see if it is more successful than its broader predecessor. As of 2023, 17 states in the U.S. allow pharmacists some level of authority to provide PrEP or nPEP, with nearly half of them in the West.
Women’s Health and Prenatal Care
Gov. Kathy Hochul (D-NY) has declared May 13 “Women’s Checkup Day.” The legislation introduced by Sen. Roxanne Persaud (D-Canarsie) creates a proclamation that cites sexually transmitted infections as one of ten key women’s health issues identified by the World Health Organization.
The recently adopted bill, coupled with Gov. Hochul’s plan to offer pregnant New Yorkers up to 40 hours of paid leave for prenatal care appointments, may bolster last year’s law that mandates all pregnant persons are tested for syphilis during their third trimester. Read more about the requirement from New York’s 2023 budget in a previous This Month in State Policy post.