566: Policies to Curb Sexually Transmitted Infections, Xylazine Regulation and Testing

ROBERT JOHNSON: 

This is the award-winning Public Health Review Morning Edition for Monday, December 18, 2023. I'm Robert Johnson. Now, today's news from the Association of State and Territorial Health Officials.

ANNE ZINK: 

This has been the number one topic that states have continued to bring up on our ASTHO calls and other places as they continue to see cases rising.

JOHNSON: 

The number of babies born with syphilis is ten times higher than in 2012. ASTHO Immediate Past President and Alaska Chief Medical Officer Dr. Anne Zink says policies can help.

ZINK: 

So, for example, in Alaska, the majority of our state is in that case, that all sexually active women and their partners get tested for syphilis and this is a really significant change, as well as regular testing for syphilis during pregnancy. So, we've seen some states take legislative action along this line, such as requiring or highly recommending syphilis testing three times during pregnancy.

JOHNSON: 

Concern over the increasing case count has led the federal government to launch a task force to address the problem.

ZINK: 

And really its mission is to address syphilis and congenital syphilis, reduce the rates, and promote health equity across all communities.

JOHNSON:

At the state and territorial levels, Zink says the response ought to include work in support of three strategies.

ZINK: 

One is just on education and awareness and that's what we're seeing really with HHS moving forward with their task force. A second one is on requiring or increasing testing, particularly around the pregnancy and the third one is just funding for really that tested treatment and connection to systems of care.

JOHNSON: 

Policies to prevent sexually transmitted infections are examined as part of ASTHO's 2024 Legislative Prospectus series. Our coverage of the series began last week, it continues through the end of this week. You can read more using the links in the show notes.

JOHNSON: 

Xylazine is in the illicit drug supply. So, what now? States and territories have reacted in different ways. This is ASTHO's Joanne McClure.

JOANNE MCCLURE: 

States have taken various initiatives. Notably, two states have taken steps to improve the consistency of toxicological testing and silencing. Other states have considered and even passed legislation around scheduling it and many states have begun to legalize drug checking equipment to ensure xylazine test strips are available in their jurisdiction.

JOHNSON: 

Testing strips can reduce the risk of accidental exposure. McClure says lawmakers have supported new or modified policies.

MCCLURE: 

With the emergence of xylazine, some states have begun to pass legislation to allow for fentanyl and xylazine-specific drug tracking equipment. Also, this year, we've seen states have amended their previously passed legislation that allowed only fentanyl-specific drug checking equipment to include all direct checking equipment, which would allow for xylazine test strips.

JOHNSON: 

McClure adds some jurisdictions also have decided to regulate xylazine through the scheduling process.

MCCLURE: 

Some considerations leaders should keep in mind are whether scheduling or criminal penalties may deter people from seeking care if they fear being arrested for unknowingly testing positive for exposure or xylazine use. The deterrent effect may affect more people than just those who intentionally use or seek xylazine.

JOHNSON: 

ASTHO has a new blog article on the impact of xylazine on overdose prevention policy. You can read it using the link in the show notes.

Tomorrow, a special issue of the Maternal and Child Health Journal is unveiled in an online event set for 12:30 p.m. ET. The issue examines perinatal substance use. It was developed by ASTHO and the Association of Maternal and Child Health Programs or AMCHP, Amani Echols is with AMCHP.

AMANI ECHOLS: 

We want folks to not only see the supplement, read it, and then mobilize into action that really requires collective action and these strategic directions provides some guidance on how to do that for state health leaders.

JOHNSON: 

Echols says many of the articles are written by local agencies doing groundbreaking work.

ECHOLS: 

The Montana Health Department supports a clinic that conducts screening of their patients at various points in the prenatal and postnatal periods, and screens them to see if they have a substance use disorder, and then promptly connects them to mental health care, substance use disorder care, and social programs.

JOHNSON: 

You can attend the online event tomorrow afternoon. Read more about the report and hold your seat using the links in the show notes.

Before we go, we'd like to remind you to follow this newscast on your podcast player and ASTHO on social media. We're on LinkedIn, Twitter, and Facebook. That'll do it for today.

We're back tomorrow morning with more ASTHO news and information. I'm Robert Johnson. You're listening to the award-winning Public Health Review Morning Edition. Have a great day.