Title X and The Role of Family Planning Providers in Preventing and Treating Sexually Transmitted Infections
This article is published in partnership with the National Coalition of STD Directors (NCSD) as part of our joint series on STD Awareness.
Over the past 40 years, Title X family planning providers have played a critical role in ensuring access to a broad range of family planning and related preventive health services for millions of low-income and uninsured individuals. Screening, testing, and treatment of sexually transmitted diseases (STDs) are key components of the essential health education and services provided by family planning providers each year. In 2010, the Title X family planning network performed over 6 million STD tests, a 3.5 percent increase over the previous year, and over 1.1 million HIV tests, a 10 percent increase over 2009. Family planning and sexual health programs have a tremendous amount of expertise in targeting “hard-to-reach” populations, particularly through education and counseling.
Family planning providers have long understood the role sexual health plays in the lifelong health and well-being of their patients. Suspected of being the number one cause of preventable infertility, chlamydia – a curable infection – is the most common bacterial STD in the US, with an estimated 2.8 million infections annually. Annual US gonorrhea infections are estimated to be as high as 700,000 a year. If left untreated, both infections can spread into the uterus or fallopian tubes and cause pelvic inflammatory disease (PID). PID and other infections in the upper genital tract can cause damage leading to infertility, chronic pelvic pain, and potentially fatal ectopic pregnancy.
Recognizing the important role publicly funded family planning providers can and do play in STD prevention, the US Centers for Disease Control and Prevention (CDC) supports chlamydia and gonorrhea prevention efforts in family planning health centers through the Infertility Prevention Project (IPP). Begun as a demonstration project in 1988 to address the leading STD-based causes of infertility, IPP has expanded to all ten of the federal Health and Human Service regions, supporting screening and treatment among sexually-active, low-income women.
CDC estimates that undiagnosed and untreated STDs such as chlamydia and gonorrhea cause at least 24,000 women in the US each year to become infertile. In addition to the health burdens that result from chlamydia and gonorrhea, chlamydia in particular has severe economic costs within the health care system. Over $2 billion is spent every year on the medical management of chlamydia and related complications. The total lifetime medical cost has been estimated at $315 per case for women. Furthermore, a single case of PID costs between $1,060 and $3,180 (in 2000 dollars).
To ensure quality sexual and reproductive health and address economic burdens, continued efforts to educate, screen, test, and treat for STDs is critical to our nation’s public health and well-being. The Title X family planning network is proud to be an essential safety-net provider in these efforts to improve access for populations that may have nowhere else to turn for these services.