At first glance, the numbers look promising.
During the first seven months of 2020, according to preliminary data provided by the Baltimore Health Department, reports of sexually transmitted diseases were down in the city. Compared to last year, reports of chlamydia decreased by 20%. Reports of gonorrhea and HIV dropped, too.
But these numbers may be deceiving, thanks in large part to complications caused by the coronavirus pandemic, warned Dr. Adena Greenbaum, assistant commissioner of clinical services at the city’s health department. In fact, she and other sexual health experts are bracing for STD rates to get worse.
“That’s just STDs that were reported — it doesn’t mean that they weren’t there,” she said of the preliminary data, which has yet to be finalized. “I don’t think the actual decrease in STDs was that severe during that time. I just think it really shows what happens when the reporting system closes down, or really gets reduced capacity.”
The pandemic has forced clinics and health care providers to cut back on in-person testing services and outreach efforts. With a new infectious disease to track, Baltimore City has also had to divert its contact tracing manpower from STDs.
Even before COVID-19 hit, STDs were at an all-time high across the U.S. According to an analysis done by a health services research group on data released by the Centers for Disease Control and Prevention, Baltimore City had the highest STD rate in the country, with 2,004 cases per 100,000 people as of 2018.
Still, the concerns of Baltimore experts are echoed nationwide. A National Coalition of STD Directors survey at the start of the pandemic found that 83% of STD programs reported deferring services or field visits as a direct result of the coronavirus, and 66% of clinics reported a drop in sexual health screening and testing. All jurisdictions surveyed expressed concern about how the service restrictions would impact the vulnerable populations they serve.
In Baltimore, before the pandemic, no appointment was necessary to visit one of the two sexual health clinics run by the city’s health department. Now walk-ins aren’t permitted, and the city is only offering limited testing to those who are symptomatic — encouraging others to request a personal test kit from a program run out of Johns Hopkins University. Additionally, the city has yet to send its mobile outreach vans back out into the community.
Chase Brexton Health Care, however, has continued offering HIV testing on a walk-in basis. The health network’s social workers have also “intensified” outreach to their existing patients with HIV, reaching quite a few who had fallen out of care, said Dr. Sebastian Ruhs, chief medical officer for Chase Brexton. Perhaps as a result, he said, the number of patients who have an undetectable viral load has improved slightly during the pandemic.
However, the network hasn’t been able to continue offering testing for other types of STDs for those who aren’t Chase Brexton patients, due to COVID-19 restrictions and staffing issues.