Declining trends in the proportion of non-viral sexually transmissible infections reported by STD clinics in the US, 2000–10*
Kwame Owusu-EduseiA Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road M/S E-80, Atlanta, GA 30333, USA.
B Corresponding author. Email: Kowusuedusei@cdc.gov
Sexual Health 11(4) 340-344 https://doi.org/10.1071/SH14057
Submitted: 19 March 2014 Accepted: 9 July 2014 Published: 18 August 2014
Abstract
Background: Recent budget shortfalls may have resulted in decreases in the number of sexually transmissible infections (STIs) reported from sexually transmitted disease clinics (STDCs) in the United States (US). The objective of this study was to examine the proportion of cases reported from STDCs for three non-viral STIs in the last decade. Methods: Data from the national surveillance database on primary and secondary (P&S) syphilis, gonorrhoea and chlamydia cases for 2000–10 were extracted. The percentage of cases reported by STDCs for the nation and for each of the 48 contiguous states were then computed. Finally, the χ2 trend test for proportions was used to determine the annual average decrease/increase in the percentage of cases reported by STDCs for the nation and for each state. Results: Results demonstrate that the average annual declines in the proportion of P&S syphilis, gonorrhoea, and chlamydia cases reported from STDCs were 1.43% (P < 0.01), 1.31% (P < 0.01), and 0.31% (P < 0.01), respectively. Additionally, most of the states with statistically significant trends (P < 0.05) in the proportion of cases reported by STDCs had negative slopes: 86% (25/29) for P&S syphilis, 89% (34/38) for gonorrhoea, and 63% (27/43) for chlamydia. Conclusion: These results document the declining role of STDCs in STI prevention and control efforts in the US. Further studies are needed to assess the direct or indirect impact of the decline in the proportion of cases from STDCs on the overall STI control and prevention efforts in the US and its implications for the future.
Additional keywords: chlamydia, gonorrhoea, syphilis, trend analyses.
References
[1] Owusu-Edusei K, Chesson HW, Gift TL, Tao G, Mahajan R, Ocfemia MC, et al The estimated direct medical cost of selected sexually transmitted infections in the United States, 2008. Sex Transm Dis 2013; 40 197–201.| The estimated direct medical cost of selected sexually transmitted infections in the United States, 2008.Crossref | GoogleScholarGoogle Scholar | 23403600PubMed |
[2] Satterwhite CL, Torrone E, Meitis E, Dunne EF, Mahajan R, Ocfemia MC, et al Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis 2013; 40 187–93.
| Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008.Crossref | GoogleScholarGoogle Scholar | 23403598PubMed |
[3] Weinstock H, Berman S, Cates W. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health 2004; 36 6–10.
| Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000.Crossref | GoogleScholarGoogle Scholar | 14982671PubMed |
[4] Centers for Disease Control and Prevention. Sexually transmitted disease surveillance, 2010. Atlanta, GA: U.S. Department of Health and Human Services; 2011.
[5] Chorba T, Scholes D, BlueSpruce J, Operskalski BH, Irwin K. Sexually transmitted diseases and managed care: an inquiry and review of issues affecting service delivery. Am J Med Qual 2004; 19 145–56.
| Sexually transmitted diseases and managed care: an inquiry and review of issues affecting service delivery.Crossref | GoogleScholarGoogle Scholar | 15368779PubMed |
[6] Golden MR, Kerndt PR. Improving clinical operations: can we and should we save our STD clinics? Sex Transm Dis 2010; 37 264–5.
| 20182405PubMed |
[7] Owusu-Edusei K, Doshi SR. Assessing spatial gaps in sexually transmissible infection services and morbidity: an illustration with Texas county-level data from 2007. Sex Health 2012; 9 334–40.
| Assessing spatial gaps in sexually transmissible infection services and morbidity: an illustration with Texas county-level data from 2007.Crossref | GoogleScholarGoogle Scholar | 22877592PubMed |
[8] Owusu-Edusei K, Doshi SR. County-level sexually transmitted disease detection and control in Texas: do sexually transmitted diseases and family planning clinics matter? Sex Transm Dis 2011; 38 970–5.
| County-level sexually transmitted disease detection and control in Texas: do sexually transmitted diseases and family planning clinics matter?Crossref | GoogleScholarGoogle Scholar | 21934575PubMed |
[9] Felsenstein D. A universal health insurance mandate does not equate to universal coverage for STI clinic patients (C3.3). National STD Prevention Conference; 12–15 March 2012, Minneapolis, MN, USA. 2012. Available online at: https://cdc.confex.com/cdc/std2012/webprogram/Paper29952.html [verified 10 December 2012].
[10] Wong W. Fact sheet: STD program capacity and preparedness in the United States: results of a National Survey. Washington, DC: National Coalition of STD Directors; 2009.
[11] Eubanks C, Lafferty WE, Kimball AM, MacCornack R, Kassler WJ. Privatization of STD services in Tacoma, Washington: a quality review. Sex Transm Dis 1999; 26 537–42.
| Privatization of STD services in Tacoma, Washington: a quality review.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c%2FgtFOktA%3D%3D&md5=a12b86e33de7b1772c3571b0448f9714CAS | 10534209PubMed |
[12] St. Lawrence JS, Montano DE, Kasprzyk D, Phillips WR, Armstrong K, Leichliter JS. STD screening, testing, case reporting, and clinical and partner notification practices: a national survey of US physicians. Am J Public Health 2002; 92 1784–8.
| STD screening, testing, case reporting, and clinical and partner notification practices: a national survey of US physicians.Crossref | GoogleScholarGoogle Scholar | 12406809PubMed |