State health officials have confirmed that the COVID-19 pandemic has hampered the effective monitoring of sexually transmitted infections and diseases in Arkansas and Washington County over the past year.
STD testing services across the U.S., except for those for syphilis and HIV, significantly dropped in priority populations following the start of the pandemic, according to the National Coalition of STD Directors. The relocation of STD program resources to COVID-19 tracing has disrupted testing and caused employee burnout, according to the NCSD.
Since 2019, the number of people receiving STD tests in Arkansas has fallen, said Brandi Roberts, the STD prevention program manager at the Arkansas Department of Health. Despite fewer Arkansans getting tested, recorded syphilis cases are rising across the state. Fear of contracting COVID-19 contributed to the drop in testing, and delayed testing and treatment likely led to the syphilis outbreak, Roberts said.
“You had people afraid to go to the clinic due to COVID,” Roberts said. “And then, of course, we had some challenges where we had individuals (who) were (COVID-19) positive.”
A downward trend in STD testing has been seen at the local level as well. Testing within Washington County decreased starting in March, and the county’s syphilis and gonorrhea cases have simultaneously risen since the pandemic began, said ADH Public Information Coordinator Danyelle McNeill in an email.
Several ADH disease intervention specialists were able to participate in COVID-19 contact tracing efforts when the pandemic began, because of the decrease in STD testing, Roberts said. McNeill said that DIS staff assisted in tracing the virus from April to August.
“At no point did we have our STD services drop off because of COVID, so we worked both,” Roberts said. “And then, as we went along, once our STD cases and testing started going back up, the DIS actually went back to STD full time. So we were never relocated fully to COVID to where we had to pretty much not do STDs.”
The ADH released the most recent annual Arkansas STI surveillance report in 2019, with numbers from 2018. The agency is currently unable to provide exact STD figures for 2020 and 2019. The ADH staff responsible for the compilation of such data instead prioritized COVID-19 information, McNeill said.
Roberts, who oversees STD management efforts across 95 Arkansas clinics, said that while the pandemic was an inconvenience, ADH disease intervention specialists adjusted. They tracked patients’ sexual partners through telephone interviews, rather than in person.
Dr. Kathleen Whitehead Paulson, a staff gynecologist at Pat Walker Health Center, said that STD testing at the women’s clinic steadily decreased beginning in March, because of an emphasis on televisits, although it rebounded slightly early in the fall semester. One of the clinic’s three healthcare providers is only seeing patients via televisits, while the other two have taken on a mix of in-person appointments and televisits.
Unlike the ADH, Pat Walker gynecologists conduct tests but do not trace contacts. Paulson said their responsibility is only to report positive test results to the ADH, although they offer patients advice on how to inform past sexual partners of such results. If one of the doctors advises a patient to get tested during a televisit, they have the option to briefly visit Pat Walker and self-administer a swab test according to a medical provider or nurse’s instructions, Paulson said. This tests for gonorrhea and chlamydia, but not HIV, syphilis, hepatitis C or herpes.
Although the drop in testing might be worrisome, one positive impact of the pandemic on sexual health is the introduction of televisits, which have benefited students seeking prescription contraceptives such as the birth control pill, patch and ring, Paulson said.
“We are making it really easy for people to get contraception,” Paulson said. “All they have to do is call and say they want to get started, and we get their history and find out what’s appropriate.”
Although STIs and STDs are usually preventable with barriers such as condoms and dental dams, fear of COVID-19 should not discourage people who do experience STD symptoms such as itching, pain, or bumps from seeking testing, McNeill said in an email.
“STDs can lead to serious complications like infertility, pelvic inflammatory disease, and blindness,” McNeill said. “STDs can also be transmitted to unborn children. The risk of HIV rises when STDs are involved. Clinics are taking proper precautions to limit the exposure to COVID, so we want to encourage people to come in for testing and treatment if they feel they need it.”