SUBJECT
Title
AUTHORIZE ACCEPTANCE OF FUNDING TO ADDRESS SEXUALLY TRANSMITTED INFECTIONS AND APPLY FOR FUTURE FUNDING OPPORTUNITIES (DISTRICT: ALL)
Body
OVERVIEW
Sexually transmitted infections (STIs) remain a significant public health concern locally and across California and the United States. STIs can be associated with increased risk of HIV acquisition and transmission and can cause multiple health complications, including infertility, blindness, hearing loss, and death. Surveillance data demonstrate that the incidence of reportable bacterial STIs increased in San Diego County starting in 2003 and continued to increase through 2022. In 2023 and 2024, data has started to show decreases in STI rates.
The County of San Diego (County) receives funding from the California Department of Public Health (CDPH) to implement public health activities related to prevention, testing, treatment, referral, surveillance, disease investigation, partner services, and community partnerships to support the most vulnerable and underserved individuals living with, or at risk for, sexually transmitted infections. This work is done in collaboration with community-based organizations within our Local Health Jurisdiction and supports increasing access to STI clinical services for LGBTQ+ populations.
On November 25, 2025, CDPH notified the County of funding for the next five fiscal years for the STI Prevention and Collaboration grant. Today’s action requests the San Diego County Board of Supervisors approve and authorize the acceptance of approximately $5,736,290 in funding for the period of July 1, 2026, through June 30, 2031, to support core STI prevention and control activities in San Diego County and authorize applications for additional funding opportunity announcements to support STI testing and prevention resources throughout the region.
Today's action supports the County vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically left behind, as well as our ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished through services that link residents who are vulnerable to HIV and STIs to testing and prevention resources, as well as ensuring that residents with STIs are linked to care and treatment services.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. Authorize the acceptance of approximately $5,736,290 in funding from the California Department of Public Health, STD Control Branch, for the period of July 1, 2026 to June 30, 2031, and authorize the Chief Administrative Officer, or designee, to execute all required documents, upon receipt, including any extensions, amendments, or revisions thereto that do not materially impact the program or funding level.
2. Authorize the Chief Administrative Officer, or designee, in this and future fiscal years, to apply for additional funding for HIV and sexually transmitted infection prevention, testing, diagnostic and/or treatment services.
EQUITY IMPACT STATEMENT
In San Diego County, sexually transmitted infections (STIs) disproportionately impact communities of color (particularly Black/African American residents), youth, and gay, bisexual, and men who have sex with men. According to the 2024 STI data from the County of San Diego (County) Health and Human Services Agency, Public Health Services, HIV, STD and Hepatitis Branch, local STI transmission rates were higher among Black/African Americans and other/mixed-race women and men than among other populations. Specifically, the rate of gonorrhea in Black/African American males was 2.8 times higher than that of white males and 2.6 times that of Hispanic males. In addition, the rate of infection in Black African American females for 3.4 times higher that of while females and 3.1 times that of Hispanic females.
Over the past few years, the County has conducted various community engagement activities focused on identifying and addressing disparities among populations most impacted by HIV and STIs in San Diego County. Currently, there are community engagement projects that focus on the HIV needs of Asian/American Pacific Islander population, and community engagement is occurring with Black/African American, Latino/Hispanic and transgender individuals with a greater emphasis on STIs, particularly congenital syphilis. Funds from the California Department of Public Health will enhance clinical services for LGBTQ+ populations.
SUSTAINABILITY IMPACT STATEMENT
Today’s proposed action supports the County of San Diego (County) Sustainability Goal #2 to provide just and equitable access to County services and resources, and Sustainability Goal #4 to protect the health and well-being of San Diegans. This will be accomplished by increasing the capacity and skill of our disease intervention staff with an aim to prevent, identify, and treat sexually transmitted infections (STIs). Testing, identification, and treatment of STIs will improve the overall health of communities, reduce the demand of associated care services, while increasing effectiveness of care providers and lowering operating costs.
FISCAL IMPACT
Funds for this request will be included in the Fiscal Year (FY) 2026-28 CAO Recommended Operational Plan for the Health and Human Services Agency. If approved, this request will result in estimated annual costs and revenue of $1,147,258 through FY 2030-31 for a total of $5,736,290. The funding source for this grant is the California Department of Public Health. There will be no change in net General Fund costs and no additional staff years.
