HMO Gives Antibiotics to Patients’ Partners Without Seeing Them

Prescribing pills without actually seeing a patient pushes the envelope of accepted medical practice.

But the San Francisco Health Plan, a nonprofit HMO, is taking an unorthodox approach to stem the rate of chlamydia, a sexually transmitted bacterial infection that is reaching epidemic proportions. The health plan’s doctors are prescribing double doses of antibiotics--one for patients with the infection and one for their partners, who often want to remain anonymous.

More than 3 million sexually active U.S. teenagers and young adults are infected by chlamydia each year.

“What we’ve seen over and again is a woman is identified with chlamydia, gets treated and then comes back three to four months later because she’s been reinfected by her partner,” says Dr. Karen K. Smith, medical director of San Francisco Health, which is dispensing the medication for free to its members, who are mostly low-income. “But it’s difficult to get their boyfriends to come in for care.”

Critics worry that unseen partners could be allergic to the antibiotics, or it could interact with other medications.

But public health officials believe that extraordinary measures are necessary to help rein in the incidence of the disease, which can have dire health consequences for women. Left untreated, women can develop pelvic inflammatory disease that can later cause infertility and life-threatening tubal pregnancies. Recent research also has linked the infection with increased susceptibility to cervical cancer and HIV.