Written by Kim Furlow, communications manager for the Institute for Public Health
St Louis is home to some of the highest per-capita rates of gonorrhea and chlamydia in the nation, making sexually transmitted infections (STIs) a pressing public health concern. Due to access barriers and structural racism, STIs disproportionally impact youth and minority groups.
As reported by the Public Health Data & Training Center, July 2022
The Public Health Data & Training Center at the Institute for Public Health and Faculty Scholar and Associate Professor of Infectious Diseases, Hilary Reno, MD, PhD, are supporting local health departments by developing the region’s first comprehensive tool to track the ever-increasing number of sexually transmitted infections. This platform is one piece of a long-term strategy to address the region’s high infection rates, and is a collaboration between local public health departments, sexual health providers, and academics. Specifically, the tool is a regional sexual health database of comprehensive, “real time” information reflecting positive and negative STI cases. This data will also assist in public health analysis of racial, age, sex and demographic disparities.
Regional cooperation around sexual health data is essential to improving care for STIs and HIV. By focusing on testing data and not only diagnosed cases, health care systems will be able to evaluate sexual health care, refocus resources where they are needed, and improve their communication with each other, and with people affected by STIs and HIV.
Hilary Reno, associate professor of infectious diseases, Washington University School of Medicine
in St. Louis
Why now?
According to the data team, we know that “timely and robust public health data is needed to understand and respond to this [STI] epidemic, however, the way in which this information is currently tracked and shared is neither timely nor robust.”
The new tool will help identify where targeted interventions and funding are needed, and to whom resources should be directed. In terms of interventions, the team points to mobile testing sites as one example that could immensely benefit local and rural communities experiencing high rates of STI’s. “Right now, there is little infrastructure in Missouri to collect all the information needed to answer our questions, as only positive cases are reported,” said Anne Trolard, staff scientist at the Institute for Public Health and part of the project team. “Each month, we are collecting both positive and negative tests to create more real-time data.”
Work so far
The Data Center has collected and aggregated information for HIV, syphilis, gonorrhea, chlamydia, and trichomonas from across the BJC system, to begin building the platform. The team has also begun building visualizations to better understand testing patterns. Maps like these will allow the team to find areas where infection prevalence is high but testing rates are low, and where more education and support is needed.
The map below shows one BJC facility (Parkland Health Center) and the zip codes from which patients came seeking STI testing. The darker the shade of the geographic area, the greater the volume of unique patients from that zip code.
The map above shows overall patient volume by zip code and the facilities that provide testing. The larger the circle (representing the facility) the larger the volume of tests. Understanding the volume of testing at each facility will also help to appropriately direct resources.
The team is also working on developing a governance structure for the platform and have talked to legal experts about how to safely leverage sensitive health information for population health. Moving forward, the goal is to develop a community-wide governance structure that will provide maximum protection of individual-level data, while allowing for key public health activities.
Benefits
“With this new tool, local health officials will have current population health data that can be used to gauge in real time, exactly what’s happening in sexual health across the region,” said Ben Cooper, manager of the Data Center. Insights from the data collected will:
- Assist local health leaders in deciding and implementing education and prevention campaigns to patients most affected by STIs
- Inform the targeted allocation of limited resources
- Enable evaluation of current health care across testing sites
Washington University’s Institute for Public Health is a convener and supporter of dialogue and planning related to public health challenges. This new tool stems from a 2019 regional meeting hosted by the institute and attended by area health leaders and researchers, which focused on advancing existing efforts and elevating conversations about barriers and opportunities for sexual well-being of the St. Louis region. The event and subsequent report was supported by funding from The Foundation for Barnes-Jewish Hospital.
A lot of people have told us that building a regional health data platform wasn’t possible, but now we’re looking at this [type of platform] for future big public health issues.
Ben Cooper