SEXUAL HEALTH MUST BE PRIORITY

We’re more than a year into the pandemic and COVID-19 has impacted nearly every facet of San Diegans’ lives. As our communities combat SARS-CoV-2 transmission across the city, we are simultaneously, and quite literally, in the fight of our lives against sexually transmitted diseases (STDs) and HIV in the region.

For the last five years, STDs have been on the rise in San Diego. So much so that in 2018, a study by AIDSVu found that residents of the San Diego metropolitan area were diagnosed with chlamydia at a rate of 656.5 per 100,000 people — bestowing America’s Finest City with the No. 1 chlamydia rate among major cities in the American West.

While the national rate of HIV infection has improved in recent years to approximately 13 per 100,000 people, we are still bearing witness to hundreds of San Diegans diagnosed with the virus annually. Perhaps most startling is the fact that hundreds of thousands more people live with HIV unknowingly — roughly 1 in 7 people who have it in the U.S., according to hiv.gov.

While the stay-at-home orders and social distancing of the COVID-19 pandemic have decreased sexual encounters where STDs may spread, they have also reduced the availability and utilization of sexual health services. Local clinics have been running at decreased capacity since last April, often diverting necessary resources to COVID-19 vaccination sites. In addition, patients are avoiding hospitals and alternative outpatient sites out of fear of contracting the virus. The result is a Catch-22 situation that diminishes the ability to both provide and receive sexual health care.

As COVID-19 vaccinations become more widely available and the pandemic comes under better control, San Diego has an opportunity to combat STDs and HIV with newfound fervor. Yes, clinics will eventually return to their normal capacities for sexual health services, and San Diegans can take stock of their sexual health without fear, but it is additional public education and investment that will help us win this battle once and for all.

First, medical, educational and governmental institutions must educate constituents on STDs and HIV, particularly in marginalized communities where the profound and longstanding effects of stigma and discrimination have discouraged people from seeking sexual health care.

If STDs and HIV have taught us anything, it is about the complexities of stigma — the intersectional, social, ecological effects that can be driven by misinformation and inequitable systems and social norms. In fact, we are bearing witness to these very structures of stigma with COVID-19 today. It is for this reason we need to reframe public conversations around sexual health, choosing science-backed data and supportive language that corrects the fear-mongering discourse that shrouds these infections.

Local leaders have a timely opportunity to begin this work with April being STD Awareness Month. The Good to Go clinic through UC San Diego School of Medicine’s AntiViral Research Center is launching a citywide Facts Over Fear campaign with local nonprofits like The San Diego LGBT Community Center, San Ysidro Health and Youth Will to foster healthy conversations on STD testing, prevention and treatment. The goal is to normalize conversations around sexual health and make regular testing a part of every San Diegans’ self-care routine — just like getting your teeth cleaned at the dentist or taking a mental health day.

Second, local government and the private sector must invest in San Diego’s sexual health services. Education and testing services are vital investments both because they enhance individual well-being and allow people to exercise their sexual and reproductive rights, and because they have farreaching benefits for societies and for future generations.

In the last decade, our city and state have seen significant funding cuts to STD prevention efforts, all while infections continue to rise at distressing rates. It’s not difficult to see how this divestment is preventing us from winning the fight against STDs and HIV.

Sexual health programs need better resources to not only revive and maintain essential STD and HIV services, but also make them resilient and sustainable post-COVID-19. This would allow clinics to invest more in detecting and rapidly responding to evolving STD threats, training frontline health workers, and providing prevention resources to local health departments and education agencies.

It’s clear: Without sexual health education and investment, we can’t turn the tide on rising STDs and HIV. This fight requires commitment from all of us, starting now.