STI Prevention

Local health departments (LHDs) are on the frontlines of sexually transmitted infection (STI) prevention, testing, and treatment. LHDs offer a multitude of services, including free or low-cost STI/HIV testing and treatment, partner services, and access to condoms, among other things. Additionally, sexual health education, community outreach, and STI/HIV screening events are often organized through LHDs. Health departments also serve as an important resource for healthcare providers by providing education and technical assistance on testing and treatment recommendations. Through the below projects, NACCHO continues to support LHDs in building capacity to address STI rates in their communities.

Recent Work

ABOUT THE PROJECT

NACCHO, with funding from the Centers for Disease Control and Prevention’s (CDC’s) Division of STD Prevention, initiated a project in October 2018 to support the use of CDC’s Recommendations for Providing Quality STD Clinical Services, published in January 2020. The Recommendations augment CDC’s Sexually Transmitted Infection Treatment Guidelines and are intended to be used as a tool to guide sexually transmitted disease clinical practice standards. This project facilitates implementation of the Recommendations by development of the STD QCS Planning Toolkit which includes an assessment tool as well as decision making and prioritization guidance and tools. Healthcare settings can use the tools to critically assess existing STD care service offerings in their facilities and identify opportunities to build, maintain, or enhance the delivery of those services.

The toolkit consists of three key components that walk healthcare settings through the process of critically assessing their services and determining whether additional services can or should be made available to address service gaps. These components include:

  • Assessing clinical services available by facility
  • Decision-making for building or enhancing STD clinical service delivery
  • Implementing next steps for the provision of quality STD clinical services

To use the assessment tool, you will need to register with NACCHO so that we can follow up as part of toolkit evaluation.

PROJECT RESOURCES

ABOUT THE PROJECT

In partnership with CDC’s Division of STD Prevention (DSTDP), NACCHO is supporting a diverse set of local jurisdictions/health departments across the U.S. to implement and evaluate a program strategy to improve congenital syphilis prevention and control efforts in their areas. The objective is to help galvanize local efforts to address rising rates of congenital syphilis and syphilis among pregnant individuals and individuals of child-bearing capacity. Specifically, innovations or improvements focus on one or more of the following areas: of congenital syphilis prevention:

  • Improving support for pregnant individuals who have syphilis
  • Improving support for pregnant individuals who do not have syphilis
  • Improving support for individuals with syphilis who could become pregnant but are not currently pregnant

The project will evaluate feasibility of innovations, barriers and facilitators to successful implementation, and the extent to which the innovation or improvement reached its intended targets and outcomes.

PROJECT RESOURCES

RECENT UPDATES

Funding Announcement for Congenital Syphilis Intervention and Evaluation - Applications Now Closed

In partnership with the CDC’s Division of STD Prevention, NACCHO will provide up to four local health departments with up to $25,000 each to implement and/or evaluate a program strategy that will improve congenital syphilis in their area. The objective is to help galvanize local efforts to address rising rates of congenital syphilis. Specifically, it will fund the implementation and evaluation of scalable interventions that focus on one or more of the following areas of congenital syphilis prevention:

  1. Linkage to prenatal care
  2. Syphilis and/or pregnancy screening in non-STD care/clinic settings
  3. Telehealth/medicine for individuals with syphilis who are pregnant

If your jurisdiction is already implementing an intervention that falls under one of these areas, it is permissible to apply just for evaluation of the intervention.

Visit NACCHO's website to learn more. The deadline to apply was January 27th, 2020.

ABOUT THE PROJECT

With funding from the CDC’s Division of STD Prevention (DSTDP), NACCHO leads the STI Express Initiative, which is designed to increase the evidence base for express STI clinical visits and support clinics in quality improvement efforts to strengthen, scale-up, and evaluate STI express models. We define STI express services as triage-based STI testing without a full clinical examination. Express services, also known as “fast-tracking,” are often associated with technology and automation and can reduce visit time, decrease time to treatment, and free up provider time; empower use of staffing models that utilize top of license strategies; enable self-collection of swabs; and increase opportunities to implement in diverse settings.

The STI Express Initiative has a number of components, including a Community of Practice with clinics that currently implement or are interested in implementing express STI visits, in-depth assessments with three sites to strengthen operational plans for STI express models, and a Data Collaborative through seven STI clinical sites will evaluate their express models across common variables; data from this project is forthcoming.

