Columbia Mailman Programs Combat Rising Rates of STIs

As April marks STI Awareness Month, public health programs are working to address the escalating rates of sexually transmitted infections (STIs) in New York City and beyond. Amidst a national surge in STI cases, particularly evident in New York City, Columbia Mailman School of Public Health initiatives such as Project STAY, in partnership with NewYork-Presbyterian Hospital (NYP), are implementing proven prevention strategies.   

In 2022, more than 2.5 million cases of gonorrhea, chlamydia, and syphilis were reported in the U.S., and New York City was no exception. In the five boroughs, primary and secondary syphilis rates increased 3 percent from 2021 to 2022, with a 35.5 percent increase among people who identify as female. Additionally, women ages 15 to 24 accounted for approximately 58 percent of all chlamydia cases; showing that women in New York City continue to be disproportionately affected by chlamydia. 

At Columbia Mailman, several programs to stem the rising STI rates are led by Alwyn Cohall, MD, professor of Sociomedical Sciences and Population and Family Health at Columbia Mailman School and professor of Pediatrics at Columbia University Vagelos College of Physicians and Surgeons. These efforts are supported by a dedicated team, including several Columbia Mailman alumni starting with program director Gowri Nagendra. Alumni are involved in key initiatives, including Project STAY, Mobile Medical Unit for Community Testing, and the NYC STI/HIV Prevention Training Center. 

Under the direction of Renee Cohall, director of Special Initiatives at the Columbia Mailman-based Harlem Health Promotion Center, more than 130 students have been trained and supervised to become health educators. Columbia students work with community partners to prepare them for careers in public health, social work, and medicine. In addition, Alwyn Cohall teaches a course on the public health impact of STIs which gives students a chance to visit sexual health clinics and school-based programs, as well as the Young Men’s Clinic—a national model for providing sexual and reproductive health care to young men of color.

For more than 25 years, Project STAY (Services to Assist Youth), a program funded by the New York State Department of Health, has provided comprehensive STI prevention and management services in New York City to bring sexual health education to where underserved populations congregate. Settings include schools, workforce development programs, agencies serving LGBGQ+ youth, organizations providing employment training for the formerly incarcerated, as well as PRIDE events, nightclubs, and sex venues. In addition to traditional treatment regimens, the team works to increase the uptake and utilization of Doxy-PEP, an antibiotic used to stem the spread of STIs within communities. Columbia Mailman graduate Caroline Carnevale is the  “clinic champion” at NYP coordinating STI clinical and prevention services offered to individuals referred through Project STAY. Alum Zoe Plewa works as Project STAY as a research coordinator. 

 To expand venue-based screening, a mobile medical unit (MMU), referred to as the “clinic on wheels,” was recently acquired with support from the Dalio Center for Health Justice and the Centers for Disease Control and Prevention. The MMU travels to community venues citywide to offer STI testing services. Two Columbia Mailman graduates—Annie Herskovitz and Maddie Pumphrey—are involved in program planning and operational support for the MMU.

The NYC STI/HIV Prevention Training Center (NYC PTC) offers training and resources to medical health professionals in New York, New Jersey, Ohio, Indiana, Michigan, Puerto Rico, and the U.S. Virgin Islands, to enhance their skills in STI prevention, diagnosis, and treatment. The program is led by Gowri Nagendra and Cohall, and assisted by Jessica Steinke, another Columbia Mailman alum, as well as faculty from Columbia Irving Medical Center. The center is funded by the U.S. Centers for Disease Control and Prevention.

Through these efforts, as well as others undertaken in collaboration with the New York City Department of Health and Mental Hygiene to mitigate the impact of clinic closures during the pandemic, Cohall and collaborators are promoting sexual health and combating the spread of STIs. His vision extends beyond current initiatives, as he seeks to integrate public health principles into medical training, ensuring a holistic approach to health care delivery.

“Albert Einstein has been quoted as saying, ‘Creativity is intelligence having fun.’ While the STI epidemic is daunting, Columbia Mailman School of Public Health, along with partners at CUIMC and in the community, have been at the forefront of developing creative, innovative approaches to reducing the community burden of infections. It is hard work, but extremely gratifying,” says Cohall.