Assessing Partner Services Provided by State and Local Health Departments, 2018.

BACKGROUND: Surveillance reports have shown that reported sexually transmitted diseases (STDs) are increasing. The provision of partner services is an effective tool for preventing and reducing the spread of STDs. We examined partner services provided by health departments and assessed for associations with jurisdiction size, STD morbidity, and region. METHODS: We used stratified random sampling to select 668 local health departments (LHDs) and selected all (n = 50) state health departments (SHDs). Rao-Scott χ2 analyses were performed to examine partner services by health department type (SHD vs. LHD), region, jurisdiction size (LHD only), and STD morbidity (LHD only). RESULTS: Approximately 49.0% of LHDs and 88.0% of SHDs responded to the survey. Most LHDs (81.6%) and SHDs (79.5%) provided partner services for some STDs (P = 0.63). Compared with SHDs, a higher proportion of LHDs provided expedited partner therapy for chlamydia (66.8% vs. 34.2%, P < 0.01) and gonorrhea (39.3% vs. 22.9%, P = 0.09). Partner service staff performed other activities such as conducting enhanced surveillance activities (23.0% of LHDs, 34.3% of SHDs; P = 0.20) and participating in outbreak response and emergency preparedness (84.8% of LHDs, 80.0% of SHDs; P = 0.51). Associations were found when partner services were stratified by health department type, jurisdiction size, STD morbidity, and region. All LHDs in high-morbidity areas provided partner services and 45.4% performed serologic testing of syphilis contacts in the field. CONCLUSIONS: A majority of STD programs in LHDs and SHDs provide a variety of partner services and partner service-related activities. It is imperative to continue monitoring the provision of partner services to understand how critical public health needs are being met.

Availability of Safety-net Sexually Transmitted Disease Clinical Services in the U.S., 2018.

INTRODUCTION: Safety-net sexually transmitted disease services can prevent transmission of sexually transmitted disease. This study assesses the availability of safety-net sexually transmitted disease clinical services across the U.S. METHODS: A 2018 survey of U.S. local health departments examined the availability of safety-net providers and the availability of specific sexually transmitted disease clinical services, including point-of-care testing and treatment. In 2019, Rao-Scott chi-square tests were used to compare service availability by clinic type (sexually transmitted disease clinic versus other clinics). RESULTS: A total of 326 local health departments completed the survey (49% response rate). Of respondents, 64.4% reported that a clinic in their jurisdiction provided safety-net sexually transmitted disease services. Having a safety-net clinic that provided sexually transmitted disease services was more common in medium and large jurisdictions. Sexually transmitted disease clinics were the primary provider in 40.5% of jurisdictions. A wide range of specific sexually transmitted disease services was offered at the primary safety-net clinic for sexually transmitted diseases. Most clinics offered human papillomavirus vaccination and appropriate point-of-care treatment for gonorrhea and syphilis. Fewer than one-quarter of clinics offered point-of-care rapid plasma reagin or darkfield microscopy syphilis testing. Compared with other clinics, services more commonly offered at sexually transmitted disease clinics included same-day services, hepatitis B vaccination, rapid plasma reagin testing (syphilis), any point-of-care testing for gonorrhea, point-of-care trichomonas testing, and extragenital chlamydia or gonorrhea testing. CONCLUSIONS: One-third of local health departments reported no safety-net sexually transmitted disease services or were not aware of the services, and availability of specific services varied. Without an expansion of resources, local health departments might explore collaborations with healthcare systems and innovations in testing to expand sexually transmitted disease services.