BUSINESS IMPACT STATEMENT
N/A
Details
ADVISORY BOARD STATEMENT
The Health Services Advisory Board recommended approval of the recommendations at its April 7, 2026 meeting.
BACKGROUND
The County of San Diego (County) Health and Human Services Agency (HHSA), Public Health Services (PHS) department has received Sexually Transmitted Infection Prevention and Collaboration funding from the California Department of Public Health (CDPH) for the past two decades. This funding is used to address and monitor the impact of sexually transmitted infections (STIs) throughout the county. On April 30, 2024 (9), the San Diego County Board of Supervisors (Board) most recently authorized the acceptance of a two-year grant agreement with CDPH in the amount of $2,164,638 for the period of July 1, 2024, through June 30, 2026 to support core STI prevention and control activities in San Diego County.
The STI Prevention and Collaboration grant received from CDPH helps support HHSA’s response to the rise in STIs, including dedicated staffing and programs to provide clinical services, disease intervention services, community health programs, and surveillance.
Clinical services are provided through three Sexual Health Clinics, which provide testing, diagnostic services, treatment, prevention and health education to uninsured or underinsured residents. Clinical staff also provide consultations to community medical providers to ensure accurate and timely diagnosis and treatment of STIs. In Fiscal Year (FY) 24-25, 4,136 clinical services were provided to 2,388 people in the Sexual Health Clinics.
Disease intervention services are provided by Communicable Disease Investigators (CDIs), who work with residents who have been diagnosed with an STI or HIV to provide linkage to care, health education, and partner services. Partner services is a specialized service that works with residents diagnosed with an STI or HIV to notify sex partners of their potential exposure and to link them to testing and treatment resources. In 2024, 2,220 syphilis case investigations were assigned, resulting in a total of 711 cases of infectious syphilis detected.
Syphilis, gonorrhea and chlamydia are bacterial sexually transmitted infection (STIs) of significant focus nationally. STIs are associated with increased risk of HIV acquisition and transmission and can cause multiple complications, including infertility, blindness, hearing loss, and death. Syphilis poses the most significant public health concern, as without treatment, an infected individual remains capable of transmitting syphilis to others for up to one year.
Locally, in California and the rest of the United States, STI rates showed year after year increases between 2000 and 2022. In 2023, and again in 2024, rates began to decrease. These decreases we reflected in downward rates of infectious syphilis, gonorrhea and chlamydia. Only congenital syphilis showed an increase between 2022 and 2023, and then decreased between 2023 and 2024.
In addition to these services, PHS also provides community-based services, including two innovative home-testing programs, Take Me Home, which is focused primarily on gay, bisexual and other men who have sex with men, and Don’t Think, Know, which focuses on women, 25 years of age and younger. Both programs provide an ordering service that provides self-testing kits, which, once used, can be sent to labs for processing. In addition to these testing programs, PHS also funds local community-based organizations to provide community engagement services, which help to mobilize disproportionately impacted communities, specifically African American/Black, Hispanic/Latinx and transgender populations, around preventing the spread of STIs and HIV. Since the inception of the community engagement projects in May 2025, there have been 9 community engagement advisory committee meetings, and 16 community engagement activities reaching 159 individuals.
Finally, HHSA conducts surveillance of STIs that are reported under Title 17 of the California Code of Regulations, which supports local efforts to focus activities on communities and areas of greatest need. PHS publishes a monthly newsletter which provides a snapshot of current cases as well as an annual comprehensive set of slides outlining trends over time in syphilis, gonorrhea and chlamydia.
The County has received funding from CDPH for the past two decades to address STIs. Authorization was most recently received from the San Diego County Board of Supervisors (Board) on April 30, 2024 (9) to accept a two-year grant agreement in the amount of $2,164,638 for the period of July 1, 2024, through June 30, 2026.
Today’s action requests authorization to accept $5,736,290 in STI Prevention and Collaboration funding for the period of July 1, 2026, through June 30, 2031. Of this funding, $2,261,655 will be directed to community-based organizations in the local health jurisdiction.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed action supports the Equity (Health) and Community (Quality of Life) initiatives in the County of San Diego 2026-31 Strategic Plan, as well as our commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This is accomplished through education about Sexually Transmitted Infections, interruption of the spread of STIs, and reduction in the impact of STIs on San Diego County residents, leading to improved physical health and a healthy, safe, and thriving region.
Respectfully submitted,
ebony n. shelton
Chief Administrative Officer
ATTACHMENT(S)
N/A