Senate Health Advances Comprehensive Bill to Address California’s STI Epidemic

Sacramento, CA – Today, California’s Senate Health Committee voted 9-0 in support of SB 1234, the STI Prevention + Treatment Fairness Act, to address California’s rising rates of sexually transmitted infections (STI). SB 1234, authored by Senator Dr. Richard Pan (D-Sacramento), seeks to close gaps in access to STI prevention and treatment for low-income, uninsured LGBTQ+ Californians. If enacted, low-income, uninsured LGBTQ+ patients and others who currently lack access to affordable or confidential STI services would become eligible to access STI care under the Family Planning, Access, Care, and Treatment (Family PACT) program. The committee’s approval of the measure comes during National LGBTQ Health Awareness Week.

Across all regions in California, STI rates are increasing and have reached record highs. In 2019, nearly 350,000 Californians were diagnosed with syphilis, chlamydia, or gonorrhea. STI rates have disproportionate impacts on LGBTQ+ Californians that perpetuate long standing health inequities, with the highest rates among young people ages 15-24, gay and bisexual men of color. California does not have a statewide coverage program for low-income, uninsured people to access STI care. Family PACT currently covers STI services, but only for patients who are at risk of experiencing or causing unintended pregnancy. SB 1234 aims to advance health access and equity by ensuring that all Californians can get the essential STI services they want and need and not be left out by existing state programs.

Bill co-sponsors APLA Health, Black Women for Wellness Action Project, Equality California, Essential Access Health, and the San Francisco AIDS Foundation released the following reactions to the bill’s passage:

“Despite California’s out-of-control STI epidemic, it’s still too hard for many LGBTQ+ and other vulnerable community members to access STI testing and treatment,” said Craig E. Thompson, Chief Executive Officer of APLA Health. “APLA Health recently opened its first 'Out Here Sexual Health Center’ that offers fast, convenient, and free or low-cost sexual health services by and for the LGBTQ+ community in the heart of L.A. County. SB 1234 will further improve access to these services by requiring the state’s Family PACT program to cover STI testing and treatment for all low-income, uninsured Californians regardless of their individual family planning needs. APLA Health is proud to partner with Senator Pan on this critical legislation.”

“Access to high quality healthcare is a basic human right. It’s our responsibility to make sure everyone has the same opportunities to access respectful and non-judge mental care to address their specific health care needs,” said Kimberly Robinson, Community Liaison of Black Women for Wellness Action Project.

"STI rates have reached historic highs and continue to climb in California. In addition, the pandemic has highlighted and worsened the health inequities that LGBTQ+ people, low-income and our most vulnerable communities continue to face every day,” said Tony Hoang, Executive Director of Equality California. "SB 1234 will expand access to essential STI prevention and treatment on a nondiscriminatory basis to LGBTQ+ people and others with confidentiality concerns, continuing California’s work to reduce health disparities for marginalized populations.”

“STI rates have reached historic highs and continue to climb in California and across the country. The COVID-19 pandemic has only reminded us that we must be vigilant and responsive when it comes to public health,” said Amy Moy, Chief External Affairs Officer of Essential Access Health. “SB 1234 will help ensure that everyone has access to the high-quality, patient-centered, and confidential STI treatment and services they want and need through a robust network of Family PACT providers. We applaud committee members for voting to advance the bill and recognizing the important role it will play in advancing health access and equity statewide. Essential Access Health is proud to work with Senator Pan and we thank him for his ongoing leadership and efforts to address the state’s STI crisis.” 

“With rates of STIs in California continuing to rise at an alarming pace, we must prioritize policy and structural solutions that increase equitable access to comprehensive STI services to communities that are disproportionately affected,” said Tyler TerMeer, PhD, CEO of San Francisco AIDS Foundation. “San Francisco AIDS Foundation (SFAF) supports SB 1234, which would close the coverage gap in STI services for LGBTQ+ individuals. This is a policy priority that will advance health justice for our communities in California. SFAF appreciates the opportunity to work with Dr. Pan on this important legislation.”  

Background

The COVID-19 pandemic has exacerbated STI rates in California and across the country that had already reached crisis levels prior to the public health emergency. According to the Centers for Disease Control and Prevention (CDC), 1 in 5 people in the U.S. have an STI.  Nearly 350,000 Californians were infected with syphilis, chlamydia, or gonorrhea in 2019. Over the past 10 years, syphilis cases in the state have increased by 349%, gonorrhea cases by 236%, and chlamydia cases by 61%. Untreated STIs can lead to serious long-term health consequences, including infertility, blindness in the case of gonorrhea and cervical cancer related to human papilloma virus (HPV) infections. Approximately $1 billion is spent annually in California on health costs associated with STIs.

Although our STI public health crisis is affecting communities across the state, California youth, communities of color, and LGBTQ+ populations are disproportionately impacted. According to the California STD Control Branch, men who have sex with men (MSM) made up more than half of reported male gonorrhea cases in 2017 – approximately 32,000 cases. In the same year, 71% of early syphilis cases reported in the state were among MSM populations. Statewide data indicate over half of all STIs in the state are experienced among California youth ages 15 – 24 years old. Young people ages 15-24 make up more than 5 out of every 10 chlamydia cases in California and 3 out of every 10 gonorrhea cases.

Despite the progress made in California to expand health access statewide, coverage gaps persist that have further fueled a rise in STI rates and continue to perpetuate long-standing health inequities. California does not have a state-funded episodic coverage program for low-income, uninsured people to access STI testing and treatment. The Family PACT program covers STI prevention, counseling, testing, and treatment for eligible low-income and uninsured people, but only within the context of a family planning visit. People not at risk for experiencing or causing unintended pregnancy are not currently eligible for Family PACT services. The group most negatively impacted by this structural inequity are LGBTQ+ individuals, particularly young gay and bisexual men of color.