FILE - This 1975 microscope image made available by the the Centers for Disease Control and Prevention shows Chlamydia trachomatis bacteria. After an unprecedented push to test and track COVID-19, public health workers are grappling with a worrisome side effect: a collapse in screening for sexually-transmitted diseases that have been on the rise for years. Testing for diseases like chlamydia and gonorrhea plummeted in many parts of the U.S. in 2020 as COVID-19 sapped away resources and staff. (Dr. E. Arum, Dr. N. Jacobs/CDC via AP)

Three years ago this month, city officials gathered at St. Mary Medical Center to announce a new strategy to combat a dramatic increase in rates of sexually transmitted diseases.

“Our STD and HIV infection rates need to be taken seriously and approached with care and support from our Long Beach community,” Mayor Robert Garcia said at the news conference that day.

To that end, he detailed the 2019-2022 Long Beach HIV/STD Strategy, a plan to bring infection rates down.

“Our goals to reduce HIV infections by 50% and STD infections by 20% are possible,” Garcia said, “and we will ensure that we have the resources in place to support these efforts.”

Among other objectives, the plan outlined efforts to better educate the community, expand access to care and identify $2 million to strengthen the city’s HIV/STD care system.

Now that the plan’s three-year timeline has wrapped up, I was curious to hear from city health officials about how effective the strategy was—particularly as the COVID-19 pandemic diverted resources away from other pressing health issues.

First, HIV/STD Strategic Implementation Specialist Everardo Avizo told me that while plenty of people in the Health Department have had to redirect their work to addressing the pandemic over the last two years, overseeing the plan has remained his top priority.

“The strategy itself created my position within the Health Department, to help successfully steer and implement it,” he said. “So in a way, that was very fortunate—unlike parts of the Health Department, including [HIV/STD Surveillance Program Supervisor Emily Johnson] and her team, who got shifted to predominantly COVID-specific efforts, my goal remained focusing on the HIV/STD Strategy specifics.”

As for what that looked like in practice, Alvizo said the pandemic did pose challenges to achieving some of the goals laid out in the strategy, but none of them were insurmountable.

Finding funding, for example, became more competitive, he said. But the Health Department has still been able to secure $2.8 million for the effort.

The strategy also noted that the city should conduct STD and HIV workshops to 4,000 adolescents and young adults per year, and provide HIV and STD education at 30 community events annually.

While the pandemic precluded the city’s ability to hold in-person events, Alvizo said the department nevertheless forged ahead with trying to meet these goals in a virtual setting.

Overall, 4,178 youth participated in sexual health education workshops that were held in partnership with the Long Beach Unified School District and AltaMed between January 2021 through April 2022, according to the Health Department. And the department held several other webinars from October 2020 through last month in which participation ranged from 25 people to 98 people.

“In that respect, we were still able to move forward in terms of engaging the community,” Alvizo said, “and I think, because of the expectation on everyone’s part that we had moved to virtual [meetings], there was very much a high level of engagement and participation.”

While it’s great that Long Beach was able to continue to implement the strategy, even in the midst of a once-in-a-lifetime global health crisis, the most important question still stands: Has it worked?

Just like COVID-19 made implementing the strategy more difficult, it also seems the pandemic and its impact on our behavior makes that question particularly hard to answer.

HIV and STD data takes a while to compile, so the Health Department has not yet released complete data on their prevalence in 2020 or 2021. That means it’s still unclear how infection rates have changed over the course of the strategy’s implementation—and over the course of the pandemic.

The city released 2019 data last summer, which showed that cases of gonorrhea, syphilis and chlamydia—the most common sexually transmitted infection—dipped slightly or held steady compared to the prior year. But preliminary numbers published late last year showed that cases of syphilis and gonorrhea soared in 2020, particularly in the months that followed strict “stay at home” orders.

Johnson told me that as the department waits for official 2020 and 2021 numbers, it’s already clear that it will be harder to glean any big-picture takeaways from the data about the strategy’s effectiveness.

“Due to COVID, it might be a little atypical in general,” she said. “We’ll take it with a grain of salt and use the 2020 numbers in a larger sense of what it was before COVID and what it looks like after.”

Johnson said she expects that different aspects of the public response to the pandemic could affect the numbers in different ways. While STD prevalence may have been lower during the initial shutdowns, the lack of easy access to health care in the following months could have reversed that trend.

“It’s really hard to say,” she said. “Just with STD numbers in general, I know a lot of points where people would normally access care were closed during COVID. But now we’re kind of seeing this increase in people accessing that care again, after we went nearly a year with people unable to.”

To learn any lessons about how the city can successfully work to lower rates of HIV and STDs, Johnson said, “we will continue to look at coming years, into 2022 this year and further into the future.”

Alvizo emphasized that point—the 2019-2022 strategy, he said, was just the beginning of a longer term focus on the issue.

“This is not so much an end-all-be-all, but more like a roadmap for us to move forward in terms of how we address our local needs when it comes to HIV and STD rates,” he said. “This is not the end. This is really just the starting point.”

Hayley Munguia

Hayley Munguia is editor of the Long Beach Business Journal.