Sexual Health in San Francisco

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Sexual Health in San Francisco

• On behalf of
• Jeffrey D. Klausner, MD, MPH
• Director, STD Prevention and Control Services
• San Francisco Department of Public
  HealthAssociate Clinical Professor of
  MedicineUniversity of California, San Francisco

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Sexual Health

• Healthful Physical, Mental,
• Emotional, State Allowing Enjoyable and Free
  Sexual Expression

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STDs among persons living with AIDS, San
FranciscoScheer S, Chu PL, Klausner JD, Katz MH,
Schwarcz S, Lancet, 2001 357432-435.
updated 2004
HAART users were more likely to have an STD than
non-HAART users.
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Male rectal gonorrhea cases, SF 1984-2004
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Male gonorrhea by anatomic site, SF 2000-2004
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Syphilis cases,San Francisco, 1999-2005
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Genital Herpes

• SFCC one of few sites offers HSV-2 serology and
  HSV PCR
• Increased risk of HIV transmission

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Human Papilloma Virus

• SFCC to be vaccine study site
• HIV infection increases risk of cervical anal
  carcinoma

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San Francisco STD Prevention and Control Services

• San Francisco City Clinic,1933
• 23,000 patient visits in 2005
• Detention screening services,1997
• 12,000 persons age 15-35 screened per year
• St. James Infirmary,1999
• Occupational health clinic for sex workers
• 500 STD tests in 2005

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San Francisco STD Prevention and Control Services

• Magnet, 2003
• gt 15,000 gonorrhea chlamydia tests in 2005
• gt 3,300 syphilis tests in 2005
• PROP, 2004
• 206 patients initiated 32 completed 90 days of
  treatment

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Expanded screening

• HIV testing sites

Jails
Gay mens health center
Sex worker safety clinic
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Online syphilis testing Levine et al, STD, 2005
New cases
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InSpot online peer-to-peer partner notification
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STD Education/ Outreach

• Medical provider training and education
• Outreach to persons at bars/clubs/sex
  clubs/bookstores/events
• Dissemination of STD screening guidelines/
  treatment
• Actively collaborating with CBOs

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STD Research/ Training

• Several CDC/NIH/State-funded research projects in
  HIV and STDs
• Molecular diagnostic methodsat home,
  non-invasive, more sensitive
• Meth/HIV/STD interactions
• ID Fellows/ CDC EIS Officers/ clinical trainees

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STD Policy Initiatives

• Allowance for MDs to offer partner treatment for
  gonorrhea statewide
• Meth prevention and treatment resources

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STD Control

• Assurance of STD treatment
• Partner notification for syphilis and HIV
• Assurance of laboratory reporting

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STD Section Budget Summary 1998 - 2004