Net meets street to defeat STDs: County home STD testing program employs cutting-edge technology

Los Angeles County Supervisor Mark Ridley-Thomas launched a high-tech outreach effort to tackle sexually transmitted diseases in the Second Supervisorial District, where STD levels are the highest in the County. Before the crowd of more than 50 health care advocates, ministers and first ladies, Supervisor Mark Ridley-Thomas led the press conference in front of the new Martin Luther King Jr. Center for Public Health in Willowbrook to announce cutting-edge enhancements to the sexually transmitted disease home testing “I know” program.
The statistics painted a stark picture: STD levels in the Second Supervisorial District are the highest in the County, with hot spots centered in South Los Angeles, and Los Angeles County has the highest number of chlamydia cases and the second-highest number of gonorrhea cases of any county in the nation. More than 30,000 women and girls acquire infections every year, with younger women most heavily affected. In 2010, there were 20,337 chlamydia cases and 2,136 gonorrhea cases reported in females ages 15-24.  With the goal of overcoming barriers to diagnosis and treatment, the County launched its award-winning “I Know” home test kit program in 2009, Monday, at the new Martin Luther King Jr. Public Health Center, Supervisor Ridley-Thomas and the Department of Public Health are rolling out cutting-edge enhancements to the program: New digital tablets and touch-screen kiosks now make home testing kits more widely and immediately available to women. Women who use the kiosks or digital tablets to order a kit will be able to receive their kit on the spot, without waiting for it to arrive by mail. All “I Know” materials and the website are available in both English and Spanish, and there is no cost to use the home testing program.  Kiosks will be placed at selected venues in the Second District; digital tablets will be put in the hands of trained outreach workers at a wide variety of locations. Both kiosks and tablets will enable secure access to the program’s website to record kit orders, so that women can later obtain their results from the program website, or by calling a toll-free number. Women throughout the County will continue to be able to order kits from the www.DontThinkKnow.org website, or by calling the County STD Program’s toll-free hotline number, 1-800-758-0880, to have test kits sent to them by mail.

“Unfortunately, these infectious diseases are at unacceptable levels and are increasing, particularly among young African-American women,” said Supervisor Ridley-Thomas. “Shame is not a cure. These are our mothers, our sisters, our daughters who are suffering from the health consequences of these STDs, and we cannot let them go untreated. Families depend upon them, communities depend upon them, but you can’t treat what you don’t know exists.”

“The “I Know” program has a track record of success,” the Supervisor continued, “so we come together today to encourage women who may be afraid — who likely have no symptoms, but who have made some choices that put them at risk — to take that first step toward getting help and taking a test right in the privacy of their own homes.”  LA County Health Officer Dr. Jonathan E. Fielding concurred: “Easy diagnostic testing and effective single-dose treatments mean that there is no reason for anyone now to suffer infertility, tubal pregnancy, complications for newborns, or other serious long-term consequences of these unnecessarily common STDs.” With most cases being asymptomatic, regular screening by sexually active individuals is the only effective way to stop the spread of the these infections, said Dr. Fielding. Chlamydia and gonorrhea are curable, but treatment does not prevent subsequent infection. The Centers for Disease Control and Prevention (CDC) recommends that sexually active women age 25 and younger be screened for chlamydia once per year.  The “I Know” home testing program has been a true success. In its first year the website received 30,878 total visits and 2,927 kits were ordered. A total of 1,543 testable swabs were returned, of which 131 (8.5%) were positive for chlamydia or gonorrhea.

“This program has been incredibly successful in promoting testing and finding STD cases,” said the Dr. Peter Kerndt, STD Program Director at the department, noting that few clinics can show a comparable rate of case detection, and that none can perform testing for such a broad cross-section of at-risk women. In addition, according to Dr. Kerndt, not all women can or will access a clinic, due to lack of transportation, privacy fears, or the lack of symptoms typical of these STDs. The launch of the new program coincides with the imminent opening of the new Martin Luther King, Jr Center for Public Health, at the corner of Wilmington and 120th Street, a County public health facility that went from ground-breaking to completion in less than one year.  According to Supervisor Ridley-Thomas, the expanded “I Know” program epitomizes the potential of public health, and dovetails with the mission of the new health center, in the 21st century.

“You can see that we have a community engagement room in this new health center, which opens large bay doors directly to the outside for large-scale events,” he said. “Like those bay doors, this health center will open the potential for public health far beyond its own walls: the “I Know” program will now be everywhere that we can put a kiosk, everywhere any partnering community agency can send an outreach worker with a tablet, and anywhere a woman has access to a computer or any phone. But for those who need treatment or follow-up exams, this new health center has its doors wide open.”

Supervisor Ridley-Thomas noted that the expansion of “I Know” is also linked to a comprehensive strategy, further extending linkages from clinics to the surrounding community. Other elements of the comprehensive strategy include an increase in community-based public health workers to follow-up on cases and ensure treatment of women and their partners, school education programs, clinic referral guides for high school and middle school students, a County authorized use of a mobile van for outreach and distribution of condoms and partnerships with community-based agencies, as well as faith-based organizations. These partnerships will put tablets in the hands of trained community outreach workers to deliver home test kits in the communities most impacted by these infections. Supervisor Ridley-Thomas emphasized that public health is a critical investment that local government must make, because there is no other entity to do so.

Supervisor Ridley-Thomas also hosted a breakfast on September 1, 2011 for some of the leaders from the ecumenical community to enlist their support for his initiative. The poignant discussions has resulted in the First Ladies of the Faith-based community taking a stand on this issue and offering a well-thought out plan to work with the Second District and the Department of Public Health to empower young women to take charge of their overall health and well-being.  Previous evaluation of “I Know” conducted by the County’s STD Program showed that women ages 18-25 (all eligible for the home testing program) who had seen “I Know” marketing materials were more than 1.5 times more likely to have been tested for Chlamydia and gonorrhea in the past six months. The program also received an achievement award in 2010 from the National Association of Counties.

In 2010, there were 44,648 total reported cases of chlamydia and 9,501 total cases of gonorrhea among L.A. County residents. Among diseases with mandated reporting requirements, chlamydia and gonorrhea are the two most commonly reported infectious diseases in the United States.

In closing the Supervisor notified onlookers that the Martin Luther King, Jr. Center for Public Health is the first facility in Los Angeles County to use a mobile STD testing van, touch screen kiosks, and digital tablets in the campaign against sexually transmitted diseases. “You are witnessing history, right here, right now, and you are a part of it,” said Supervisor Ridley-Thomas.

About eight kiosks will be placed around South Los Angeles. Test-takers are able to get their test results online or by calling 1-800-758-0880.


Press Release (PDF)
Gonorrhea Cases (PDF)
Chlamydia and Gonorrhea (PDF)
I Know Posters (PDF)
Fact Sheet – Spanish (MS Word)
Fact Sheet – English (MS Word)

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