[HIV-STD-Prevention] Service Changes at MCHD Downtown STI Clinic #u#

[Bortoli Gianna A]

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Hello community partners,
Please feel free to share this broadly within your organizations and networks.
Back in late June we sent out communication that beginning in July, there would be changes to the services offered by Multnomah County Health Department's Downtown STI Clinic. We are now in a place where we can slowly begin adding capacity to the services we provide in our clinic!
What's changing?

*  The clinic will begin, in a limited capacity, offering appointments for routine HIV/STI screening to individuals who do not have symptoms or do not have an exposure to a partner with a positive test or symptoms.

*  The clinic will begin including into its STI list focus Chlamydia along with HIV, Syphilis and Gonorrhea for individuals with symptoms or exposure through a partner.

What's not changing?

*  The clinic will continue to focus on scheduling appointments for concerns related to HIV, Syphilis, Gonorrhea, and PrEP initiation/refills.

*  The clinic will no longer provide appointments for concerns that are not related to HIV, Syphilis, Gonorrhea, Chlamydia or PrEP. This includes concerns related to yeast infections, UTIs, Mycoplasma Genitalium (Mgen), Herpes, HPV, genital warts, bacterial vaginosis, chancroid and trichomoniasis.

*  Clinic staff will refer individuals seeking appointments for services no longer provided to urgent care or other community providers.

*  Some targeted community testing through our program will continue. Our mobile testing unit will still continue offering asymptomatic screening at a smaller number of priority locations.

*  We will also continue to offer testing for people who use drugs through our harm reduction syringe services sites.

*  We remain committed to the sexual health of our patients and the residents of Multnomah County. Our DIS and clinic providers will continue to provide consultation to community clinicians on best practices for STI management and treatment. Our Community Testing Coordinator can offer technical assistance to organizations interested in starting their own testing programs. While we cannot do it all ourselves, we are here to support referrals and ensure the broader health system has access to current and up to date sexual health guidance.

Why the change to services?

*  The downtown STI Clinic received a significant decrease in funding that began Jan 1st, 2023. We were able to identify alternative funding to sustain the same level of service delivery January-July 2023 to allow for a planning period. Reduced staffing and services will go into effect July 1st.

How service decisions were made

*  As a safety net public health clinic, our priority is services and interventions that promote community health and reduce community transmission of STIs based on the potential severity of their various associated health outcomes.

*  We also needed to consider our statutory obligations to provide essential services related to reportable communicable disease detection and prevention.

*  Public health's role in direct service delivery focuses on needs that are of population level benefit to all that are not being fully met through other health systems. In other words, we attempt to fill the gaps in available services.

How we are taking care of client needs

*  Program staff have been contacting other community providers of sexual health services to verify information such as eligibility criteria, insurance requirements, and types of services provided so we are up to date and accurate when making referrals.

*  We have compiled a robust list of test sites for individuals who are seeking a "Just Checking" appointment for routine testing. Many are low-barrier and free or low cost. There are also online/at home options.

*  Sexual health services are an integral component of overall preventive health services, so we will encourage and support individuals in seeking testing through their primary care home. Their primary care providers can provide more expansive care for their overall physical and mental health needs.

*  We are working with CAP's PrEP Navigation Program to support people who have the resources to access PrEP through other prescribers and establish a new permanent care home. This includes enrollment in financial assistance and insurance programs where applicable and help identifying a competent and affirming provider. We will continue to provide PrEP maintenance services to current patients through their transitions.

Other HIV Test Sites

When asked for, HIV testing is available at most primary care providers as part of regular medical care, family planning or STD exams.

Multnomah County Health Department Primary Care Clinics<https://www.multco.us/health/primary-care-clinics>  Call to establish care and schedule an appointment.  503-988-5558

Drop-in and Free

Available on a walk-in basis, unless otherwise noted.
*  Cascade AIDS Project<https://www.capnw.org/get-tested> | 971-279-7033
*  Outside In - Clinic Services<https://outsidein.org/health-services/medical-services/> | 503-535-3860 *(by appointment)
*  Outside In - Syringe Exchange<https://outsidein.org/health-services/needle-exchange/> | 503-535-3826
Health Centers

Testing available as part of a medical appointment. Call for eligibility and fees.
*  Planned Parenthood - Northeast Portland<https://www.plannedparenthood.org/health-center/oregon/portland/97212/ne-portland-center-3943-91400> | 888-576-7526
*  Planned Parenthood - Southeast Portland<https://www.plannedparenthood.org/health-center/oregon/portland/97206/se-portland-health-center-3353-91400> | 888-576-7526
*  Old Town Clinic<https://centralcityconcern.org/services/health-care/> | 503-228-4533
Local Health Departments
*  Clark County Health Department<https://clark.wa.gov/public-health/sexually-transmitted-diseases-std>
*  Clackamas County Health Department<https://www.clackamas.us/healthcenters>
*  Washington County Health Department<http://www.co.washington.or.us/HHS/CommunicableDiseases/std.cfm>
At Home
*  Takemehome.org<https://takemehome.org/>- If you haven't had an HIV test in the past year, you may be eligible to have a home test kit mailed to you
*  OraQuick In-Home HIV Test Kit<http://www.oraquick.com/Home>


--
-josh

[https://lh4.googleusercontent.com/0iqBoqNt5n96U3R-Bei5BBj1Ujk3AamXCPG0L6TToEgbVf-TJ9jQ8WC7dKW9KvvYYtBcLIPOPaaxF8YPf0RgLn7SnnFCIkZweA_ZFZN74r26M-vw0z4wx5sOm3qL2hVh7Zqjjylp]

Josue Arevalo (El/He/Him)

Josh Arevalo

Clinic Supervisor

Communicable Diseases | STI Program

Public Health Division, Multnomah County Health Department

619 NW 6th AVE | Portland, OR 97209

Ph: 503-988-2577

Cell: 503-319-6757

josue.arevalo at multco.us<mailto:josue.arevalo at multco.us>
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