PROJECT RESOURCES

With funding from the CDC’s Division of STD Prevention (DSTDP), NACCHO and Cardea Services engaged seven sites in a multi-jurisdiction data collaborative to understand the impact of express STI services on patient characteristics and satisfaction; clinic capacity and time; STI testing and treatment outcomes; and cost. The final report, “Evaluating Sexually Transmitted Infection Express Services: Findings from a Multi-Site Data Collaborative,shows that express STI services increase clinic capacity, reduce time to treatment, and reduce visit time, therefore making them an important tool for increasing access and testing while maximizing available resources. The accompanying clinic guide Implementing Express STI Services: Considerations and Lessons Learned details multiple factors and real-life lessons learned that clinics should consider when designing and implementing an express STI model.

NACCHO additionally engaged Cardea to conduct in-depth assessments of three jurisdictions considering or planning to establish STI express services. NACCHO and Cardea visited Jackson, MS; Providence, RI; and San Francisco, CA to develop a better understanding of the role that STI express services can play in each jurisdiction and to explore clinical operations and resource requirements related to express visits. As a result of the in-depth assessments, Cardea developed a report with recommendations and considerations for each site, and for express models more generally. The executive summary is now available.

To learn more, visit our homepage for the STI Express Initiative, where you can access our issue brief, view conference posters from the STD Prevention 2020 conference regarding satisfaction and characteristics of express vs non-express patients, and watch our recent presentation from the 2020 Ryan White Conference. For questions or support, please contact Samantha Ritter, Director of Maternal, Adolescent, and Child Health, at sritter@naccho.org.

In partnership with CDC’s Division of STD Prevention (DSTDP), NACCHO is supporting three local health departments (LHDs) to strengthen partnerships with substance use disorder (SUD) treatment and other behavioral health (BH) providers and implement screening, brief intervention, and referral to treatment for high-risk substance use (HRSU) in STI clinics. The goals of this project are to assess the syndemic of STIs and HRSU and identify models for connecting STI clinic patients to SUD treatment and other BH services. For additional information, contact Kat Kelley, Senior Program Analyst, HIV, STI, & Viral Hepatitis (kkelley@naccho.org).

Additional Resources

NACCHO is working with the CDC Division of STD Prevention, the National Coalition of STD Directors, and the Public Health Accreditation Board to develop a national certification program for disease intervention specialists (DIS). The effort aims to strengthen and formalize the role of DIS, expand the recognition of DIS and the profession, ensure adequate training, and improve service provision and health outcomes. Learn more about this project here and by reading the article titled “Strengthening Public Health at Its Core: A Focus on Disease Intervention Specialist” in the Winter 2015 NACCHO Exchange.




During and beyond COVID-19, local health departments (LHDs) continue to work to find solutions so that all people have access to HIV/STI testing. Self-testing is one strategy for individuals who are unable or prefer not to visit traditional testing facilities.

Learn about local health departments implementing non clinic-based self-collected testing for HIV/STIs and access provider- and client-facing resources at our self-testing webpage below.

Stories from the Field provides a means for local health departments to share their experiences and demonstrate the value of public health.

To be featured on our blog, email Shalesha Majors (she/her) at smajors@naccho.org with an overview of your idea or program! Visit Stories From the Field to access more stories.

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NACCHO’s Model Practices Program nationally honors and recognizes outstanding local public health practice and shares the outstanding practices through the Model Practices Database. By submitting a practice, LHDs contribute to the overall improvement of public health through effective evidence-based practice methods.

Model Practices are awarded to local health departments across the country for implementing programs that demonstrate exemplary and replicable outcomes in response to an identified public health need. Promising Practices are exciting approaches and strategies to local public health issues that are on track to becoming Model Practices. Each awarded practice was reviewed by a committee of peers, made up of other local health department professionals, and selected from a competitive collection of applications.

View the drop-downs below to access select STI-related Model Practice and Promising Practice award winners from the last two years. To view all Model Practice awardees from previous years, visit our searchable database.

