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Ohio bill would allow patients to get STD meds for partners

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COLUMBUS, Ohio » A bill in Ohio seeks to expand access to treatment for certain sexually transmitted diseases by allowing doctors to prescribe medication to their patients’ partners without examining them.

Licensed health professionals in Ohio must first see patients before prescribing them antibiotics. But legislation before state lawmakers would create a limited exception for partners of patients who have been diagnosed with chlamydia, trichomoniasis or gonorrhea. The aim is to reduce infections.

Ohio is one of four states that prohibit expedited partner therapy, according to the Centers for Disease Control and Prevention. Others are Florida, West Virginia and Kentucky.

Ohio’s rate of reported gonorrhea and chlamydia cases is higher than the national average, with most cases occurring among residents ages 15 to 24.

For every 100,000 people in Ohio, 460 have chlamydia and 144 have gonorrhea, according to 2013 health statistics from the CDC. Ohio ranks seventh among states in its rate of reported gonorrhea cases, and 19th in its rate of reported chlamydia cases.

Republican state Rep. Steve Huffman, a physician from Tipp City, said he was surprised to learn that Ohio lagged behind others in permitting expedited partner therapy. He co-sponsored the bill.

Now, Ohio doctors can only encourage infected patients to tell their partners they should be seen and treated, Huffman said. But it’s difficult to get young people, particularly men, to seek medical care.

"This is solving a problem that’s already happening," he said.

The legislation would permit a prescriber to treat up to two partners of one patient without examination. Those partners could remain anonymous. But if their names are given, the nurse or doctor must try to reach them. The bill also requires pharmacists to explain potential side effects of the medication.

Partner treatment proposals in West Virginia and Kentucky passed House committees but failed to gain traction before state lawmakers adjourned for the year.

The CDC has endorsed expedited partner therapy for chlamydia and gonorrhea since 2006 and says evidence shows it’s an effective prevention strategy. Chlamydia can permanently damage a woman’s reproductive system, making it difficult or impossible to get pregnant later on.

Dr. Gail Bolan, director of the CDC’s division of STD prevention, said reluctance at the state level to expedited partner therapy often reflects the attitude of the clinical community. Physicians are trained to not provide care without a good-faith exam of their patients, so the approach is a change in thinking.

"Unfortunately, we found that sometimes the clinical provider community doesn’t realize that doing nothing is actually causing more reproductive health harm for women in their state than (expedited partner therapy) is," Bolan said.

The Ohio State Medical Association backs the proposal, which easily passed the House on Wednesday. It now goes to the state Senate for consideration.

State Rep. Kristina Roegner, a Republican from Hudson in northeastern Ohio, voted against the measure, citing safety concerns about providing prescriptions to anonymous partners and the allowance of prescriptions for up to two sexual partners.

"Gosh, you know, you really only should be having one sexual partner — if any," she said. "We don’t want to promote promiscuity."

Treatment for the STDs listed in the bill is straightforward, said Dr. Laura David, an OB-GYN for University Hospitals in suburban Cleveland who chairs the Ohio section of the American Congress of Obstetricians and Gynecologists. Patients typically get one or two days of antibiotics and could tell providers almost immediately whether they had any complications.

"If you’re looking at reaching out to 15- and 20- and 25- and 30-year-olds, you have to look for new ways to approach them, treat them, educate them, without necessarily having them sit in a doctor’s waiting room," said David, who supports the bill.

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