Written by Maya Terry, BA, Washington University in St. Louis; Gold Family Summer Research Scholar for the 2020 Institute for Public Health Summer Research Program – Public and Global Health Abbreviated Track
On July 16, 2020, as part of the Institute for Public Health Summer Research Program – Public and Global Health Abbreviated Track, we heard from Anne Trolard, MPH, Manager of the Public Health Data & Training Center. Her presentation highlighted the importance of working to address the sexual health landscape of St. Louis, whether that is at the provider level, through public health surveillance, or research. In the United States on a whole, the rates of sexually transmitted infections (STIs) has only increased, which inversely relates to a decrease in funding for the public health system. Consequently, there has been a decline in testing, treatment, and other available services to protect against STIs. The most prevalent, chlamydia and gonorrhea, both bear a high burden in the St. Louis region, which is frequently referred to as the STI capital of the nation.
Trolard and her team found that in the St. Louis region, individuals are more likely to rely on emergency departments (ED) for STI services as opposed to specialized clinics, even when there is a clinic location in close proximity to the patient’s home. This underscores the need for clinics to change the way they market themselves in the community and it is important for them to increase awareness of the services they provide. It is possible that stigma plays a role in patient decisions on where to go; in a paper published by the team they express, “people with an STD concern may make the choice to seek care in the ED intentionally, either because they believe the ED would do a superior job of diagnosing and treating them, or potentially to preserve their anonymity in going to a place further from their residence where they are less likely to encounter someone they know.”
There is a lot of work that needs to be done to improve the rates of STIs not only in St. Louis, but across the country. Using available data and building a provider coalition are just some of the ways to address how to close gaps in STI care access.