Common sexually transmitted infections like chlamydia, gonorrhea and syphilis are on the rise in Maine, indicating that there is a public health problem that needs a rapid response. It’s a good thing that Maine has a powerful weapon for this fight – it just needs to use it.
The Maine Center for Disease Control and Prevention reports that 2015 brought a dramatic rise in the infections, and 2016 is on pace to go even further. The infections are passed through unsafe sex, and if they are not identified and treated, they will spread deeper into communities, making them harder to root out and eliminate. The number of HIV infections has been more stable, but since that virus is spread in the same ways as the others, it could also spike unless there is an intervention.
As with any infectious disease, the strategy begins with finding out who is sick and treating them, while taking steps to prevent future infections. Both aspects of that fight could be aided by a bill to expand Medicaid for reproductive health services, which became law a year ago but is now bogged down in rule-making within the Maine Department of Health and Human Services.
The program covers men and women with annual incomes up to $24,000, and pays for a variety of services including testing and treatment for sexually transmitted infections as well as birth control.
Under the program, the services are fully covered, with the federal government paying $9 for every $1 spent by the state.
An issue that still has to be resolved could make a big difference in how successful this program will be in fighting these infections. Because people who are not eligible for other MaineCare services could meet the requirements for this program, there may be some confusion about who should get the testing and treatment.
It might sound financially prudent to make anyone who asks for STI testing to first establish their eligibility, but that would be a bad way to save money. It would be much smarter to write the rules so that people are presumed to be eligible for the services, tested and, if necessary, treated before having them fill out paperwork.
That would not only protect these individuals from the consequences of an untreated infection that can cause sterility and other lifelong consequences but also slow the spread of the disease and spare the cost to the community of delaying treatment until the patient is much sicker.
The department is having a public hearing on the issue June 6, and will take written comments until June 16. We hope that the final rule will create a low barrier for new clients seeking testing and treatment. The increase in sexually transmitted infections show that Maine needs to get this program out of the planning stage and into action as soon as possible.
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