Aiming to Improve Sexual Health and Reduce Health Disparities in the St. Louis Area, Washington University Infectious Disease Physicians Expand Screening and Treatment Services for Sexually Transmitted Infections in northern St. Louis County.
The St. Louis region has some of the highest rates of sexually transmitted infections (STIs) in the country, with the burden falling particularly heavily on Black residents and people with marginalized sexual orientations and gender identities.
Aiming to reduce disparities and improve overall sexual health in the region, the Division of Infectious Diseases at Washington University School of Medicine in St. Louis will offer expanded STI testing and treatment services in its Village Square clinic, located north of Saint-Louis. County, a historically medically underserved area. The effort is supported by a five-year, $2.5 million grant from the Centers for Disease Control and Prevention and is part of a national program to expand access to comprehensive sexual health services.
“St. Louis’ STI rates are very concerning,” said Hilary Reno, MD, PhD, professor of medicine and principal investigator of the grant. An STI specialist, Reno sees patients at the Village Square clinic. “Syphilis rates have more than doubled since 2015. We have started to see more cases of congenital syphilis, which can lead to babies being born with physical defects and neurological problems, including blindness or deafness. as to end the HIV epidemic. And the disparities are shocking. STI rates are 11 to 19 times higher among black residents than among white residents in St. Louis County. public health community to recognize that what we are doing is not enough and to find better ways to provide people with the services they need.
Part of the problem is that the parts of the St. Louis region with the highest rates of STIs – the city and north county of St. Louis – are also places where access to sexual health care is minimal. In the absence of specialized clinics, many people use hospital emergency departments to test and treat STIs. Although emergency departments can and do provide such services, they are not equipped to provide comprehensive STI care, such as follow-up care, contact tracing, and prevention education.
The expansion of services offered by the Village Square Clinic in Hazelwood is a first step toward improving testing and care options for residents of northern St. Louis County. The clinic was established in 2023 primarily to provide care to people living with HIV and offered a limited number of walk-in HIV tests. With support from this grant, the clinic aims to provide free or low-cost walk-in testing to all, as well as treatment, if needed, for walk-in patients and their sexual partners. The clinic will also provide the HIV preventative medication PrEP, which is taken regularly to reduce the risk of infection, as well as two medications to take within hours of potential exposure to an STI: PEP (for HIV ) and doxyPEP (for HIV). syphilis, chlamydia and gonorrhea). Ultimately, the plan is to expand prevention education in Village Square and establish mobile services to reach other underserved communities in northern St. Louis County.
The details of what services will be offered and how have yet to be determined. The first year of the five-year project is dedicated to working with community members to develop a plan tailored to the needs and preferences of the community. Priority will be given to meeting the needs of the most underserved members of the community, including people living with HIV; gender and sexual minorities; young adults; and people of color, especially black women.
I once heard someone say, “You don’t need focus groups if you bring in the right voices from the start.” When people have symptoms of an STI or learn that someone they have had sexual contact with is infected, it is extremely important to be able to be seen by a doctor and get care and treatment very quickly. Not only does this make them feel better, but it also helps reduce transmission, which benefits the entire community. What we hope to do is create clinical care options that the community actually wants so that we can meet their health care needs and begin to reduce STI rates in the region.
Hilary Reno, MD, PhD, professor of medicine and principal investigator on the grant
Along with Reno, the team includes Ernie-Paul Barrette, MD, professor of medicine at Washington University and medical director of the Village Square Clinic, as well as the St. Louis County Department of Public Health; Planned Parenthood of the St. Louis area; Christian Hospital, a BJC HealthCare hospital near Village Square Clinic; SPOT, a University of Washington clinic for youth and young adults; and the Saint-Louis STI/HIV Prevention Training Center.