Special Focus Profiles

The Special Focus Profiles highlight trends and distribution of STDs in populations of particular interest to STD and HIV prevention programs in state and local health departments: women and infants, adolescents and young adults, racial and ethnic minority groups, and gay, bisexual, and other men who have sex with men (collectively referred to as MSM). These populations are most vulnerable to STDs and their consequences and often lack adequate access to healthcare services. In 2014, in the U.S., age was strongly associated with having health insurance. Older adults (65 years and older) and children (19 years and under) were most likely to have health insurance. Working-age adults (19 years to 64 years) had higher uninsured rates. The rates of non-insured for non-Hispanic Whites, non-Hispanic Blacks, and Hispanics were: 7.6%, 11.8%, and 19.9%, respectively.¹ The Patient Protection and Affordable Care Act (ACA) aims to increase access to sexual and reproductive health services through reforms based on the U.S. Preventive Services Task Force recommendations that include: chlamydia and gonorrhea screening (for sexually active women under 25 years and all women at increased risk), HIV screening (everyone 15–65 years old, pregnant, and higher risk), STD counseling (for all sexually active adolescents and higher-risk adults), and syphilis screening (for pregnant women and adults at higher risk).² However, although health insurance coverage has been expanded for most groups, including both men and women, and for most race and ethnic groups, evidence suggests that disparities in health insurance coverage and access to STD services remain.^3,4

1 Smith, J and Medalia, C. U.S. Census Bureau, Current Population Reports, P60-250, Health Insurance Coverage in the United States: 2014, U.S. Government Printing Office, Washington, DC, 2015.

2 Oglesby, WH. Perceptions of and preferences for federally-funded family planning clinics. Reproductive Health 2014; 11(50)1-9. http://reproductive-health-journal.biomedcentral.com/articles/10.1186/1742-4755-11-50

3 O’Hara, B and Brault, MW. The disparate impact of the ACA-dependent expansion across population subgroups. Health Serv Res. 2013 Oct;48(5):1581-92.

4 Drainoni, M, Sullivan, M, Sequeira, et al. Health reform and shifts in funding for sexually transmitted infection services. Sexually Transmitted Diseases 41(7), July 2014, p 455–460.

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