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Public‑health officials flag disparities and funding risks in STI/HIV report; committee asks that budget options be considered
Summary
Public‑health staff reported stable HIV diagnosis rates but rising rates among Hispanic/Latinx residents and persistent disparities among Black residents; the department warned that federal and state grants that support services are sunsetting and asked the board to consider funding options.
Public‑health officials told the Santa Clara County Health and Hospital Committee that rates of bacterial sexually transmitted infections (chlamydia, gonorrhea, syphilis) and new HIV diagnoses fell during the initial COVID‑19 period and have moved back toward pre‑pandemic levels. Officials highlighted persistent racial and geographic disparities and warned that grant funding that supports prevention and treatment is at risk of sunsetting.
Dr. Sarah Rudman, from the Public Health Department, and Dr. Akanksha Vaidya, who leads harm reduction and related programs, presented the annual epidemiology, grants, contracts and services report covering July 1, 2023, through June 30, 2024. Rudman noted that chlamydia and gonorrhea trends in Santa Clara County mirror state and national patterns and that the drop in 2020 reflected reduced testing during the pandemic. "These early 2023 data are a little encouraging," she said, but stressed that more time is needed to determine a sustained trend.
The presenters showed that new HIV diagnoses have remained broadly stable over many years, but case rates among people identifying as Hispanic or Latinx are high and rising. Officials also said Black residents show disproportionately high case rates, though some counts are suppressed for privacy due to small numbers. County epidemiologists used the Healthy Places Index to show higher STI/HIV rates correlate with census tracts that have fewer community resources.
Rudman and staff said the department is prioritizing increased access to screening and prevention for priority and hard‑to‑reach populations, using sites such as emergency departments for opt‑out screening and partnering with health plans and community organizations. She also warned that numerous federal and state grant sources that fund prevention services are declining or expected to sunset, leaving programs increasingly dependent on county general fund allocations.
Committee members noted that the county currently has approximately $5,900,000 in general‑fund support allocated to STI programming and asked whether that funding could be reallocated as needed. Rudman said some redirections already occurred this fiscal year to preserve services; she warned, however, that shifting general fund dollars risks jeopardizing other funding streams that require matching or specific uses.
Chairperson Lee moved that the committee refer discussion of STI program funding to the board's May budget process so the full board can consider options; Vice Chairperson Abakoga seconded. The motion passed on a recorded aye vote by Abakoga and Lee.
The presenters recommended continued work on sustaining services, addressing social determinants of health tied to higher STI/HIV rates, and seeking partnerships to replace or augment expiring grant support.
