Fulton County Board of Health’s program, “Testing My Way,” addressed rising STI rates and the Mpox outbreak by partnering with community-based organizations, fostering trust among marginalized populations. Originally designed for at-home STI testing, the program expanded to offer on-site testing at various locations. FCBOH also integrated drug user health services in response to the opioid crisis. The home test kits successfully closed access gaps, but Georgia’s inadequate sex education posed challenges. FCBOH’s progressive messaging faced resistance in a conservative environment. Moving forward, they plan to further integrate sexual health and drug user health programs, enhancing accessibility and patient education.
In the realm of public health, the Fulton County Board of Health (FCBOH) in Georgia undertook an ambitious project to enhance access to STI testing. Little did they know that this endeavor would coincide with a convergence of public health crises. Led by Joshua O’Neal, the sexual health program director at FCBOH, the project aimed to address the rising rates of STIs and the Mpox outbreak, particularly impacting the LGBTQ+ community.
The initiative, known as “Testing My Way,” was integrated into FCBOH’s broader #StopHIVATL program to bridge the gap in STI testing within the region. In recent years, STI cases, including gonorrhea, syphilis, and chlamydia, have been on the rise, as reported by the Centers for Disease Control and Prevention (CDC).
The #StopHIVATL program emerged as a response to these concerning statistics and the observed difficulties in accessing STI testing. It sought innovative approaches to screening that would offer diverse options to individuals seeking better healthcare access. Central to this effort was the collaboration with Ash Wellness, which provided at-home STI test kits. Those interested in testing could apply to receive a home test kit through the FCBOH Stop HIV ATL webpage.
However, unforeseen circumstances arose as the test kit distribution coincided with the nationwide Mpox crisis. Mpox cases surged in the summer of 2022, with Georgia experiencing one of the highest case counts, as indicated by CDC data.
Despite the challenges posed by this “perfect storm” of public health crises, FCBOH seized the opportunity to engage with thousands of metro Atlanta queer and trans individuals, Black and Brown individuals, and people living with HIV. This outreach allowed FCBOH to build trust with a population that had long felt marginalized.
By partnering with community-based organizations (CBOs), FCBOH was able to distribute Mpox vaccines to the communities they served. This partnership fostered a sense of trust and connection with the Fulton County Board of Health among these communities.
This set the stage for the expansion of the #StopHIVATL and Testing My Way programs, leading to the creation of an integrated healthcare experience.
Expanding Beyond Home Test Kits
Originally designed to facilitate at-home STI testing, Testing My Way adapted its approach in response to its growing presence within the community during the Mpox outbreak. FCBOH decided to extend the program to include on-site testing, utilizing the test kits to conduct screenings at locations without full lab capabilities, such as mobile clinics and various community sites.
FCBOH’s efforts extended beyond Mpox and STIs. In response to the national opioid and overdose crisis, FCBOH adopted an integrated approach to address the community’s most pressing public health needs. This approach included the establishment of sexual health express services, a screening center, and a drug user health center. These centers provided essential supplies, including syringes, fentanyl test strips, xylazine test strips, and Narcan, contributing to a comprehensive public health experience. These services were made possible with the support of the home test kits.
Filling Access Gaps with Home Test Kits
A year following the program’s launch, FCBOH celebrated the successes of its home testing kit program. Impact data revealed its effectiveness in closing access gaps. Notably, 40% of those accessing the tests had not undergone STI screening in the past year, and 20% had not been tested for HIV in the same period. Moreover, the test kits aided in the detection of STI cases, with 18% of the distributed kits being registered and 15% yielding results.
However, challenges remain. Georgia faces a deficiency in comprehensive sex education, affecting both healthcare consumers and providers. The lack of open dialogue around sex and sexuality hinders effective communication about STIs. Healthcare providers often lack the necessary language and knowledge to discuss these topics in a sex-positive and non-stigmatizing manner.
Improving public health education, not only among the general population but also among healthcare providers, is crucial to address this issue. This task is especially challenging given cultural norms in Georgia that can clash with FCBOH’s mission.
Navigating Cultural Challenges
FCBOH faces setbacks in conveying what some consider a progressive message in a more conservative region. It emphasizes the importance of a sex-positive approach in STI testing messaging but encounters resistance from local businesses and even the state Department of Health. For example, FCBOH’s messaging on drug use aims to address the overdose crisis but has been met with resistance.
Moving Forward
FCBOH intends to continue its partnership with Ash Wellness and expand its integrated approach, incorporating sexual health and drug user health programming. Furthermore, FCBOH is considering integrating PrEP follow-ups into the testing kit program to enhance accessibility. The organization is also focused on patient education, particularly in guiding individuals on how to use the test kits effectively.
In conclusion, FCBOH’s multifaceted efforts underscore the importance of community collaboration, trust-building, and adaptability in public health initiatives. Despite the challenges faced, FCBOH remains committed to addressing the unique healthcare needs of its community and promoting a comprehensive, inclusive approach to public health.