STI partner services outcomes before and during the SARS-CoV-2 pandemic in King County, WA

Sex Transm Dis. 2024 Feb 23. doi: 10.1097/OLQ.0000000000001960. Online ahead of print.

Abstract

Background: SARS-CoV-2 pandemic mitigation efforts resulted in reallocation of public health personnel, likely impacting provision of timely sexually transmitted infection (STI) partner services (PS). We describe PS outcomes before and during the pandemic in King County, WA.

Methods: We examined PS outcomes for syphilis and gonorrhea cases diagnosed in 2019 and three periods in 2020 (pre-lockdown:1/1/2020-3/23/2020; lockdown: 3/24/2020-6/5/2020, post-lockdown: 6/6/2020-12/31/20). We described changes over time in three PS outcomes: cases initiated, interviewed, and with named sex partners. We calculated adjusted prevalence ratios (aPRs) with Poisson regression comparing these outcomes in the 2020 periods to 2019.

Results: Reported gonorrhea (4,611 vs. 4,179) and syphilis (665 vs. 586) cases declined from 2019 to 2020. In 2019, 60.7% of cases were initiated, compared with 42.1% before lockdown (aPR:0.74, 95% CI:0.70-0.78%), 41.7% during lockdown (aPR:0.79; 95% CI:0.73-0.85), and 41.7% after lockdown (aPR:0.81, 95% CI:0.77-0.85). Among initiated cases, the proportion interviewed also appeared to drop in the three lockdown periods (52.4%, 41.0%, 44.1%) compared to 2019 (55.7%). However, in adjusted analyses, the prevalence of interview among case patients was only lower pre-lockdown (aPR:0.91; 95% CI:0.85-0.99), and higher during (aPR:1.10; 95% CI:1.01-1.20) and after (aPR:1.12; 95% CI:1.06-1.19). Interviewed patients named partners more often during (21.4%, aPR:1.35; 95% CI:1.05-1.74) and less often after lockdown (16.0%, aPR:0.63; 95% CI:0.51-0.79), compared to 2019 (26.6%).

Conclusions: These results underscore the need for a trained public health worker reserve, and plans for deployment of existing workers and prioritization of cases to continue essential STI public health activities during public health crises.