Sometimes public health efforts operate like a loudspeaker, serving large areas of the community at once, such as with our work to protect drinking water or to respond to emergencies. However, when it comes to reproductive health, our local public health efforts usually operate more like a cell phone, serving one resident at a time with confidential one-on-one education or clinical services.

The Virginia Department of Health is committed to ensuring that all Virginians have access to reproductive health services. Our seven Roanoke City & Alleghany Health Districts (RCAHD) locations offer reproductive health services to all district residents, including confidential counseling, routine checkups, prevention services, testing, treatment, and partner referrals. We place a strong emphasis on maintaining privacy and confidentiality for our clients in a non-judgmental environment. We accept most insurances and offer a sliding scale with free services for those who qualify based on income.

Recently there has been a concerning rise in sexually transmitted infections (STIs) across the country, including in our own districts. According to the CDC, rates of three common STIs (chlamydia, gonorrhea, and syphilis) continue to increase, including in rural settings such as ours. Nationwide, half (49.8%) of reported STI cases in 2022 were among teens and young adults aged 15–24 years. In our area, specifically in Alleghany County, Roanoke City, and Roanoke County, we are particularly concerned about high rates of early syphilis.

It is essential that individuals protect themselves from STIs because such infections may cause serious health problems when left untreated. Fortunately, we have the tools to change this trend. Because STIs often do not show symptoms, screening is one of the important tools to ensure timely diagnosis and treatment. In addition, we know that evidence-based sexual health education can have a positive impact by delaying the initiation of sexual intercourse, reducing the number of sexual partners, and increasing the use of safer sex practices, including condom use. RCAHD is doing its part to improve access to good quality education about reproductive health education, including education about STIs. RCAHD staff have increased outreach visits to community colleges such as Virginia Western in Roanoke and Mountain Gateway in Clifton Forge to better connect students with public health and other partner services in the community.

RCAHD is committed to ensuring access to the services we provide. We recognize that in our more rural areas, residents may have fewer providers to choose from and are likely to face more geographic challenges with transportation. Increasingly, we are encouraged to see many of our healthcare partners use telehealth services as a practical solution to decrease barriers to health care access. We also recognize that in smaller rural communities, our health department staff often know their patients, not just as patients, but as neighbors and friends, and in some cases even as relatives. Please be assured that the privacy and confidentiality of every person we serve is of paramount importance to our team.

Understanding the community’s needs, such as barriers that are unique to rural communities, is critical for successful public health activities. To ensure that we do understand community’s needs, we work with local stakeholders to routinely ask residents for their input about their needs and possible solutions. And as we work together to decrease the burden that STIs place on people in our community, RCAHD recommends that:

• All pregnant women should be tested for syphilis at their first prenatal appointment. They may also need testing again later in their pregnancy.
• People between 15-44 years old talk with their healthcare professional about STI testing, especially because symptoms can sometimes be missed or mistaken for other health conditions.

As we continue to face the threat that STIs present to our community’s health, we know that when RCAHD residents—including teenagers—have access to quality reproductive and sexual health care and education, they can live happier and healthier lives.