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Clam It Down!

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Adults ages 20-29 in San Francisco are eligible to participate in the program.

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Chlamydia infection, is a sexually transmitted disease caused by the bacterium Chlamydia trachomatis. Chlamydia can often not have any symptoms but can cause serious health outcomes. Symptoms to look out for are discharge from genitals and painful urination. Transmission is spread through vaginal, anal, or oral sex with an infected person.

(About Chlamydia, 2024)

(California Department of Public Health, 2021)

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This program and all its components were designed following a theory that aligned with our programs values. This program illustrates the community power by building strength for adults in San Francisco are facing ages 20-29 with STI's such as Chlamydia due to limited resources or education. For these reasons, we are hosting workshops to educate people every day on a new topic that pertains to Chlamydia. In addition, we are having a peer-to-peer program that will allow people to discuss issues that are affecting them. Lastly, we are conducting information that will be illustrated a social media campaign.

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San Francisco County is the largest host of Chlamydia in California

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San Francisco County is the largest host of Chlamydia in California

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Adults from ages 20-29 in San Francisco, California are suffering at a disproportionate rate compared to their neighboring cities in California.

In both male and females, chlamydia is the highest among 20-24 year olds.

In November 2023, both men and women had a total amount of 11,183 cases

The female Chlamydia rate is 1.5 times more than the male Chlamydia rate

The number of Chlamydia cases per 100,000 people is 791.2 in SF, which is higher than the state average

Chlamydia has the highest rates of STIs in California, with SF rates being the largest compared to other counties

(California Department of Public Health, 2021), (San Francisco Monthly STD Report Nov 2023 and California Department of Public Health Chlamydia Datat 2021), and (Stacker, 2024)

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Program Activities Phase 1: Program Development (mos. 1-3)

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Program Activities Phase 1: Program Development (mos. 1-3)

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Hire staff: Teacher, President, Vice President, Treasurer, Social Media Coordinator, & have volunteers to be ambassadors. As well as clinical staff: general physician, nurse practitioner, and volunteers

Develop Partnerships with non-profits and/or clinics in San Francisco

Purchase materials and self testing kits

Develop an informative curriculum on “No Clam Zone” to teach our staff the importance on understanding what are Sti’s, Specifically on chlamydia

Rent out a space

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Decrease in the number of chlamydia cases in San Francisco amongst adults aging 20-29 in 2 years

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Chlamydia has been an ongoing issue in San Francisco. According to San Francisco Department of Public Health (SFDPH), there were rates of (1174.3 per 100,000) in 2019.

In 2019, over 18% of people in the San Francisco region were testing positive.

After the start of the COVID-19 Pandemic, there was an uprise of positive Chlamydia rates of 5,200 new cases.

(San Francisco Department of Public Health, 2022)

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Chlamydia is contracted sexually and person to person due to unprotected sexual intercourse. Most people who contract Chlamydia in San Francisco are young individuals who do not use condoms or have safe practices of cleaning toys or bodily fluids. A main contributor to this issue is due to inadequate access to condoms or contraceptives for San Francisco natives such as store policies that allow retail stores to lock up or hold contraceptives behind the counter.

Not enough access to condoms since most Safeways in Potrero have them behind the counter (San Francisco Bay Guardian Archive, 2011)

Hygiene: many people are not taught how to clean their toys after use or may not think it is a big deal. 14% of people do not clean their toys. (Brooks, 2023)

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Risky Sexual Behavior Can Lead To Chlamydia 

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Risky Sexual Behavior Can Lead To Chlamydia 

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In SF, the rates of chlamydia has increased particularly in the young youth group age.

Specific groups that are more at risk are those who:

15-24 years old as they may not be as well versed in sexual protection, thus engaging in unprotected intercourse.

Have new sex partners within the past 60 days as it can increase exposure to chlamydia.

No or inconsistent condom use when not in mutually monogamous partnerships.

Have history of a prior STI, such as chlamydia, gonorrhea, HPV, or syphilis.

(09. Sexually Transmitted Infections (STIs), n.d.)

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Influenced by family and friends, stigma comes from a lack of education, and the language of shame creating a barrier to notifying sex partners.

Never-tested and tested individuals are scared of shame and receiving stigmatizing reactions from people outside their trusted network if they share their intention of testing or encouraging testing.

