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sexually transmitted infections; STI services; Medicaid program


The United States is undergoing an epidemic of sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis. All three bacterial infections are detectable and treatable, yet they often go diagnosed. Untreated chlamydia and gonorrhea can lead to serious pelvic infections and infertility; untreated syphilis can result in severe complications, including death. Congenital syphilis is increasing as well, with a concurrent rise in stillbirth and newborn deaths.

Increased resources and heightened attention are urgently needed to supplement the work of the public health infrastructure, for which STI funding has remained stagnant for two decades. Fortunately, the Medicaid program is well situated to improve STI services on a broad scale. The federal-state health insurance program covers 73 million people, and is the primary payer for family planning services for low-income women. Medicaid eligibility overlaps significantly with STI risk, and the program already covers a disproportionate share of STI-related visits.

Open Access