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Poster Session II: Health Services

(P189) DECREASES IN STATE STD PROGRAM CAPACITY DURING COVID-19

Wednesday, September 18, 2024
4:15 PM - 5:15 PM EST
Background:
Health departments (HDs) provide essential STD services to combat rising syphilis. During the COVID-19 pandemic, many HDs struggled to maintain services and had to reallocate funds and personnel. The scope of these disruptions in the context of rising syphilis cases has not been systematically studied.

Methods:
We analyzed data from the U.S. STD Infrastructure Survey, a survey conducted periodically (2018, 2021), to assess the level and capacity of publicly funded STD programs pre/post COVID-19. Topics included services, budget, staffing, and changes due to COVID-19. We stratified by low versus high primary and secondary (P&S) syphilis rates using the STI National Strategic Plan’s 10-year goal (12.2 per 100,000 by 2030) as the threshold.

Results:
Of the 50 HDs, 35 state STD program directors responded in both 2018 and 2021 (response rate=70.0%). From 2018 to 2021, most states (94.3%) reported increased syphilis rates. States considered high syphilis morbidity increased from 27.7% in 2018 to 54.3% in 2021 (p < 0.001). 91.4% of respondents reported some of their STD workforce was detailed to COVID-19. In 2021, 57.9% of high morbidity states reported a decrease in staffing compared to 25.0% in low morbidity states (p=0.05). The percentage reporting that state (not local) HDs conduct the majority of partner services increased for low morbidity (54.0% to 62.5%, p=0.84) and high morbidity areas (44.4% to 47.4%, p=0.91). STD clinic closures increased from 5.7% in 2018 to 20.0% in 2021.

Conclusion:
During the COVID-19 pandemic, state STD program staffing decreased while state syphilis rates increased. State STD programs reporting high syphilis morbidity experienced greater disruptions to staffing and programs yet were still responsible for a disproportionately large percentage of partner services. The increased burden experienced by state HDs due to COVID-19 may have impacted their ability to meet the need for safety net STD services and partner services within their jurisdictions.