In a poll by the Herny J. Kaiser Family Foundation

About 1 in 8 individuals say they are uncomfortable discussing STIs with a sexual partner

While 1 in 7 individuals are uncomfortable talking about STIs with a doctor

(“The Impact of Social Stigmas on Sexual Health Seeking Behavior: A Review of Literature,” 2020)

(Taking the Stigma Out of STIs, 2023)

(M Theunissen et al., 2015)

(Kirzinger et al., 2021)

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At the community level, there are many factors that play a role in the epidemic of STI rates, with one being not enough resources due to disparities amongst the community. According to San Francisco Aids Foundation, they illustrate the main campuses that are available for free testing and despite them being free, they are primarily located in the Castro which is great but far from those in low income areas such as the Bayview or Visitacion Valley.

(San Francisco AIDS Foundation, 2024)

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At least 70% of women and 50% of men are asymptomatic with chlamydia at the time of diagnosis (Factsheet About Chlamydia, 2010)

Chlamydia often presents with no symptoms, thus leading to undetected infections that can easily transmit person to person. The major strategy for control of STIs in sexually transmitted disease clinics are usually to manage symptomatic infections for individuals seeking treatment.

Training healthcare workers to proactively offer STI screening and reduce biases that can discourage people from testing. Encouraging free and accessible testing would not only benefit those who are symptomatic, but also those who are sexually active but don’t have symptoms!

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Not getting STD tested can leave individuals at risk. Chlamydia a bacteria infection can negatively affect one’s health. When not treated it can lead to scaring in the fallopian tubes. Also ectopic pregnancy which is outside of the womb or also lead to infertility. Another negative outcome would be abdominal and pelvic pain, pelvic pain can also be a sign for pelvic inflammatory disease. Sores and inflammation from chlamydia can make the body more vulnerable to HIV.

Chronic pelvic pain occurred in approximately 32% of participants

Infertility in approximately 18% participants

Ectopic pregnancy in <1% of participants

(California Department of Public Health, 2021)

(Pelvic inflammatory disease, 2021)

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Here are the citations organized alphabetically:

1. About Chlamydia. (2024, February 20). Chlamydia. https://www.cdc.gov/chlamydia/about/index.html

2. Brooks, Lauren. Forbes. https://www.forbes.com/sites/lakenbrooks/2023/05/31/14-of-people-have-never-cleaned-their-vibrator-heres-how-to-wash-your-sex-toys/. 2023 May 31.

3. CA. (n.d.). https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/2021-STD-Surveillance-Executive-Summary.pdf

4. California Department of Public Health. (2021). Sexually transmitted diseases in California. In 2021 Executive Summary [Report]. https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/2021-STD-Surveillance-Executive-Summary.pdf

5. Factsheet about chlamydia. (2010, July 27). European Centre for Disease Prevention and Control. https://www.ecdc.europa.eu/en/chlamydia/facts

6. Kirzinger, A., Muñana, C., Brodie, M., Frederiksen, B., Weigel, G., Ranji, U., & Salganicoff, A. (2021, April 13). Public knowledge and attitudes about sexually transmitted infections: KFF polling and policy insights | KFF. KFF. https://www.kff.org/womens-health-policy/issue-brief/public-knowledge-and-attitudes-about-sexually-transmitted-infections/

7. Mitchell CM, Anyalechi GE, Cohen CR, Haggerty CL, Manhart LE, Hillier SL. Etiology and Diagnosis of Pelvic Inflammatory Disease: Looking Beyond Gonorrhea and Chlamydia. J Infect Dis. 2021 Aug 16;224(12 Suppl 2):S29-S35. doi: 10.1093/infdis/jiab067. PMID: 34396407; PMCID: PMC8365120.

8. SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH. (2019). Stop the hidden epidemic: Five steps to prevent and treat HIV, HCV, and STDs among people experiencing homelessness. https://californiaptc.com/wp-content/uploads/2020/03/Stop-the-Hidden-Epidemic-Five-Steps-to-Prevent-and-Treat-HIV-HCV-and-STDs-Among-People-Experiencing-Homelessness.pdf

9. San Francisco Bay Guardian Archive. (2011, September 20). Hiding the condoms — San Francisco Bay Guardian Archive 1966–2014. San Francisco Bay Guardian Archive 1966–2014. https://sfbgarchive.48hills.org/sfbgarchive/2011/09/20/hiding-condoms/

10. San Francisco Homeless Count and Survey Planning Team. (2024). San Francisco 2024 Homelessness Point-In-Time Count. https://hsh.sfgov.org/wp-content/uploads/2024/08/2024-San-Francisco-Point-in-Time-Count-Report-8_13_24-1.pdf

