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Public health officer warns of high STI rates, funding reliance on federal grants
Summary
Dr. Olivia Kasirye told the Board of Supervisors that Sacramento County continues to see high rates of chlamydia, gonorrhea and syphilis and that the county's STD and HIV services rely heavily on federal and state grants; she urged attention to possible federal funding changes and highlighted clinic and community partnerships.
Dr. Olivia Kasirye, Sacramento County public health officer, briefed the Board of Supervisors on June 10 about sustained increases in sexually transmitted infections and the county’s HIV program, stressing both clinical accomplishments and funding vulnerabilities.
Kasirye said several factors explain high STI rates: multiple causative organisms, frequent asymptomatic infections that require screening to detect, the absence of lasting immunity after infection, and population mobility along California’s I‑5 corridor. She noted chlamydia, gonorrhea and syphilis rates dropped in 2020 amid COVID‑19 disruptions but have since rebounded. "The STIs are caused by a number of bacteria, viruses, and parasites," she said, noting that many infections are asymptomatic and thus detected only through screening.
The county operates a low‑barrier clinic and mobile outreach programs. Kasirye described the clinic’s evolution: an initial $600,000 seed allocation grew into a roughly $3 million clinic operation with about 45 full‑time staff, and the county runs a mobile "Wellness Without Walls" unit to reach people experiencing homelessness. Services include testing, vaccinations, PrEP navigation and linkage to care. Kasirye credited community‑based organizations and partnerships (for example, a pharmacy partner used for vaccination outreach) for helping reach populations reluctant to use government clinics.
Funding concerns: Kasirye told supervisors the STD and HIV program receives about $11 million in federal and state grants and must braid multiple funding streams to cover staffing and contracts with roughly 38 community organizations. She warned that proposed or potential federal policy changes could threaten that funding and advised continued monitoring and advocacy. "A large part of our funding does go out to the CBOs," she said, noting that losing federal funds could impair community partners’ solvency and the county’s ability to reach high‑risk groups.
The board and public discussed stigma reduction, prevention campaigns and outreach. Supervisor Patrick Kennedy urged continued public advertising and noted the importance of maintaining prevention infrastructure, while Director of Health and Human Services staff said they would monitor state and federal developments and consider contingency plans.
Ending: Kasirye invited board members to visit the clinic and emphasized the department’s appreciation for staff and community partners. She said the department will continue to seek alternative funding sources and report back if material changes threaten service continuity.