Application Title Award Status Year Awarded Health Department Name Keywords
MCHD-Grindr Partnership to Alert Grindr Users to Syphilis Outbreak Model Practice 2020 Monongalia County Health Department STI prevention, partnerships, promotion, outreach, MSM, social media, dating app, syphilis outbreak, sexual health
Public Health Detailing as a Strategy to Address Congenital Syphilis Model Practice 2020 Los Angeles County Department of Public Health (CA) STI prevention, partnerships, public health detailing, provider engagement, congenital syphilis, reproductive health, pregnancy, perinatal screening
Increasing Access to PrEP in a Sexual Health Clinic Model Practice 2020 Jefferson County Department of Health (AL) PrEP, STI, HCV testing, HCV treatment, HIV prevention
Be Well Maryland Mobile Wellness "Wellmobile" Model Practice 2020 Anne Arundel County Department of Health (MD) Harm reduction, mobile services, MAT, naloxone, HIV prevention, STI prevention, syringe exchange
Healthcare on the Spot: Integrated Mobile Treatment Promising Practice 2020 Baltimore City Health Department (MD) Harm reduction, mobile services, MAT, naloxone, HIV prevention, STI prevention, syringe exchange
The Ask: Partnering to Connect At-Risk Teens with Sexual Health Resources Promising Practice 2019 DuPage County Health Department (IL) Sexual health, adolescent health, education, HIV prevention, STI prevention, community engagement, coalition
Community Collaboration to Enhance STD Testing at a Juvenile Assessment Center Promising Practice 2019 Pinellas County Health Department (FL) STI prevention, adolescent health, corrections facility, chlamydia, gonorrhea, STI testing, partnerships, linkage to care

Policy Statements

NACCHO's policy statements and communications to Congress and the administration related to STIs are found below. The organization's Board of Directors determines positions on public health issues. Learn how local health departments have used NACCHO's policy statements to influence local, state and federal policy.

NACCHO members participate actively in the organization's policy development process through workgroups. The HIV, STI, and Viral Hepatitis Workgroup contributes to the development and revision of all STI-related policy statements. Learn more about this workgroup and apply to join here.

STI-related policy statements

        Health equity policy statements

        Letters to Congress and the Administration

          View more policy statements and letters to Congress and the administration on NACCHO's Policy and Advocacy page.

          Stay up to date on the latest HIV, STI, and viral hepatitis tools, news, and resources on our blog, The Essential Elements of Local Public Health! Click through the arrows below to see recent our recent posts or visit the blog to view all posts related to HIV, STI, and viral hepatitis.

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          New! RFA: Leveraging Retail Health Clinics and Pharmacies for STI Services and Care

          NACCHO, with support from the Centers for Disease Control and Prevention (CDC) Division of STD Prevention (DSTDP), will fund 2-4 projects up to $75,000 (per site) to develop, design, and implement a collaborative partnership between local health departments and retail health clinics or pharmacies to expand STI services and care. This project will offer essential information about the development of expanded STI patient care provided in retail health or pharmacy settings. Findings will be shared broadly with STD programs across the country. Full RFA can be found here. The deadline to apply is April 30, 2021 by 11:59PM PDT.

          An informational webinar was hosted for potential applicants on March 30, 2021. The slides from the webinar are posted here. Questions may be submitted to rhorowitz@naccho.org.

          Webinar Link
          Call in details: +1 301 715 8592, Meeting ID: 2159647452

          RFA: Pharyngeal Gonorrhea Test of Cure (TOC) Project

          In partnership with the Centers for Disease Control and Prevention (CDC), NACCHO is pleased to announce a Request for Applications (RFA) to galvanize local efforts to assess test of cure (TOC) for pharyngeal gonorrhea as a strategy to identify and prevent the spread of antimicrobial-resistant gonorrhea.

          NACCHO will fund up to 4 local health departments (LHDs) up to $100,000 each to implement pharyngeal gonorrhea TOC. This implementation will provide essential information about the feasibility of implementing TOC for all pharyngeal gonorrhea cases in clinical practice. Findings will be shared broadly with STD programs across the country.

          To learn more about the project, find the full RFA here and view a recording of our January 2021 webinar for potential applicants. Applications are now closed.

          RFA: Local Innovations in Congenital Syphilis Prevention

          In partnership with the CDC’s Division of STD Prevention, NACCHO's Local Innovations in Congenital Syphilis Prevention project will provide at least five local health departments with up to $25,000 each to implement and evaluate a program strategy that will improve congenital syphilis in their area. The objective is to help galvanize local efforts to address rising rates of congenital syphilis. To learn more about the project, view the recording and presentation slides from our informational webinar, held December 17, 2020. Applications are now closed.

          For questions about NACCHO's work regarding STI prevention, detection, and response, contact our STI specialists below.

          Community Health Program

          Rebekah Horowitz

          Senior Program Analyst, HIV, STI & Viral Hepatitis

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          Community Health Program

          Shalesha Majors

          Program Analyst, HIV, STI & Viral Hepatitis

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