Background: The successful prevention and control of sexually transmitted diseases (STD) requires a stable, well-funded state and local public health infrastructure. The impact of the current economic recession on STD programs is unknown.
Objectives: To describe program capacity and the impact of the economic recession on STD control programs in the US; to describe STD program contributions to public health preparedness.
Methods: A self-administered survey of STD program directors in state and local health departments (LHD) in all 50 states and selected health jurisdictions was conducted in Sept 2009.
Results: Sixty-four (81%) of 79 eligible jurisdictions completed the survey. Respondents were state (80%) and LHD (20%). State and local governments enacted salary freezes or reductions in 64%, furlough and government shutdown days in 47%, and staff layoffs in 25% of STD programs. Among 39 jurisdictions that operate STD clinics, 10 (25%) reported recent clinic closures; nationwide, 32 STD clinics closed in 2008-9. Program reductions affected STD clinical and laboratory services (20/64, 31%), disease intervention (23/64, 36%), and STD screening tests (17/64, 27%). The majority (68%) of programs experienced funding cuts, including half receiving cuts in state and local support (48%) and federal CDC funding (54%). Almost all (85%) STD programs trained staff in public health preparedness. Two-thirds (67%) of STD programs directly participated in H1N1 influenza outbreak activities in Spring 2009, and 76% of STD programs anticipate participation in H1N1 response during the 2009-10 influenza season.
Conclusions: State and local STD program capacity and infrastructure has severely eroded. Capacity reductions come at a time of increased demand for public health response.
Implications for Programs, Policy, and/or Research: Without additional support for state and local programs, STDs and HIV will increase and local capacity for emergency response will diminish. Funding to support STD control and public health infrastructure is urgently needed.
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