STD Clinic Capacity Survey – Monkeypox Response

June 14-16, 2022

The National Coalition of STD Directors (NCSD), the association representing state and local health department sexually transmitted disease (STD) directors and staff, has conducted the first known survey on sexual health clinics’ capacity to manage the emerging monkeypox outbreak. The survey of more than 100 clinics—including categorical STI clinics, FQHCs, reproductive health clinics, ASOs, CBOs, and primary care providers—conducted on June 14-16, 2022, demonstrates that clinics have the willingness and skills to play a central role in the monkeypox response, but need supplies, information, and staffing to scale up an appropriate response.

1. Clinics providing STD testing and treatment services have seen an increase in monkeypox symptoms and patients seeking monkeypox testing.
   • Nearly 20% of clinics have seen patients for monkeypox concerns or symptoms.
   • 8% have had suspected monkeypox cases in their clinic.
   • In the first 30 days of the outbreak, some clinics have seen more than 30 patients present with monkeypox concerns or symptoms.

2. Clinics have a need to serve monkeypox patients but lack specific supplies, information, and staffing to manage the current outbreak.

• Supplies
  • Less than 20% currently have the correct test tubes needed to collect monkeypox samples for testing.
  • Only 44.2% have the correct swabs needed to collect monkeypox samples for testing.
  • Clinics are willing and able to conduct testing if provided supplies.
• Information
  • Only 29.5% of clinics feel that their providers/staff have enough information TODAY to test for/diagnose monkeypox in their clinic
  • Clinics report that the CDC’s protocols are too lengthy and cumbersome to deploy quickly and that general public health guidance for providers has been vague and unclear.
• Staffing
  • Only 41.1% of clinics have the current staff capacity to meet the current monkeypox testing demand.
  • Only 32.1% of clinics could provide staff to meet increased monkeypox testing demand if cases increased

3. STD clinics are frontline healthcare providers in the monkeypox response.  Sexual health clinics are not only safety net clinics, they are specialty clinics that have the key expertise to address public health crises (contact tracing/COVID-19 response, syphilis outbreaks, etc.,) including monkeypox
   • 61% of patients presenting with monkeypox symptoms have tested positive for another sexually transmitted infection, such as syphilis. Providers need the capacity and training to differentiate between similar-looking infections.

4. STD clinics are committed to and able to mobilize in the monkeypox response.
   • 60% report being able to provide smallpox vaccines if the need arises, but only 4.7% currently offer the vaccine.
   • 82% of clinics report having the refrigeration capacity to store and deliver smallpox vaccines.

About the Survey

NCSD developed the STD Clinic Capacity Survey – Monkeypox Response to assess the needs of clinics that may see monkeypox patients nationwide and distributed it via NCSD’s listserv of clinics on June 14-16, 2022. It is the first assessment of clinics’ capacity to respond to the growing outbreak of monkeypox in the U.S. Clinics on the listserv include more than 1,000 categorical STD clinics, family planning clinics, primary care providers, health departments, federally qualified health centers (FQHCs), AIDS services organizations, and other health providers that participate in NCSD’s Clinic + network or receive training or information about STDs.

Download the Survey