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STIs rose in Iowa following defunding and closure of family planning health clinics

Study looked at rates of gonorrhea and chlamydia in Iowa following the 2017 law that restricted the use of federal funds for clinics that provided abortion services. Those clinics also provided testing and treatment of sexually transmitted infections.

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"Statewide gonorrhea burden significantly increased" following the year of family planning health center closures, the study's authors reported.
Traci Westcott / Post Bulletin photo illustration
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IOWA — Sexually transmitted infections rose following the closure of family planning clinics in Iowa, a new study has learned.

The study, conducted by researchers from the Institute for Global Health and Infectious Diseases at the University of North Carolina at Chapel Hill, was published last week in the journal JAMA Network Open. It is believed to be the first such study to look at the effect on sexually transmitted infections following the closing of family planning health centers due to federal funding restrictions imposed by state law.

The study was initiated to better understand the effects of a May 2017 law in Iowa restricting funding for family planning health centers, facilities which then closed. Iowa is one of 18 states to have implemented abortion-related policies prohibiting the use of federal funds at the clinics, which are used by many patients as their primary source of health care.

The closed Iowa clinics offered abortion and sexually transmitted infection services in four counties (Des Moines, Lee, Scott and Woodbury). The study authors utilized Centers for Disease Control and Prevention data for gonorrhea and chlamydia diagnoses between 2010 and 2019 in all Iowa counties. They then compared case rates per 100,000 persons for the two infections, and how they differed before and after the closures.

"Statewide gonorrhea burden significantly increased" following the year of the closures, the authors reported. The study found a 2016 gonorrhea case rate of 83 per 100,000 residents had nearly doubled to 153.7 cases per 100,000 residents in 2018. Chlamydia cases rose as well, from 414 per 100,000 population to 466 per 100,000 population. Calculations also showed a significantly worse rate of gonorrhea rates in the counties with clinic closures.

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"Despite having fewer clinics reporting STIs during the later period," the authors wrote, "there were substantial increases in gonorrhea and smaller increases in chlamydia, particularly in areas with clinic closures."

Chlamydia and gonorrhea are bacterial infections that are both treatable and curable with antibiotics, according to the Guttmacher Institute, an abortion rights research and policy organization.

Such persons with "untreated bacterial infections can transmit them to their sexual partners" however, "even when they are asymptomatic or unaware that they are infected."

"Ensuring access to essential STI services," the Iowa authors argued, will be increasingly of concern given the disruption of some 36 million people facing reduced access to abortion services, following the U.S. Supreme Court ruling Dobbs v Jackson.

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Paul John Scott is the health reporter for NewsMD and the Rochester Post Bulletin. He is a novelist and was an award-winning magazine journalist for 15 years prior to joining the FNS in 2019.
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