(P176) HAS STD CLINIC UTILIZATION RETURNED TO PRE-COVID LEVELS? FINDINGS FROM FOUR U.S. JURISDICTIONS

Background:
STI services and staffing were reduced in 2020 due to the COVID-19 pandemic. Reported chlamydia (CT) and gonorrhea (GC) rates increased from 2020-2021. In 2022, gonorrhea rates decreased while chlamydia rates were stable. Case-based surveillance is influenced by testing and prevalence. Whether testing at STD clinics has returned to levels preceding the pandemic is unclear. We evaluated annual visits and CT/GC testing at STD clinics across multiple jurisdictions.

Methods:
We evaluated aggregate data from four jurisdictions (Louisiana, Michigan, North Carolina, and Virginia), as available: number of STD clinic visits (North Carolina and Virginia), number of unique people attending STD clinic visits (Michigan, North Carolina, and Virginia), CT/GC tests (Louisiana, Michigan, and Virginia), and unique people tested for CT/GC (Louisiana, Michigan, and Virginia) during 2018-2022. We averaged 2018 and 2019 counts to stabilize the period ‘pre-COVID’. We calculated the relative percentage change from 2021 to 2022 and pre-COVID to 2022. All outcomes were evaluated by sex; CT/GC tests were also evaluated by age and race/ethnicity.

Results:
From 2021-2022, there were increases in STD clinic visits (+10%, n=+9,696), persons visiting STD clinics (+11%, n=+10,150) and persons tested for CT/GC (+32%, n=+12,477); resulting totals in 2022 (n=108,881, n=100,107, n=51,228, respectively) were each approximately two-thirds their pre-COVID totals. Tests increased more slowly in 2021 for people aged <30 years (+26%, n=+5,246) compared to those ≥30 (+39%, n=+7,207). For people aged <30 years, total tests in 2022 (n=25,426) were half pre-COVID totals, compared to three-quarters the pre-COVID totals for people ≥30 (2022 tests: n=25,740). Findings did not differ by sex or race/ethnicity.

Conclusion:
Following pandemic-related reductions in staffing and services at STD clinics, gaps in visits and testing persist and were strongest among young people. Strengthened strategies to engage young people and promote STI services may improve the reach of health department STD programs.