{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T06:50:49Z","timestamp":1777963849311,"version":"3.51.4"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,5,11]],"date-time":"2025-05-11T00:00:00Z","timestamp":1746921600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institute of Health Research","doi-asserted-by":"crossref","award":["PJT-468611"],"award-info":[{"award-number":["PJT-468611"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study investigated whether the COVID-19 pandemic was associated with changes in sexually transmitted infection (STI) incidence and trajectories in Ontario, Canada and the modifying role of public health funding for infectious and communicable diseases (ICD).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A repeated cross-sectional study was conducted using population-level age and sex standardized incidence of chlamydia, gonorrhea, and infectious syphilis by public health unit (PHU) in Ontario from January 2015\u2013October 2022. A negative binomial regression interrupted time series analysis estimated trends in STI incidence rates pre- and post-pandemic-onset and whether associations differed by public health ICD funding per capita.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There was an immediate reduction post- compared to pre-pandemic onset in chlamydia (Rate Ratio (RR)\u00a0=\u00a00.27, 95% confidence interval (CI): 0.21\u20130.35), gonorrhea (RR\u00a0=\u00a00.15, 95% CI: 0.02\u20130.94), and syphilis (RR\u00a0=\u00a00.16, 95% CI: 0.02\u20131.18). Post-pandemic onset, a dollar increase in PHU\u2019s ICD funding per capita was associated with greater incidence of chlamydia (RR\u00a0=\u00a01.10, 95% CI: 1.08\u20131.12), gonorrhea (RR\u00a0=\u00a01.14, 95% CI: 0.99\u20131.32) and syphilis (RR\u00a0=\u00a01.11, 95% CI: 0.97\u20131.28). Following this initial drop, trends in STI incidence did not differ importantly by ICD funding.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Findings are consistent with a role of public health funding in mitigating observed decreases in STIs. Results suggest that public health funding plays a role in maintaining STI detection services during a public health emergency.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/pubmed\/fdaf053","type":"journal-article","created":{"date-parts":[[2025,5,11]],"date-time":"2025-05-11T08:37:18Z","timestamp":1746952638000},"page":"395-403","source":"Crossref","is-referenced-by-count":3,"title":["The COVID-19 pandemic\u2019s impact on sexually transmitted infections and the modifying role of public health funding: an interrupted time series study"],"prefix":"10.1093","volume":"47","author":[{"given":"Naomi","family":"Schwartz","sequence":"first","affiliation":[{"name":"Public Heath Ontario, 661 University Avenue , Suite 1701, Toronto, ON M5G 1M1 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Hunter","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alberta , 3-300 Edmonton Clinic Health Academy, Edmonton, AB T6G 1C9,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha M","family":"Forbes","sequence":"additional","affiliation":[{"name":"Public Heath Ontario, 661 University Avenue , Suite 1701, Toronto, ON M5G 1M1 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dionne","family":"Gesink","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health, University of Toronto , 155 College St Room 500, Toronto, ON M5T 3M7 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Hobin","sequence":"additional","affiliation":[{"name":"Public Heath Ontario, 661 University Avenue , Suite 1701, Toronto, ON M5G 1M1 ,","place":["Canada"]},{"name":"Dalla Lana School of Public Health, University of Toronto , 155 College St Room 500, Toronto, ON M5T 3M7 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura N","family":"Anderson","sequence":"additional","affiliation":[{"name":"Health Research Methods, Evidence, and Impact, McMaster University , 1200 Main Street West, Hamilton, ON L8N 3Z5,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Rebellato","sequence":"additional","affiliation":[{"name":"Simcoe Muskoka District Health Unit , 15 Sperling Drive, Barrie, ON L4M 6K9,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman","family":"Pabayo","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Alberta , 3-300 Edmonton Clinic Health Academy, Edmonton, AB T6G 1C9,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan T","family":"Smith","sequence":"additional","affiliation":[{"name":"Public Heath Ontario, 661 University Avenue , Suite 1701, Toronto, ON M5G 1M1 ,","place":["Canada"]},{"name":"Dalla Lana School of Public Health, University of Toronto , 155 College St Room 500, Toronto, ON M5T 3M7 ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,5,11]]},"reference":[{"key":"2025082909325171300_ref1","volume-title":"Sexually Transmitted Infections (STIs)","author":"World Health Organization","year":"2024"},{"key":"2025082909325171300_ref2","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1097\/IM9.0000000000000024","article-title":"Antibiotic resistance and treatment options for multidrug-resistant Gonorrhea","volume":"2","author":"Yang","year":"2020","journal-title":"Infectious Microbes and Diseases"},{"key":"2025082909325171300_ref3","article-title":"Syphilis","author":"Centers for Disease Control","year":"2023"},{"key":"2025082909325171300_ref4","article-title":"About chlamydia","author":"Centers for Disease Control","year":"2024"},{"key":"2025082909325171300_ref5","article-title":"About Gonorrhea","author":"Centers 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