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With the most STD cases in the nation, California needs to expand access to prevention and treatment
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With the most STD cases in the nation, California needs to expand access to prevention and treatment
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By Julie Rabinovitz and Aaron Fox, Special to CalMatters
Julie Rabinovitz is president and CEO of Essential Access Health, a nonprofit organization that promotes sexual and reproductive health care, jrabinovitz@essentialaccess.org. Aaron Fox is the director of government relations at the Los Angeles LGBT Center, a nonprofit provider of LGBT services, afox@lalgbtcenter.org. They wrote this commentary for CalMatters.
While California’s health system is focused on the COVID-19 pandemic, our state’s capacity to test, treat and conduct community tracing activities for sexually transmitted diseases has been dramatically reduced.
With already limited public health resources shifting away from STD prevention activities, rates are expected to surge. According to a recent survey by the National Association of City and County Health Officials, many local health departments have already experienced an increase and are discussing the risk for an outbreak during or following the COVID-19 crisis.
California has the unfortunate distinction of having the most reported cases of STDs in the nation. According to statistics released by the California Department of Public Health, nearly 340,000 Californians contracted an STD in 2018 – a 30-year high. In recent years, gonorrhea rates have increased by 211% and chlamydia rates by 56%. Since 2010, both syphilis and congenital syphilis rates have skyrocketed by 265% and 600%, respectively. Although California’s STD epidemic is affecting regions across the state, many counties including Los Angeles, San Francisco, Sacramento, Kern, San Joaquin, and Fresno have numbers much higher than state and national averages.
Health inequities also persist. Approximately 50% of all STDs in our state are experienced by youth ages 15-24. People of color, low-income populations and our LGBT communities are also disproportionately impacted.
Left unaddressed, STDs can lead to serious health consequences. Since many STDs don’t have obvious symptoms, they often go undetected and untreated. This can lead to long-term health problems including infertility and cancer. STDs also increase the transmission and acquisition of HIV, particularly among gay and bisexual men.
Although we have made great strides in expanding access to health care since the passage of the Affordable Care Act, coverage gaps remain for STD services.
This has caused too many Californians to forego care or be forced to be resourceful when they are ready to take control of their health. One client sought STD services at the Los Angeles LGBT Center in Hollywood because the center’s patient assistance program allowed him to get tested without paying any out of pocket costs. Getting tested not only allowed him to know his STD status, his blood work also revealed that he had leukemia. Although his diagnosis was scary, early detection allowed him to work with his care team to beat his leukemia.
We must ensure that all Californians can get the care they want and need to support their health and well-being. No one should be left without essential services because of their sexual orientation and who they love.
That’s why we are calling for California’s Family PACT (Planning, Access, Care and Treatment) program to be leveraged to provide a pathway to no-cost STD services for low-income and uninsured LGBT patients.
Family PACT has a network of trusted providers that have long been a resource for high quality, non-judgmental contraceptive and STD care for income-eligible women, men and teens. However, the program is restricted to individuals at-risk for experiencing or causing an unintended pregnancy. This means LGBT patients who need no-cost STD care are excluded from Family PACT services and benefits, and California does not have an alternative program to serve them.
We know the state’s economy will continue to be hit hard by the COVID-19 pandemic. Our state spends approximately $1 billion annually on health costs associated with STDs. Expanding access to STD prevention and treatment to all Californians is not only in line with California values, it is fiscally responsible. We cannot afford or accept inaction any longer.
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Julie Rabinovitz is president and CEO of Essential Access Health, a nonprofit organization that promotes sexual and reproductive health care, jrabinovitz@essentialaccess.org. Aaron Fox is the director of government relations at the Los Angeles LGBT Center, a nonprofit provider of LGBT services, afox@lalgbtcenter.org. They wrote this commentary for CalMatters.