11. Sexually transmitted infections (STIs). (n.d.). Hospital Handbook. https://hospitalhandbook.ucsf.edu/09-sexually-transmitted-infections-stis/09-sexually-transmitted-infections-stis

12. Stacker. (2024, April 9). Counties with the highest STI rates in California. Santa Rosa Press Democrat. https://www.pressdemocrat.com/article/news/counties-with-the-highest-sti-rates-in-california/

13. Taking the Stigma out of STIs. (2023, January 25). Planned Parenthood. https://www.plannedparenthood.org/planned-parenthood-pacific-southwest/blog/taking-the-stigma-out-of-stis

14. Talley, Jason O. (2020). "The Impact of Social Stigmas on Sexual Health Seeking Behavior: A Review of Literature," McNair Scholars Research Journal: Vol. 13, Article 11. https://commons.emich.edu/mcnair/vol13/iss1/11

15. Theunissen, M. A. T., Bos, R. A. E., Hoebe, J. P., Kok, G., Vluggen, S., Crutzen, R., & Dukers-Muijrers, H. T. M. (2015). Chlamydia trachomatis testing among young people: What is the role of stigma? BMC Public Health, 15. https://doi.org/10.1186/s12889-015-2020-y

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1. Increase in the number of adults aged 20-29 in SF who are using contraceptives by 12 months.

2. Increase in the number of adults ages 20-29 in SF who are taking action by getting STI tests completed, especially when engaging with multiple sexual partners and/or having unprotected sex in 12 months.

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1. Increase in the number of adults aged 20-29 in SF believe that contraceptive use is important for their health within 6 months.

2. Increase in the number of adults aged 20-29 in SF know how to beware of transmission, symptoms, and prevention of STIs in 6 months.

3. Increase in the number of adults aged 20-29 in SF who believe that getting tested for chlamydia is important for their health within 6 months.

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Program Activities Phase 2: Program Implementation (mos. 4-21)

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Program Activities Phase 2: Program Implementation (mos. 4-21)

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No Clam Zone: Educational Component

San Francisco State University and SF City College will host education workshops on chlamydia prevention, intervention, and treatment topics.

One-hour workshops occur monthly with lectures, Q&A segments, and social media messaging campaigns during sessions.

A total of 50 participants per session complete one workshop and a survey to receive health certification after attending all 17 workshops.

CSHAs (Community Sexual Health Ambassadors) will assist with data collection of attendance and engage with attendees to other resources available to the community with program pamphlets of the next workshops and clinics.

Don't Spread the Infection, Go Get Tested: Access of Resources

Collaboration with local colleges and clinics to hold testing events and 4 clinic events monthly for 17 months.

Nurse practitioners and staff will be present from 5 pm-10 pm once a week.

Clinic Events will include an informational booth providing on-site free chlamydia rapid tests, condoms, and educational pamphlets

Chlamydia Crusaders: Awareness Peer-to-Peer Support

Program Admin peer support to CSHAs (Student Interns) to support staff at workshop seminars and clinic events, geographical research, and canvassing for one-on-one community engagement.

CSHA's will be meeting 3x a week to canvass materials and plan canvassing maps

Student Interns will have undergrad and post-grad majors in health education or experience in sexual health with bi-lingual translation skills.

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Program Activities Phase 3: Closing (mos. 22-24)

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Program Activities Phase 3: Closing (mos. 22-24)

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Conduct assessment on if chlamydia rates are reduced in adults aged 20-29 in SF.

Develop a final report regarding all programs such as, "No Clam Zone" and free testing sites/clinic.

Provide student ambassadors with health education work experience and sexual health knowledge

Hosting a, "No Clam Zone!" party to celebrate the program's accomplishment, share testimonies, thank partners, participants, ambassadors, and volunteers.

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1 curriculum to train the ambassadors

3 Clam It Down! ambassadors

2 curriculums for, “No Clam Zone!”

850 participants will be in attendance within 2 years for No Clam Zone!

17 sessions of No Clam Zone!

68 pop-ups for free testing and resources

5100 free home testing kits for chlamydia

680 patients will utilize on-site lab testing

1,700 condoms will be given out in the free clinic

15,300 brochures will be given out by clinic volunteers containing information about chlamydia, transmission, etc.

15,300 door handle flyers

1000 program business cards for “No Clam Zone” and “DSIGGT”

500 clinic service flyers

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Project Director (Full-Time)

Project Coordinator (Full-Time)

Health Educator for No Clam Zone

4 Sexual Health Ambassadors (Part-Time)