“Sex in the Time of COVID”: Clinical Guidelines for Sexually Transmitted Disease Management in an Era of Social Distancing

Barbee, Lindley A; Dombrowski, Julia C.; Hermann, Susannah; Werth, Brian J.; Ramchandani, Meena; Ocbamichael, Negusse; Barash, Elizabeth; Golden, Matthew R.

doi:10.1097/olq.0000000000001194

Cited by 28 publications

(39 citation statements)

References 11 publications

(8 reference statements)

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“…However, the authors are unaware of evidence to support such a change, and there is evidence to support the notion that sex and casual encounters were still occurring. 21 , 22 , 23 , 24 …”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Chlamydia and Gonorrhea Screening in the U.S.

Pinto

Niles

Kaufman

et al. 2021

American Journal of Preventive Medicine

100

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Introduction: This study evaluates the impact of the COVID-19 pandemic on testing for common sexually transmitted infections. Specifically, changes are measured in chlamydia and gonorrhea testing and case detection among patients aged 14−49 years during the COVID-19 pandemic.Methods: U.S. chlamydia and gonorrhea testing and positivity were analyzed on the basis of >18.6 million tests (13.6 million tests for female patients and 4.7 million tests for male patients) performed by a national reference clinical laboratory from January 2019 through June 2020.Results: Chlamydia and gonorrhea testing reached a nadir in early April 2020, with decreases (relative to the baseline level) of 59% for female patients and 63% for male patients. Declines in testing were strongly associated with increases in weekly positivity rates for chlamydia (R 2 =0.96) and gonorrhea (R 2 =0.85). From March 2020 through June 2020, an expected 27,659 (26.4%) chlamydia and 5,577 (16.5%) gonorrhea cases were potentially missed. Conclusions:The COVID-19 pandemic impacted routine sexually transmitted infection services, suggesting an increase in syndromic sexually transmitted infection testing and missed asymptomatic cases. Follow-up analyses will be needed to assess the long-term implications of missed screening opportunities. These findings should serve as a warning for the potential sexual and reproductive health implications that can be expected from the overall decline in testing and potential missed cases.

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“…However, the authors are unaware of evidence to support such a change, and there is evidence to support the notion that sex and casual encounters were still occurring. 21 , 22 , 23 , 24 …”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Chlamydia and Gonorrhea Screening in the U.S.

Pinto

Niles

Kaufman

et al. 2021

American Journal of Preventive Medicine

100

View full text Add to dashboard Cite

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“…Prior to the COVID-19 pandemic, the HIV epidemic in the United States was experiencing modest downtrends due in part to successful harm reduction strategies, such as HIV pre-exposure prophylaxis (PrEP), as well as increasing testing to identify new cases, improving linkage to care, and more convenient and tolerable dosing of antiretroviral (ART) therapy [ 7 ]. Early COVID-19 mitigation strategies affected our ability to provide prompt, in-person care, leading to a tremendous shift to virtual medicine platforms, including telephone and video telemedicine [ 8 ]. This transition allowed care to continue for many, highlighting a new avenue for ongoing care [ 9 ].…”

Section: Covid-19 Impact On Hiv and Sexual Healthcarementioning

confidence: 99%

HIV and COVID-19: Lessons From HIV and STI Harm Reduction Strategies

Gravett

Marrazzo

2021

Curr HIV/AIDS Rep

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Purpose of Review This review highlights the intersection of the COVID-19, HIV, and STI pandemics and examines how harm reduction strategies can be applied broadly to controlling a pandemic. Recent Findings Since the onset of the COVID-19 pandemic, remarkable advances in the understanding of COVID-19 prevention, diagnosis, and treatment have been made at a much faster pace than prior pandemics, yet much more still remains to be discovered. Many of the strategies to control the COVID-19 pandemic mirror those employed to stem the HIV pandemic. Summary Harm reduction principles used in the HIV pandemic can be applied to reduce the morbidity and mortality of the COVID-19 pandemic through effective prevention, detection, and treatment strategies.

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“…COVID-19 has disproportionately affected non-white, historically marginalized communities in the US, ranging from African Americans ( 40 ) to Native Americans ( 41 ). Moreover, the COVID-19 pandemic continues to threaten access to sexual health services, including follow-up care such as expedited partner tracing ( 42 , 43 ), and thus may further exacerbate existing racial/ethnic health disparities. A recent survey of sexual health providers indicated that only 18% of respondents could offer STI testing to asymptomatic patients, 80% were treating patients without diagnostic testing, and only 25% of respondents could maintain HIV testing ( 42 ).…”

Section: Unique Impact Of Covid-19mentioning

confidence: 99%

“…A recent survey of sexual health providers indicated that only 18% of respondents could offer STI testing to asymptomatic patients, 80% were treating patients without diagnostic testing, and only 25% of respondents could maintain HIV testing ( 42 ). Recommendations for providing STI clinical care during the COVID-19 pandemic include deferring asymptomatic patient screening visits, resorting to syndromic management using phone-based interviews, and treating with oral instead of intramuscular antibiotics ( 43 ).…”

Section: Unique Impact Of Covid-19mentioning

confidence: 99%

“…EPT is not legal in all states, and many states do not allow billing of the patient’s insurance for their partner’s treatment, creating a financial barrier to care than may adversely affect marginalized groups ( 39 ). In addition, budget cuts or reassignment of public health staff for other public health responses, such as the ongoing SARS-CoV-2 pandemic, can negatively impact patient follow-up and partner services ( 28–30 , 42 , 43 ).…”

Section: Post-analytical Challengesmentioning

confidence: 99%

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Laboratory Perspective on Racial Disparities in Sexually Transmitted Infections

Lieberman

Cannon

Bourassa

2020

The Journal of Applied Laboratory Medicine

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Background Rates of sexually transmitted infections (STI) have risen steadily in recent years, and racial and ethnic minorities have borne the disproportionate burden of STI increases in the United States. Historical inequities and social determinants of health are significant contributors to observed disparities and affect access to diagnostic testing for STI. Content Public health systems rely heavily on laboratory medicine professionals for diagnosis and reporting of STI. Therefore, it is imperative that clinicians and laboratory professionals be familiar with issues underlying disparities in STI incidence and barriers to reliable diagnostic testing. In this mini-review, we will summarize contributors to racial/ethnic disparity in STI, highlight current epidemiologic trends for gonorrhea, chlamydia, and syphilis, discuss policy issues that affect laboratory and public health funding, and identify specific analytic challenges for diagnostic laboratories. Summary Racial and ethnic disparities in STI in the US are striking and are due to complex interactions of myriad social determinants of health. Budgetary cuts for laboratory and public health services and competition for resources during the COVID-19 pandemic are major challenges. Laboratory professionals must be aware of these underlying issues and work to maximize efforts to ensure equitable access to diagnostic STI testing for all persons, particularly those most disproportionately burdened by STI.

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“Sex in the Time of COVID”: Clinical Guidelines for Sexually Transmitted Disease Management in an Era of Social Distancing

Cited by 28 publications

References 11 publications

Impact of the COVID-19 Pandemic on Chlamydia and Gonorrhea Screening in the U.S.

Impact of the COVID-19 Pandemic on Chlamydia and Gonorrhea Screening in the U.S.

HIV and COVID-19: Lessons From HIV and STI Harm Reduction Strategies

Laboratory Perspective on Racial Disparities in Sexually Transmitted Infections

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