Estimating the Size and Cost of the STD Prevention Services Safety Net

Abstract

The Patient Protection and Affordable Care Act is expected to reduce the number of uninsured people in the United States during the next eight years, but more than 10% are expected to remain uninsured. Uninsured people are one of the main populations using publicly funded safety net sexually transmitted disease (STD) prevention services. Estimating the proportion of the uninsured population expected to need STD services could help identify the potential demand for safety net STD services and improve program planning. In 2013, an estimated 8.27 million people met the criteria for being in need of STD services. In 2023, 4.70 million uninsured people are expected to meet the criteria for being in need of STD services. As an example, the cost in 2014 U.S. dollars of providing chlamydia screening to these people was an estimated $271.1 million in 2013 and is estimated to be $153.8 million in 2023. A substantial need will continue to exist for safety net STD prevention services in coming years.

The Spatial Association Between Federally Qualified Health Centers and County-Level Reported Sexually Transmitted Infections: A Spatial Regression Approach

“…32 One study estimated that over 4.5 million persons will require safety net STI clinical services in 2023 at a cost of over US $150 million. 33 Across jurisdictions, providers of safety net STI services include STD clinics, public clinics, family planning clinics, and FQHCs. 33 With the closure of several STD clinics, public health officials and practitioners are tasked with identifying appropriate safety net STI services to reduce further transmission of STIs.…”

Continued Importance of Sexually Transmitted Disease Clinics in the Era of the Affordable Care Act

“…A recent study predicted that, despite the ACA, more than 10% of Americans are expected to remain uninsured over the next 8 years and, by 2023, 4.7 million uninsured people will be in need of STI services. 10 …”

US Public Sexually Transmitted Disease Clinical Services in an Era of Declining Public Health Funding: 2013–14

“…(5–6) Subsequent to changes in the U.S. health care system in 2010, it has been estimated that almost 5 million persons will remain uninsured and in need of STD services in 2023. (7) The estimated cost of these safety net STD services in 2023 is anticipated to exceed $150 million. (7) Additionally, STD clinics also often serve populations at high risk of acquiring HIV and may be ideal places to implement HIV testing or pre-exposure prophylaxis (PrEP) for at-risk persons.…”

“…(7) The estimated cost of these safety net STD services in 2023 is anticipated to exceed $150 million. (7) Additionally, STD clinics also often serve populations at high risk of acquiring HIV and may be ideal places to implement HIV testing or pre-exposure prophylaxis (PrEP) for at-risk persons. In 2013, STD clinics accounted for 27% of newly identified HIV-positive persons among all Centers for Disease Control and Prevention (CDC) funded HIV testing events.…”