Article Text

PDF

Health services and policy poster session 6: services
P5-S6.08 STD surveillance and control: do STD and family planning clinics matter?
  1. S Doshi,
  2. K Owusu-Edusei
  1. Centers for Disease Control and Prevention, Atlanta, USA

Abstract

Background Information on the potential impact of the presence of an STD and/or family planning (FP) clinic on STD surveillance and control is scant. In the study, we examine the impact of STD and/or publicly funded Title V, X, and XX FP clinics on county-level surveillance and control of three reportable STDs (chlamydia (CT), gonorrhoea (GC) and primary and secondary syphilis (P&S)) in Texas during 2000 and 2007. Specifically, we examined the following two questions: (1) Are the counties with STD/FP clinics reporting relatively more cases of STDs? (2) Does having STD service(s) (the presence of an STD/FP clinic) in a county matter?

Methods We used spatial regression to analyse the impact of STD/FP clinics on county-level STD morbidity using surveillance data on CT, GC, and P&S. the impact of STD/FP clinics on STD control was examined using a backward stepwise regression on the changes in incidence rates between 2000 and 2007. Dummy variables represented the presence of STD/FP clinic(s). Incidence rates were transformed into natural logs. County-level demographics for 2000 and 2007 were used as control variables.

Results The coefficients on the dummy variables representing the presence of STD/FP clinics were: 0.11 (95% CI 0.05 to 0.16, p<0.01) in 2000 and 0.07 (CI 0.02 to 0.12, p<0.01) in 2007 for CT; 0.13 (CI 0.05 to 0.20, p<0.01) in 2000 and 0.06 (CI −0.002 to 0.12, p<0.01) in 2007 for GC and 0.18 (CI 0.12 to 0.23, p<0.01) in 2000 for P&S (2007 was not significant). This implies that the transformed GC and CT rates in the counties with STD/FP clinics increased by at least 6% in 2000 and 2007, while P&S increased by 18% in 2000. The coefficient for the changes in rates between 2000 and 2007 were: −0.04 (CI 0.01 to −0.09, p<0.10) for CT; −0.08 (CI −0.02 to −0.14, p<0.01) for GC and −0.09 (CI −0.03 to −0.15, p<0.01) for P&S. Thus, the transformed incidence rates of GC and P&S reduced by 8% and 9%, respectively, between 2000 and 2007 for those counties that had at least one STD/FP clinic.

Conclusion The results from this ecological study are consistent with (but do not establish) a causal relationship between having an STD/FP clinic and improved surveillance and/or reduction in STDs at the county-level in Texas. However, the results suggest that STD/FP clinics play an important role in STD surveillance and control. Finer level analyses (such as census block or cities) may be able to establish a strong causal relationship.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.