The San Francisco Department of Public Health (SFDPH) Population Health Division (PHD) is a leader in STD and other communicable disease surveillance and has successfully maintained a robust, integrated STD surveillance platform. SFDPH PHD has identified a significant burden of STDs among San Francisco residents and prioritizes surveillance and prevention efforts among two priority populations experiencing health inequities due to excess rates: (1) adolescent and young adult males and females, particularly those of color, and (2) gay, bisexual, and other men who have sex with men. While STD rates and risk for adverse outcomes (e.g., congenital syphilis and neurosyphilis) are increasing, SFDPH PHD STD Program staff size remains unchanged and resources are effectively decreasing. SFDPH PHD will leverage STD PCHD activities to more strategically meet the goals of reducing disease incidence and sequelae. SFDPH PHD will enhance its data-driven prioritization of public health activities and conduct evaluation for continuous quality improvement of client services and novel interventions. SFDPH PHD will build on its foundation of data-informed decision-making and policy-level collaboration to meet growing and more complex public health needs by integrating sexual health services; establishing community-based partnerships to ensure comprehensive, patient-centered care for people diagnosed with or at risk of STDs; and further improving completeness and use of surveillance and program data to increase the effectiveness, efficiency, and impact of targeted STD prevention and care.
SFDPH PHD STD PCHD activities will build upon ongoing efforts to (1) integrate and streamline sexual health services (e.g., STD, HIV, and HCV testing and clinical management) across SFDPH PHD and (2) bolster the capacity of both SFDPH and non-SFDPH providers to conduct routine, appropriate STD screening and treatment. Building upon experiences with community providers who target key populations with high STD/HIV burden or risk for associated complications, we can expand STD screening and partner follow-up through primary care, non-traditional, and community-based settings (e.g., jails, pharmacies) and evaluate the impact on STD morbidity, treatment, reinfections, and utilization of the municipal STD clinic. The increasing complex needs of STD patients associated with homelessness, drug use, and other behavioral health issues requires partnerships with agencies that address these needs.
SFDPH PHD is a community- and client-centered organization with Branches that work together in multi-disciplinary teams to address complex public health issues. The SFDPH PHD STD PCHD Project draws upon staff expertise to enhance the understanding of trends and determinants of STDs, thereby improving the ability to evaluate outcomes and develop effective and efficient interventions to reduce STD morbidity. The SFDPH PHD mission and strategic objectives are directly aligned with STD PCHD, through which we can improve our capacity in the core public health functions of assessment, assurance, and policy development to monitor the practice and use of STD prevention and care services.