Background: Investments in the healthcare system are increasing the proportion of insured individuals. There will be shifts for some historically vulnerable and at-risk populations, which may reduce reliance on the STD public health safety net. In light of this, the STD AAPPS Funding Opportunity Announcement required awardees to provide at least 13.5 percent of the overall award amount to non-profit organizations, including those with or without 501(c)(3) designation and health department clinics, that have demonstrated their ability to provide safety net STD clinical preventive services serving uninsured populations.
Methods: We developed an administrative reporting template to determine how the 13.5% funds have been used by awardees in 2014 to support safety net STD clinical preventive services. Using SAS, we analyzed data from all 59 awardees. We collected information on clinical partner types, number of clients served, description of STD tests performed and associated positivity for tests funded by AAPPS.
Results: Based on aggregate data, awardees reported funding or providing in-kind support, such as STD test kits, to a total of 2,854 clinical partner sites, including community health centers, school based clinics, and juvenile correctional facilities. Of those that reported data on billing, 48.5% of their total number of patients aged 16-44 years were uninsured or underinsured. Over 73% of these clinical partner sites were identified as family planning clinics or state or local public STD clinics. Of the AAPPS-supported syphilis (n=163,595), chlamydia (n=603,560), and gonorrhea (n=578,664) tests performed, 1.4% were positive for newly diagnosed syphilis cases, 11.9% were positive for chlamydia, and 4.1% were positive for gonorrhea.
Conclusions: STD AAPPS funded programs are partnering with safety net clinical providers who are serving at-risk uninsured or underinsured patients. There is a need to continue support for STD safety-net clinical preventive services for the most vulnerable populations post Affordable Care Act implementation.