An update from the CDC-Division of STD Prevention's Director
The past few months have brought a whirlwind of changes in our COVID-19 world. As we continue to adapt STD prevention and control in this unchartered territory, I’d like to share with you some new efforts we have been working on in the Division of STD Prevention (DSTDP). Here’s what we’ve been up to recently:
DSTDP Strategic Direction: COVID-19 Response
DSTDP COVID-19 Deployment
As of June 26, 2020, 42 percent of DTSDP staff have deployed to work on the COVID-19 response. Deployments average 40 days with many staff completing multiple deployments. Currently, 1 in 6 staff are deployed, including our deputy director, Raul Romaguera, DMD, MPH, who recently accompanied CDC Director Robert Redfield, MD, on a site visit to North Carolina, where CDC staff are supporting the Mecklenburg County Health Department in their COVID-19 response.
CDC Letters on Clinical Guidance When In-person, Patient-clinician Contact Is Limited
With limited facility-based services and in-person patient-clinician contact for STD prevention and care due to the COVID-19 pandemic, DSTDP has provided two letters outlining guidance on patient prioritization, phone or telemedicine-based triage and leveraging other clinics and/or pharmacies to ensure patients continue to receive needed treatment. The letters also provide clarification on the use of expedited partner therapy (EPT).
Disease Intervention Training Skills Vital to COVID-19 Response
The rapid COVID-19 response has highlighted the critical role our DIS workforce plays not just for STDs and HIV, but for disease investigation and emergency response. DIS skills are a vital asset with expertise in case investigation, education and counseling, contact tracing, linkage to care, and provider and community engagement. However, these honed skills require extensive on the job training that is not always available in emergencies. To meet the needs of an immediate, short and efficient COVID-19 training, DSTDP/CDC, along with our National Network of Disease Intervention Training Centers and the Association of State and Territorial Health Officials in partnership with the National Coalition of STD Directors are developing online knowledge-based and skills-based training programs for contact tracers, case investigators, and their supervisors. These trainings will serve as a national resource to support a highly trained DIS workforce for local and state health departments to use in addressing emerging infectious disease threats such as COVID-19.
Exploring STD Burden and Patterns During COVID-19
Early analysis shows that the number of cases of chlamydia, gonorrhea, and syphilis reported to CDC significantly decreased in March and April compared to the same months in 2019. As of June 17, week 15 in 2020 shows the percent of cases of gonorrhea and primary and secondary syphilis reported to CDC was 66% and 68% lower than the same time period in 2019. We continue to explore these trends and what this means for our STD prevention field.
Beyond surveillance data, DSTDP researchers are exploring innovative data sources to better understand the nation’s STD epidemic in the COVID-19 era. For example, data analysis of online forums, like Reddit, is helping us gain insight into the public’s health concerns and discussions regarding new technologies, partnering patterns, and questions regarding sexual health. We look forward to sharing more as those analyses progress.
Leveraging State of the Art Science
Missed Opportunities for Prevention of Congenital Syphilis
A new MMWR report reveals that gaps in testing and treatment result in 1 in 2 newborn syphilis cases in the United States. Analyzing commonly missed opportunities that prevent congenital syphilis, researchers found that nationally congenital syphilis cases resulted from a lack of adequate maternal treatment despite timely diagnoses of syphilis (31%), a lack of timely prenatal care (28%), and identification of syphilitic infections acquired during pregnancy after the first prenatal screening test too late to prevent congenital syphilis (11%). Commonly missed opportunities also differed by region, which underscores the importance of tailoring prevention solutions to the needs of affected communities.
UPDATED! Toolkit for Technology-based Partner Services
The Toolkit for Technology-based STD and HIV Partner Services is a general resource for health departments, community-based organizations, and others authorized to provide HIV/STD partner services to continue or improve their use of technology to trace and contact persons potentially exposed to HIV and other STDs in digital venues. The toolkit includes instructions for creating profiles and screen names, tips and techniques for contacting and interviewing clients while maintaining confidentiality, and numerous sample scripts for social networking sites, email, instant messaging, mobile devices, mobile applications, and texting.
The 2020 STD Prevention Conference Is Going Virtual!
With the evolving COVID-19 pandemic, this year’s conference will be entirely virtual. Spanning two weeks from September 14-24, 2020, attendees will be able to enjoy a mix of live sessions, recordings, and virtual meeting spaces to network with colleagues. Visit the conference website for the latest news on the conference. Register for the 2020 STD Prevention Conference today!
STI Treatment Guidelines
CDC’s next edition of the STI Treatment Guidelines is now in clearance. Stay tuned for further updates.
SNEAK PEEK: Scaling Up STI Self-Collected Testing Options Outside of Clinical Facilities in the United States
With clinic closures, expanding telehealth practices, and many staff working on the frontlines for COVID-19, DSTDP staff with other NCHHSTP programs are involved in developing a phased approach to increase STI self-collected testing outside of clinical facilities along with HIV and Viral Hepatitis self-testing. We will continue to provide updates on this exciting area of STD prevention opportunities in the coming months.
As always, thank you to everyone for continuing to support STD prevention and control efforts and to those who are involved in the COVID-19 response. We incredibly value and appreciate everyone’s contributions as we continue to work towards reducing the incidence and prevalence of these infections in our communities.
Gail Bolan, MD
Director, Division of STD Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention