Background The neighbourhoods surrounding Fort McPherson in southwest Atlanta, GA are in transition due to closure of the Fort in 2011 and pending redevelopment. Health services in the area are in transition due to budget cuts and changes to the US health system. Neighborhoods surrounding the Fort have some of the highest STD rates in the US. The objective of this assessment was to obtain community member and provider views on available services for sexual health, and potential changes to services as a result of redevelopment and health system changes.

Methods We carried out 35 in-depth interviews with representatives from 23 health and social service agencies and 12 community residents in July 2012. A checklist of available sexual and reproductive health services was administered to 18 agencies. Qualitative and checklist data were analysed using QSR’s NVivo 8 and MS Excel.

Results Providers and community members perceived that affordable, accessible options for sexual health care in the neighbourhoods adjacent to the Fort had severely declined in recent years, due to economic pressures and neighbourhood deterioration. Providers stressed the need for more holistic models of health care that address a range of client health and psychosocial needs, in addition to sexual health. While sexual health services are available within 5 miles of the Fort, there are significant social and structural barriers that may prevent community members from using them, including lack of awareness of existing services, cost, transportation barriers, stigma, and geographic and social isolation.

Conclusions Reaching vulnerable populations with sexual health services will continue to be challenging even as the US health system evolves. Nesting sexual health services within a broader array of health and social services, and developing stronger linkages and referral networks between STD programmes and other agencies may improve reach to those who most need these services.