STD Clinics Contribute to Ending the HIV Epidemic in the United States
STD clinics (PDF, 587 KB) play a key role in HIV diagnosis, prevention, care, and treatment. The Centers for Disease Control and Prevention (CDC) recognizes this role and in August 2020 awarded $3 million to seven jurisdictions to scale up HIV services in eight STD clinics through funding announcement PS20-2010: Integrated HIV Programs for Health Departments to Support Ending the HIV Epidemic in the United States (EHE).
Having a sexually transmitted infection (STI) can increase the chances of getting or transmitting HIV, because having an STI may make HIV transmission easier. Additionally, the same behaviors and circumstances that place people at risk for STIs also can place them at risk for HIV.1
STD clinics are important healthcare settings for people who may not otherwise have access to healthcare services, including those who are uninsured or seek confidential services.2 They serve people who are not engaged in HIV prevention programs or the primary healthcare system for STD and HIV prevention and care.3 For example, in 2018, an analysis of CDC-funded HIV tests found STD clinics provided more than one-third of all HIV tests conducted among healthcare settings and identified approximately 20% of all people newly diagnosed with HIV in these settings.4
The COVID-19 pandemic has put unprecedented demandsExit Disclaimer on all STD programs, but despite these challenges, awardees have made progress in scaling up HIV services. For example, funded clinics conducted a baseline assessmentExit Disclaimer of STD and HIV services outlined in the Recommendations for Providing Quality Sexually Transmitted Diseases Clinical Services, 2020. Findings and recommendations from the assessment are being used to tailor resources to meet the unique needs of each clinic. The assessment found nearly all funded clinics have laboratory capacity and the ability to provide PrEP by prescription, provide extragenital STI and fourth-generation HIV testing, and conduct education and an assessment for PrEP. Additional examples by the eight funded STD clinics to scale up HIV services include progress to:
- Establish telePrEP as an option for PrEP patients.
- Contact PrEP patients lost to follow up to reengage in care and better understand barriers to care.
- Implement express clinics to increase clinic capacity.
- Streamline electronic medical record communication with local HIV providers to more rapidly link patients to care.
CDC will support these STD clinics as they expand HIV services, including assistance in monitoring and evaluating clinic and patient outcomes. Measuring the impact of EHE STD clinic efforts will help to identify best practices to end the HIV epidemic and reduce the rates of STIs in the US.
1 Hayes R, Watson-Jones D, Celum C, van de Wijgert J, Wasserheit J. Treatment of sexually transmitted infections for HIV prevention: end of the road or new beginning? AIDS. 2010 Oct;24 Suppl 4(0 4):S15-26. doi: 10.1097/01.aids.0000390704.35642.47. PMID: 21042049; PMCID: PMC3827743.
2 Hoover KW, Parsell BW, Leichliter JS, Habel MA, Tao G, Pearson WS, Gift T. Continuing Need for Sexually Transmitted Disease Clinics After the Affordable Care Act. Am J Public Health. 2015 Nov;105 Suppl 5:S690-5.
3 Seth P, Wang G, Sizemore E, Hogben M. HIV testing and HIV service delivery to populations at high risk attending sexually transmitted disease clinics in the United States, 2011-2013. Am J Public Health. 2015;105(11):2374-81.
4 Centers for Disease Control and Prevention. CDC-Funded HIV Testing in the United, States, Puerto Rico and the U.S. Virgin Islands, 2018 Annual HIV Testing Report. https://www.cdc.gov/hiv/pdf/library/reports/cdc-hiv-annual-HIV-testing-report-2018.pdf.