"Director's Update - Leandro Mena, MD, MPH, FIDSA"

STD Prevention and Control in 2021: A Year in Review

Dear Partners in Prevention,

I hope this letter finds you safe and healthy.

Before we entirely move on to our 2022 to-do lists, I wanted to commemorate some of DSTDP’s 2021 accomplishments, much of which reflects continued collaboration and input from you.

Though, of course, this letter doesn’t reflect every activity of the last year, my hope is that it can jog our collective memory on key milestones and maybe even generate some ideas for collaboration and innovation in 2022.

On a personal note, I want to acknowledge that this is my first “end-of-year” message as the Director of CDC’s Division of STD Prevention. I have joined the Division at both an exciting and overwhelming time for our field. In my brief time here, I’ve already learned so much about the intricacies of public service and seen first-hand the dedication of staff to the American public. This is a group of people truly devoted to improving the health of our nation, reducing disparities and inequity, and halting continued STI increases.

On behalf of the Division, I want to share our sincere, heartfelt gratitude for your contributions to our field last year. It has been an unbelievably trying time professionally and personally for many of us, but I am invigorated by the momentum we have. The STI National Strategic Plan and the NASEM Report have provided us with a much-needed roadmap and support for our work. As we work toward implementation of both, all of us will play important roles. I look forward to our work together.

Here’s to a happy, healthy, productive 2022!


2021 Highlights

Advancing Programmatic and Clinical Response

For some, it will be an unnecessary reminder, but I will share it as a reminder for those less intimately connected – 2021 was the year we received the historic investment to strengthen the disease intervention specialists workforce!

We’ve all known for decades how critical this workforce is to our nation’s public health infrastructure and we were thrilled to see this investment. Many working in local and state health departments have worked tirelessly in recent months along with staff in DSTDP’s Prevention Development & Evaluation Branch to adjust work plans and re-strategize to accommodate this new funding. It’s been challenging, but we know this will provide critical support to 21st century infectious disease investigation and outbreak response.

Simultaneously, DSTDP’s Disease Intervention & Response Branch mobilized quickly to develop and expedite the delivery of training to meet the needs of this expanding workforce.

The 2021 STI Treatment Guidelines published in 2021, thanks to years’ worth of work by colleagues in DSTDP’s Clinical, Economics, and Health Services Branch, as well as other colleagues in the field. The new Guidelines provide current evidence-based prevention, diagnostic, and treatment recommendations.

Several resources published to support the Treatment Guidelines release and other clinical support needs, including a wall chart, pocket guide, and updated Guide to Taking Sexual History, as well as the STD QCS Toolkit.

The STD field continued contributing to Ending the HIV Epidemic in the U.S., by leveraging the power of STD clinics to deliver HIV services. In 2021, CDC awarded a total of $11.1 million to 19 communities to scale up quality HIV prevention services in STD clinics. This investment allowed us to fund 12 new recipients, in addition to the seven recipients funded as part of the first year of the project in 2020.

The Minority HIV/AIDS Fund (MHAF) continued to supplement this work, funding a second year of supplemental funds to support training and technical assistance efforts. MHAF also funded an expansion of STI/HIV prevention and care services, and sexual health services more broadly, to retail health clinics through collaborations with local health departments in EHE jurisdictions. Services will include STI/HIV testing, STI treatment and ART startup, prevention activities such as PrEP, as well as a network of referrals for complex care.

Rippling underneath it all is our field’s continued contribution to both the ongoing COVID-19 pandemic, as well as other STD-related outbreaks. On the CDC side, we’ve deployed countless staff to the national COVID-19 response, as well as local responses, and supported STD-related outbreaks in West Virginia and Indiana, among other jurisdictions.

Outside the walls of CDC, we know that so many of you have given your time and expertise to the relentless public health response needs, while continuing to face your own personal journeys with this pandemic

Learning Together

DSTDP’s Office of Science hosted several virtual meetings in 2021 to encourage information-sharing across public health, academia, and industry on pressing, urgent STI-related topics. The meeting on remote health, for instance, generated important, spirited conversations about the opportunities and challenges to delivering sexual health services within the current landscape.

And, in another virtual meeting, we spent three days exploring opportunities to enhance disease investigation and intervention functions. Day one focused on rules, regulations, accountability, cost-benefit considerations and the organizational context and structure of DIS teams related to the effectiveness and impact of disease investigation and intervention; day two examined recently developed technologies and how they can be adapted to DIS work; and day three summarized the first two days of the webinar and included an active panel discussion about DIS functions, their effectiveness, and their impact.

Leveraging State-of-the-Art Science

In our continued response to drug-resistant gonorrhea, colleagues collaborated across DSTDP branches (the Surveillance & Data Science Branch and the STD Laboratory Reference & Research Branch, or STDLRRB) to fund American Type Culture Collection (ATCC) to generate a CDC International AR Gonorrhea Isolate Bank. This bank will include bacterial isolates exhibiting geographic diversity, originating from at least four different continents.

Colleagues in STDLRRB also met with many of you throughout the year to provide technical assistance on the topic of STI specimen self-collection and home testing, disseminated gonococcal infection, and other pressing lab-related topics.

Tracking the State of STDs in the United States

In 2021, with the support of surveillance colleagues across the nation, DSTDP’s Surveillance & Data Science Branch published not only the 2019 STD Surveillance Report and preliminary 2020 analyses of congenital syphilis, but also the latest-and-greatest STI prevalence, incidence, and cost estimates. Each report provided a reminder that STDs continue to exact a severe toll in our country, including the youngest among us, as congenital syphilis continues its staggering increase. They also published an analysis of the effect of the COVID-19 pandemic on reported STD cases in 2020, detailing a concerning picture about the continued burden of STIs, even during a pandemic.

As is always the case, in addition to the publications we can see, there was significant behind-the-scenes work that we can’t see, but which remains critical for ensuring the highest quality STD surveillance possible. In 2021, that included updating the chlamydia case definition to allow for collection of LGV data using standardized definitions, as well hosting several learning opportunities, including small-group study sessions on adult syphilis staging.

More for You in 2022
Later this year, we look forward to:
  • The launch of the new-and-improved Treatment Guidelines mobile app (expected in Q1 2022).
  • The latest iteration of Passport to Partner Services: Principles, Practices, and Pathways to Disease Intervention (3DPI) (expected by Spring 2022).
  • More webinars and learning and networking opportunities, including the virtual STD Prevention Conference (September 19-22, 2022).