Changes in providers diagnosing sexually transmitted infections in Louisiana, 2018-2024

BACKGROUND: Louisiana ranks high nationally for chlamydia (CT), gonorrhea (GC), and syphilis rates. During the COVID-19 pandemic, many providers operated with limited staff and business hours, potentially limiting access to routine sexually transmitted infection (STI) care. We evaluated changes in STI morbidity and provider types in Louisiana from March 2018 to February 2024. METHODS: Using Louisiana surveillance data, we compared reported STI case counts by demographic characteristics and identified the type of healthcare providers diagnosing STIs before, during, and after COVID-19 pandemic. We calculated the percent change in case counts across time periods and assessed for differential shifts in the proportion of cases diagnosed by provider type. RESULTS: The number of reported GC and syphilis cases increased pre- to post-COVID (by 8.7% and 62.5% respectively), while CT diagnoses nearly returned to pre-COVID levels (1% decrease). Sex, age and race/ethnicity of cases remained similar across time periods. The proportion of STIs diagnosed by private providers increased pre- to post-COVID: 75% to 82.2% of CT; 74.5% to 82.9% of GC; and 66.1% to 77.3 % of syphilis cases. There was a corresponding decrease in the proportion of cases diagnosed by public providers. Specifically, the proportion of cases diagnosed by private clinics, hospitals, and urgent care increased; the proportion of cases diagnosed by parish health units decreased. CONCLUSIONS: Reported STI case counts in Louisiana have increased since COVID, and we observed a notable increase in the proportion diagnosed by private providers. Outreach efforts may be needed to reach cases diagnosed outside of traditional sexual health care settings.