With the new year comes a new law. California has become the first state to require health insurance plans to cover at-home testing for sexually transmitted infections (STIs), such as HIV, syphilis, gonorrhea and chlamydia. It’s the latest effort to address an ongoing nationwide spike in STIs that has only worsened amid the COVID-19 pandemic.
The law, SB 306, went into effect January 1, but it’s so new that billing practices for the tests have yet to be updated. As a result, reports Kaiser Health News in the Los Angeles Times, many providers might not prescribe the tests for another year.
“This is the first law of its kind, and I’d say it’s kind of cutting-edge,” Stephanie Arnold Pang, senior director of policy and government relations for the National Coalition of STD Directors, told Kaiser Health News. “We want to bring down every single barrier for someone to get STI testing, and out-of-pocket cost is a huge factor.”
At-home tests also offer privacy to folks concerned about visiting an STI clinic or speaking with a health care provider about sexual issues. In addition, at-home kits make it easier for residents of rural areas to get tested.
The new law aims to fight the STI crisis in four ways:
- Require health plans to cover at-home test kits for HIV and STIs;
- Increase the number of providers that can offer STI tests;
- Promote expedited partner therapy, meaning that patients can quickly get STI treatment for their partners;
- Require syphilis screening during both the first and third trimester of pregnancy.
STI rates have been soaring nationwide for the past six years, including in California. For example, syphilis spiked nationwide from 74,709 cases in 2015 to 129,818 cases in 2019, according to data from the Centers for Disease Control and Prevention. In California, the numbers rose from 14,449 to 28,812 during the same time span.
Alarmingly, rates of congenital syphilis, which is contracted in the womb and can have devastating effects on children’s health, have surged since 2015. California reported 445 cases in 2019—a 232% increase from 2015—including 37 stillbirths.
“We have children born in California with syphilis,” Richard Pan (D–Sacramento), a pediatrician and senator who wrote the law, told the news service. “You’d think that went away in the Victorian era.”
In a press statement issued when Governor Gavin Newsom signed SB 306, Pan added, “STI rates across the country have reached crisis levels, and it has become worse as an antibiotic-resistant strain of gonorrhea spread across the country.”
During the early days of the COVID-19 pandemic, many clinics that offered STI testing shuttered, meaning fewer people got tested. In addition, many health care workers who used to offer STI testing and treatment pivoted in 2020 to devote their time and energy to COVID-19 issues.
The California bill was cosponsored by APLA Health, the Black Women for Wellness Action Project, Essential Access Health, Fresno Barrios Unidos, the Los Angeles LGBT Center and the San Francisco AIDS Foundation. They released the following statement:
“Rising STI rates have gone largely ignored for far too long. STI prevention is an equity issue. Pre-existing structural barriers to STI treatment and care have only worsened during the COVID-19 pandemic, disproportionately impacting Black, Indigenous and people of color, rural regions, California youth, and LGBTQ+ communities. Factors linked to social determinants of health contribute to STI rate disparities, including inequitable access to safe, culturally competent, quality health, mental health and substance use treatment services, as well as high rates of incarceration, lack of access to economic mobility and education opportunities, adequate housing, racial segregation, and racism.
“SB 306 is the bold action California needs to turn the tide on rising STI rates. The bill seeks to expand the tools and resources that health providers can use to increase access, reduce STI transmission and improve health outcomes across the state in partnership with advocates, local organizations and community members.
“We applaud Dr. Pan for his leadership in introducing this comprehensive and robust approach to STI prevention, and thank Governor Newsom for signing this important measure into state law. California will once again lead with innovation and best practices in STI prevention and care, and serve as a model for other states to follow.”
In related news: Non-California residents seeking at-home tests may be eligible for a free STI and HIV kit from TakeMeHome. To learn more about the STI epidemic, click the hashtag #Sexually Transmitted Infection and you’ll find a collection of POZ articles including:
- “The Roaring Twenties Are in Full Swing,”
- “Good and Bad News About Global Rates of HIV, Viral Hepatitis and STIs,”
- “Insurers Must Cover PrEP and Related Services to Prevent HIV,”
- “$4.3M Will Help Integrate HIV Services in STI Clinics,”
- “Which U.S. Region Sees the Highest Rates of HIV Diagnoses and Deaths?” and
- “Sexually Transmitted Infections Reach Record High for 6th Year in a Row.”