Development of STI prevention policy recommendations for Baltimore City, MD

Issues: According to the Centers for Disease Control and Prevention (CDC), Baltimore ranks among the top 20 cities and counties in the U.S. with the highest rates of sexually transmitted infections (STIs). The city's perpetually high rates of syphilis, chlamydia, and gonorrhea warrant concern. One of the core functions of public health – policy development – has the power to change the dynamic of health problems in communities, cities, states, and the country. The aim of this research was to explore possible policy options that may help to decrease STI rates in Baltimore. Description: Eight interviews were conducted with STI experts from the Baltimore City Health Department, Prince George's County Health Department, Maryland Department of Health and Mental Hygiene, National Association of County & City Health Officials, Georgetown University, and a former Assistant Surgeon General. A literature review was also conducted to explore existing policies that may appropriately address high STI rates. Lessons Learned: There is a need for more education and outreach to the public, physicians, and pharmacists to facilitate conversations about STIs. There is also an inherent communication problem between the public and private sectors, which subsequently affects surveillance and STI case reporting from the private sector to the Baltimore City Health Department. Recommendations: It is recommended that an incentive based policy enforcing the private sector's adherence to laws regarding STI case reporting be created. This policy recommendation would reward physicians, hospitals and laboratories for adequately reporting STI cases and subsequent treatment of infected patients.