Julia Zigman on STIs and the pandemic

Bloomberg Fellow Julia Zigman has seen workers at health departments across the country stretched thin during the pandemic as they have taken on COVID response duties in addition to their regular work. 

The Program Analyst on the HIV, STI and Viral Hepatitis team at the National Association of County and City Health Officials has seen the change firsthand as she works directly with health departments to build the capacity of their HIV and STI programs to reach more people. That means creating educational materials and other resources - such as webinars, toolkits, and one-page fact sheets -  that can be easily accessed. 

“Health departments are so overwhelmed with work and I think we see, especially in the HIV and STI space, that it is often staff that were working there who were getting redeployed into COVID response,” she said. 

It has also become harder to track STI rates, she said. In general, people weren’t keeping up with their health appointments during the pandemic, which also meant fewer people were getting tested for STIs, possibly skewing the rates.

All of these challenges pushed health providers to think outside the box and offer more innovative services, one of the good things Zigman believes resulted from the pandemic. 

She said more health departments are considering, or already deploying, self-testing options so that a patient can collect test samples at home. This has provided a safe option for people who don’t want to wait in person or find it difficult to social distance. People with HIV are also at higher risk for severe illness from COVID, so health departments have had to be mindful about how to keep these services going without putting people at risk for contracting COVID-19.

Zigman too found herself doing COVID response work early in the pandemic but now is back to focusing on mostly HIV and STI work. She has a particular interest in HIV prevention with youth from marginalized groups, including, Black, Brown, Indigenous and other youth of color. They are often more at-risk and harder to reach. LGBTQ youth, she said, are at much higher risk for HIV than many other populations, but have not historically found government-funded public health clinics all that accessible or friendly.

“I would love to be part of changing that,” she said. 

She is excited about working with another Fellow, Armonté Butler, the LGBTQ Health & Rights Senior Program Manager at Advocates for Youth, on reviewing a new policy proposal put together by Johns Hopkins faculty and colleagues for financing pre-exposure prophylaxis medications that prevent HIV so that more people can afford it. 

“We're working together to understand how local health departments, community advocates and community members might play a role in implementing it and making sure that it is realistic and accessible for people,” she said.