A novel suggestion in Minnesota's new strategy to halt the spread of Chlamydia is to deliver single-dose antibiotics to people who test positive for the sexually transmitted infection but don't return to their clinics for treatment.

Physicians already are required to notify the Minnesota Department of Health when patients have Chlamydia, which often goes undetected but can cause infertility and birth defects, and other reportable STDs. The state then confidentially contacts infected people to ensure they are treated, and reaches out to their sexual partners to alert them of their STD risks.

Physicians also are permitted to give extra antibiotics to infected patients so they can pass them along to sexual partners. (This is called expedited partner therapy.) But "field delivery" of drugs to patients who haven't sought treatment would be an extension of the state's STD/HIV Partner Services program.

MDH's Marcie Babcock estimates that as many as 400 Minnesotans infected with Chlamydia or gonorrhea would benefit annually from this approach -- particularly teens who are hesitant to return for treatment or uninsured patients who are worried about the cost. State workers would not only deliver the meds, but watch the patients take them. This approach has been used to ensure tuberculosis patients take their antibiotics, but it is new for STDs in Minnesota. Babcock said it was first tried in the late 1990s in San Francisco with positive results.

I imagine this proposal will trouble privacy advocates, who weren't thrilled in 2008 when the Minnesota legislature removed legal impediments to expedited partner therapy. Logistically, I do wonder how the state can reach out to infected patients -- especially teens living with parents -- and ensure confidentiality.

But there are compelling reasons to be aggressive. A record 17,760 Chlamydia infections were detected last year -- due partly to increased screening but also due to unprotected sex in the at-risk population. The majority of infections involved teens and adults younger than 25.

There is no timetable for a state field-delivery program. Babcock only said the health department is "considering the feasibility" of the approach.