Regular sexually transmitted disease (STD) screening, early detection, and consistent treatment are all essential to maintaining sexual and reproductive health. Many STDs are asymptomatic, but when left untreated, can cause serious health problems including infertility in both men and women, life-threatening congenital problems in newborns, and STD-related cancers.  STDs also increase a person's risk for HIV.

2018-2023

Policies

• N.J.A.C 8:67 implemented Expedited Partner Therapy, effective January 17, 2023, in accordance with P.L. 2019, c. 336.
• NJDOH STD Program recommends CDC policies and guidelines for screening and treatment of STDs
• As of 2022, NJDOH STD Program recommends additional syphilis screening in the third trimester for all pregnant patients in New Jersey.

Legislation

• N.J.S.A. 26:4-48.2, et seq. The Expedited Partner Therapy (EPT) Statute authorizes a health care professional to give patients, whom the professional diagnoses as having one or more STDs, medication or prescriptions to give to their sex partners to treat the STD without conducting a medical evaluation or clinical assessment of the patient’s sex partners.
• P.L.2021, c.413 repeals the statute that criminalizes sexual penetration while infected with a venereal disease or HIV under certain circumstances. Additionally, the bill requires that in prosecutions for endangering another by creating substantial risk of transmitting infectious disease, the name of the defendant and other individual be kept confidential.  

Outreach

• NJDOH’s STD Program Disease Intervention Specialists (DIS) reach out to patients throughout the state who are infected with syphilis to ensure treatment, notification of sexual partners for testing and treatment, ensure HIV testing, linkage to care, or referral to Pre-exposure prophylaxis (PrEP).  Local health departments also provide DIS services within their jurisdictions.
• Since 2017, the number of congenital syphilis cases reported to NJDOH has increased. Education, via Grand Round presentations, has been done with many of the delivery hospitals in New Jersey to ensure testing is being done according to the law at first prenatal visit and at delivery as well as to promote CDC and American College of Obstetrics and Gynecology recommendations for testing early in the third trimester due to increased rates of syphilis throughout New Jersey. Many of the cases being seen today are among women with little to no prenatal care who are polysubstance users making case investigation and contact tracing difficult to prevent syphilis transmission to their child.
• Since 2021, congenital syphilis cases have been presented to the Fetal Infant Mortality Review Board for case review by practitioners in the field. The emerging themes are presented to a community action board to develop an action plan to intervene and prevent transmission.
• Specialized outreach is conducted by Disease Intervention Specialists (DIS) to pregnant patients diagnosed or at-risk for syphilis to ensure timely testing and treatment in an effort to prevent congenital syphilis.
• Starting in 2021, services were expanded to conduct enhanced interviews with persons diagnosed with gonorrhea. These interviews are conducted in Essex, Camden, and Hudson counties to learn more about patient’s risk profiles and treatment. This has allowed for DIS to link persons to treatment and educate providers on the updated treatment guidelines that were released in 2021.
• NJDOH’s STD Program works with and provides support to local health department STD programs for community outreach, free/low-cost testing in higher prevalence communities. The STD Program also works with the New Jersey Family Planning League to provide free testing to persons within their network which covers every county in New Jersey.

Grants given by NJDOH

• Health Service Grants to support Disease Intervention Specialists (DIS) activities:
  • Burlington County Health Department
  • Camden County Health Department
  • Monmouth County Health Department
  • City of Newark Health Department
  • City of Paterson Health Department
  • CAPCO (Community AIDS Alliance of Passaic County)
  • Henry J Austin Health Center
  • Rutgers University
  • Gloucester County Health Department
  • Jersey City Health Department
• Health Service Grants to support STD clinical services:
  • Burlington County Health Department
  • Camden County Health Department
  • City of Elizabeth Health Department
  • Henry J Austin Health Center
• Health Service Grant to support STD safety net screening among females under age 30 who are uninsured or underinsured:
  • New Jersey Family Planning League

Grants received by NJDOH

• CDC’s Strengthening STD Prevention and Control for Health Departments (PS 19-1901)
• CDC’s DIS Workforce Development Funding provides funds to strengthen DIS workforce for contact tracing for STDs, HIV, COVID-19, and other communicable diseases.

Other actions

• Work is underway to update our laws, many of which were last updated in 1938 to update the language from “venereal disease” to “sexually transmitted infections” and review some laws which predate effective treatment for syphilis.

Assets/resources

• Through the Health Resources and Services Administration’s (HRSA) 340B Drug Pricing Program, NJDOH provides free medications to qualifying clinics, including local health departments, to treat STDs in patients who are underinsured or uninsured
• Through CDC TRAIN’s Passport to Partner Services Modules, followed by a week-long face-to-face component, NJDOH has been able to provide in-house training on the development of skills and techniques for interviewing STD and HIV patients in order to identify sex partners and social contacts for referral to medical evaluation. Specifically, communication skills, problem-solving capabilities, and motivational techniques are honed. Investigation and notification tools, including texting and the internet, are discussed, and feedback on mock interviews (role plays) is provided to each participant.

Challenges

• STDs continue to increase nationwide and in New Jersey.  Overall, there has been an increase of 35% in reported STDs between 2012 and 2021.  This includes a 300% increase in syphilis cases.
• Comprehensive sexual education is necessary as many adolescents and young adults who are sexually active are uneducated regarding their risk and how to seek routine STD testing.
• Many clinicians are not comfortable asking about sexual behavior and patients are embarrassed to ask for testing.

Disparities/inequities

• Men who have sex with men (MSM) are disproportionately affected by primary and secondary syphilis.
• Black New Jerseyans account for a majority of reported STD cases.
• The majority of STD cases are among those aged 15-24 years.
• Among mothers whose children are born with congenital syphilis, polysubstance use is common.

Final Assessment

• None of the Sexually Transmitted Diseases targets were achieved by 2020.

For more information, please refer to these resources:

• NJDOH STI Program
• Get Tested
• CDC Division of STD Prevention 
• Healthy People 2030