• 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)

• 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)

(San Francisco AIDS Foundation, 2024)

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

• 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)

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)

  
  

  
  

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!

(About Chlamydia, 2024)

(California Department of Public Health, 2021)

• 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)

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.)

• 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.