A Regional Approach to Improving STI Care

December 3, 2015

by Hilary Reno, MD, PhD, Washington University

In November, the Centers for Disease Control and Prevention (CDC) released two reports detailing the increasing rates of sexually transmitted infections in the US. As a provider of care for patients with sexually transmitted infections (STIs) and HIV, increasing rates of all STIs are a great concern to me.

National STI data indicates that rates of chlamydia, gonorrhea, and primary and secondary syphilis all increased from 2013 to 2014 (Sexually Transmitted Disease Surveillance 2014). Increasing rates in men accounted for some of these increases, and at risk groups including youth and men who have sex with men (MSM) continued to have high rates of STIs.

For many years, the per capita rates of STIs in the St. Louis region have been some of the highest in the United States. In the St. Louis region, patients with STIs seek care at a variety of providers and locations. Thus, we felt that improving the care of patients with STIs in our region would require a group effort from such systems as public health departments, universities, primary care providers, and emergency departments to address this multi-faceted health issue.

With the support of the Institute for Public Health, earlier this year I formed the STI Regional Response Coalition (STIRR). STIRR first met this past spring with nearly fifty attendees from a variety of agencies, including state, city, and county health departments, academic medical centers, emergency departments, urgent cares, federally qualified health centers, and private providers attending. Focused work by primary care/women’s health providers, emergency department providers, and HIV providers will now start to examine STI testing and treatment practices.

Hillary Reno headshot
Assistant Professor, Divisions of Infectious Diseases and Hospitalist Medicine, School of Medicine

2015 STD Treatment GuidelinesWith a cooperative approach from health departments and providers, we can target clinical practice for improvement and focus our resources. We will also be able to draw on the resources offered from the St. Louis STD and HIV Prevention Center to help raise awareness of CDC treatment guidelines and STI standards of care for providers.

This regional effort is much needed. Patients infected with an STI, especially syphilis and gonorrhea, are more vulnerable to infection with HIV, so these increasing STI rates especially in our youth and MSM who are at higher risk of HIV infection should encourage increased awareness in providers.


Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2014. Atlanta: U.S. Department of Health and Human Services; 2015.

Increase in Incidence of Congenital Syphilis — United States, 2012–2014. MMWR 64(40); 1150-1.


hivaidsThis post is part of the December 2015 “HIV/AIDS” series of the Institute for Public Health’s blog. Subscribe to email updates or follow us on Twitter and Facebook to receive notifications about our latest blog posts.

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