Background:
Most STD clinics focus solely on STD treatment and prevention, however women presenting for care are also at high-risk for unintended pregnancy.

Objective:
To describe an integrated family planning program developed within an existing STD clinic that compliments STD services.

Method:
Computerized record review of female visits seen for family planning services (FPS) at an STD clinic from 4/01 to 6/05 was performed. Services were for women (13-49 years) needing FPS, with most women transitioned to primary care after evaluation. Descriptive statistics and Cochran-Armitage trend analyses were performed.

Result:
To date, 5330 women have received FPS. Participants receiving both STD and FPS increased from 26% in 2001 to 67% in 2005 (p<0.0001). In 2001, 1 of 9 STD clinicians were cross-trained in FPS, which increased to 5 of 7.5 in 2005, with all clinicians providing emergency contraception (EC). Participation has been highest among young patients (74% <25 yrs vs. 26% ≥25 yrs), with the racial breakdown being 66% Caucasians and 22% African-American, and 38% being Hispanic ethnicity. Most women (81%) were ≤150% of the Federal Poverty level and have no health insurance (67%). At enrollment, 85% reported sex with ≥1 partner during the previous month, 47% were previously pregnant, 19% had a previous therapeutic abortion, and 76% were using no contraception. Overall, 23% had an STD, decreasing from a rate of 28% in 2001 to 19% in 2005 (p<0.001). Services included pregnancy testing/options 3%, preconception counseling 3%, and initial contraception services: 90% condoms, 49% pills/patch, 9% depo, 8% EC. Most (83%) were referred to primary care for ongoing reproductive healthcare, with 17% referred to our teen/continuity clinic.

Conclusion:
Integrating family planning with STD services in an STD clinic is feasible and does not require STD clinicians to provide long-term contraception management.

Implications:
STD clinics should provide integrated pregnancy and STD prevention services.