Sexually transmitted infection testing and treatment expanded in northern St. Louis County – Washington University School of Medicine in St. Louis

The St. Louis region has some of the highest rates of sexually transmitted infections (STIs) in the country, with the burden falling particularly heavily on Black residents and people with marginalized sexual orientations and gender identities.

To reduce disparities and improve overall sexual health in the region, the Division of Infectious Diseases at Washington University School of Medicine in St. Louis will offer expanded STI testing and treatment services at its Village Square clinic in north St. Louis County, a historically medically underserved area. The effort is supported by a five-year, $2.5 million grant from the Centers for Disease Control and Prevention and is part of a national program to expand access to comprehensive sexual health services.

Reno

“St. Louis’ STI rates are very concerning,” said Dr. Hilary Reno, professor of medicine and principal investigator of the grant. As an STI specialist, Reno treats patients at the Village Square clinic. “Syphilis rates have more than doubled since 2015. We are seeing increasing cases of congenital syphilis, which can cause babies to be born with physical deformities and neurological problems such as blindness or deafness. We are not making the progress we would like to end the HIV epidemic. And the differences are shocking. STI rates are 11 to 19 times higher among black St. Louis County residents than white residents. It is time for us in public health to recognize that what we are doing is not enough and find better ways to provide people with the services they need.”

Part of the problem is that the parts of the St. Louis region with the highest STI rates — the city and county of north St. Louis — are also places with minimal access to sexual health care. Because there are no specialized clinics, many people turn to hospital emergency rooms for STI testing and treatment. Although emergency departments can and do offer such services, they are unable to provide comprehensive STI care such as follow-up care, contact tracing, and prevention education.

The expansion of services at the Village Square clinic in Hazelwood is a first step toward improving testing and care options for people in northern St. Louis County. The clinic was founded in 2023 primarily to care for people living with HIV and offered limited on-site HIV testing. With the support of this grant, the clinic aims to provide walk-in testing to all patients at no or low cost, as well as treatment for walk-in patients and their sexual partners if needed. The clinic also provides the HIV prevention drug PrEP, taken routinely to reduce the risk of infection, as well as two medications taken in the hours after possible exposure to a sexually transmitted infection: PEP (for HIV) and DoxyPEP (against syphilis, chlamydia and gonorrhea). Ultimately, there are plans to expand prevention education at Village Square and establish mobile services to reach additional underserved communities in northern St. Louis County.

The details of which services will be offered and how remain to be clarified. The first year of the five-year project is dedicated to working with community members to develop a plan tailored to the needs and preferences of the community. Priority will be given to meeting the needs of the most underserved members of the community, including people living with HIV. gender and sexual minorities; young adults; and people of color, especially black women.

“I once heard someone say, ‘You don’t need focus groups if you include the right voices from the start,'” Reno said. “If people have symptoms of an STD or have learned that someone they have had sexual contact with has an STD, it is vitally important to be seen by a doctor and receive care and treatment very quickly. Not only does this make them feel better, but it also helps reduce transmission, which benefits the entire community. We hope to create clinical care options that the community truly wants so we can meet their healthcare needs and begin to reduce STI rates in the region.”

In addition to Reno, the team includes Ernie-Paul Barrette, MD, professor of medicine at Washington University and medical director of the Village Square Clinic, as well as the St. Louis County Department of Public Health; Planned Parenthood of the St. Louis Region; Christian Hospital, a BJC HealthCare hospital near the Village Square clinic; SPOT, a Washington University clinic for adolescents and young adults; and the St. Louis STI/HIV Prevention Training Center.

The Village Square clinic is located at 1 Village Square Shopping Center in Hazelwood, Missouri.