Sexually transmitted infection testing is no longer free at county health departments due to recent federal cuts to COVID-19 pandemic relief funding.

Community-based organizations and health providers that previously received free STI testing at the state’s public health laboratory through federal grant funding will now have to pay for the services or contract with a commercial lab.

The grant was part of a five-year, $1.13 billion nationwide federal investment to bolster infrastructure to support COVID-19 and STI prevention efforts. It was originally set to end in January 2026.

The cut delivers a double blow to Mississippi, which lost funding for STI services last month when the federal government froze millions of dollars of Title X funding. Title X is used to provide basic reproductive health care, including STI testing and treatment, to Mississippians.

The change will impact chlamydia, syphilis and gonorrhea testing, said Kendra Johnson, the director of communicable diseases for the Mississippi State Department of Health.

Mississippi has some of the highest sexually transmitted infection rates in the country.

The state has been battling skyrocketing syphilis rates for over a decade and has experienced a more recent surge in congenital syphilis, which occurs when a mother passes the infection to her infant during pregnancy. Congenital syphilis is associated with serious health outcomes, including preterm deliveries and infant deaths.

Mississippi’s chlamydia and gonorrhea rates are second and fifth in the nation, respectively, but have been declining since 2020, according to Centers for Disease Control and Prevention data.

County health departments will now accept insurance for STI tests, and people without insurance will have to pay out of pocket. The agency is considering offering a discounted rate for uninsured people.

However, no one seeking STI testing will be turned away from the health department, Johnson said.

“If they don’t have the means to pay for services, we will be able to support it.”

The Centers for Disease Control and Prevention pulled back $230 million in funding to the Mississippi State Department of Health in March that was originally allocated by Congress for testing and vaccination against COVID-19.

The slashed funding to the agency has impacted planned improvements to the public health laboratory, the agency’s ability to provide COVID-19 vaccinations, community health workers and preparedness efforts for emerging pathogens like H5 bird flu.

In the wake of the funding cuts, the health department was forced to make decisions about its funding priorities. Federal funding accounts for 66% of the agency’s budget.

“With limited resources, you’re kind of forced to determine how to keep things moving with what you have, and what’s necessary and what’s not,” said Johnson.

Community-based organizations and health providers were suddenly notified last Friday that agreements for free testing services were halted.

“Effective immediately, the MSDH requires your facility to cease submitting specimens to the (Mississippi Public Health Laboratory),” the April 11 letter from the Health Department stated.

Open Arms Clinic, which has locations in Jackson and Hattiesburg and seeks to make health services accessible to marginalized and underrepresented populations, was using the grant funding to support community STI testing through its mobile clinic, said President and CEO June Gipson.

The mobile clinic will now have to utilize a new funding source to continue providing free STI testing to patients.

Unchecked STIs could be devastating in Mississippi, said Gipson, who remembers the first months of the COVID-19 pandemic, when most resources and attention shifted away from HIV and STI efforts and infection rates climbed unchecked.

“You have to pay attention to STDs like you pay attention to the road,” Gipson said. “Drive for others.”

Plan A, a clinic in the Delta that provides free health care services with an emphasis on sexual and reproductive health, had been receiving free STI testing through the health department lab for about a year before it was notified of the funding cuts last week.

Before the cuts, the clinic had already noticed a heightened need for such tests after some county health departments cut or pared down their clinical services.

The increase in need paired with a sudden decrease in funding is a “brutal combination,” said Caroline Weinberg, the founder and program director of Plan A. But the clinic will work to find another funding source to ensure that patients don’t experience disruptions in services.

Plan A’s STI positivity rate is significantly higher than the state’s overall rate, Weinberg said. She hypothesizes this may be due to the clinic’s commitment to free testing, which encourages people to get tested even when they don’t have symptoms.

Gonorrhea and chlamydia often go untreated because infected people never have symptoms.

Decreased access to testing will lead to lower STI rates, but will conceal high rates of infection, Weinberg said.

“It’s going to have a longstanding ripple effect,” she added.

A spokesperson for the health department declined to say what other organizations will be impacted by the change.

The health department is not experiencing other cuts to STD or HIV health services at this time, said Johnson.

“But if you ask me that same question next week, we may have a different response.”

Gwen Dilworth, Mississippi Today