Three years post-Affordable Care Act sexually transmitted disease clinics remain critical among vulnerable populations

Post Date: 
2018-06-18
Publication: 
American Journal of Preventive Medicine
Summary: 


INTRODUCTION:

The purpose of the study is to examine whether demand for publicly funded sexually transmitted disease clinics changed after Affordable Care Act implementation.



METHODS:

The percentages of total incident sexually transmitted infections in Baltimore City that occurred at publicly funded sexually transmitted disease clinics were compared between the 3 years prior to and following the 2014 Medicaid and private insurance expansions. Risk factors associated with diagnosis at sexually transmitted disease clinics were identified using log binomial regression. Statistical analyses were conducted in May 2017.



RESULTS:

Post-Affordable Care Act, the relative proportion of total sexually transmitted infection diagnoses increased among private and hospital-affiliated clinics, remained unchanged at sexually transmitted disease clinics, and decreased at federally qualified health centers and other publicly funded programs (p<0.001). Multivariable analysis controlling for age, sex, race, and ethnicity showed an overall decline in the risk of diagnosis at sexually transmitted disease clinics post-Affordable Care Act compared with prior (adjusted relative risk=0.92, 95% CI=0.89, 0.96), but the risk among black and Latino men aged <25 years persisted (relative risk=1.03, 95% CI=0.96, 1.10).



CONCLUSIONS:

The Affordable Care Act increased access to traditional health care, reducing burden on publicly funded programs. However, demand for sexually transmitted disease clinics remains substantial among priority patients. In the healthcare reform era, sexually transmitted disease clinic funding remains critical.

Citation: 
Mehtani NJ, Schumacher CM, Johnsen LE, Greenbaum A, Patrick Chaulk C, Ghanem KG, Jennings JM, Page KR. Three years post-Affordable Care Act sexually transmitted disease clinics remain critical among vulnerable populations. Am J Prev Med. 2018 Jul;55(1):111-114. doi: 10.1016/j.amepre.2018.03.019. Epub 2018 Jun 18. PMID: 29776778
Collaborators: 


  • Department of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, Baltimore, MD

  • Division of Population Health and Disease Prevention, Baltimore City Health Department, Baltimore, MD