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Health care advocates are raising alarms over the possible shutdown of Multnomah County’s sexually transmitted infections clinic in Old Town.
Last month, the county health department listed the STI clinic’s $1.4 million annual budget among $9 million in cuts needed to reduce the department’s budget by 12%, as part of a budgeting exercise ordered by County Chair Jessica Vega Pederson. She asked departments to list what they’d cut to bridge the county’s $21 million budget shortfall.
“In response to this significant budget challenge, the Health Department was asked to think strategically and concentrate on providing core services,” a Multnomah County spokesperson said in a statement to WW.
The health department raised the possibility of eliminating the STI clinic altogether, closing its doors in June. The health department’s other clinics would be expected to pick up the STI clinic’s services, which include testing and treatment for illnesses such as HIV, syphilis and gonorrhea.
Since then, the budget outlook has grown sunnier: The county only needs to trim $15 million, and the STI clinic is listed by the health department as its first priority to be saved.
Still, those close to the program have in recent weeks expressed concern about its future, given that the county is in delicate negotiations with other governments over its homeless services budget, and its budgeting woes for that office could have a domino effect. Social media posts began circulating across platforms in February, urging voters to contact Vega Pederson and county commissioners about the clinic’s survival.
“Eliminating this clinic is not just going to inconvenience or something like that—it’s going to cost lives in the long run,” says Jeanne Krinsley, who worked there for nearly 25 years. “We’ve spent decades building trust with people, especially with the LGBTQ+ community and immigrants. They’re not comfortable going to someone they don’t trust.”
The STI clinic has operated around Old Town since the 1960s and is currently housed in the Gladys McCoy Building on Northwest 6th Avenue. Last year, the clinic’s staff treated nearly 3,000 patients, and is on track to treat a similar caseload this year. Krinsley, who retired in 2023, not only treated and educated patients who contracted STIs through consensual encounters, but she also treated sexual assault victims, many of whom hadn’t told anyone else what happened to them.
“When someone says, ‘I’ve never told anyone that,’ that’s a real honor when someone confides in you like that,” Krinsley says. “Our patients—we’re supposed to call them ‘clients,’ but I don’t see what’s wrong with ‘patients’—just loved us.”
The medical specialty requires sensitivity toward patients of all backgrounds, including houseless people, people who don’t speak English fluently, and people navigating the complexities of American health care. Krinsley says she remembers the STI clinic leading treatment during the mpox outbreak of 2022 and staying open in 2020 for in-person care when primary care doctors pivoted to telehealth.
“People trusted us, so they came in,” she says. “If we’re so unimportant, why were we still coming in?”
Multnomah County’s STI clinic workers attempt to lower the barriers patients face when seeking treatment for STIs. Some clinicians visit sites like camps of houseless people to offer testing and treatment, a service that would be cut if the clinic had to close its doors. This keeps treatment accessible for people who might not be able to afford care without insurance, or who fear the stigma associated with STI testing. A familiar staff of expert providers also means patients have access to culturally competent clinicians who can help reassure them when their care leaves them physically or emotionally vulnerable.
“We had a guy who did not speak English who we spent a year trying to get into HIV treatment because he did not trust the medical system,” Krinsley says.
Though new STI cases fell in Multnomah County in 2023 from their immediate post-pandemic spikes in 2020–22, the rates still remain around pre-pandemic highs.
Vega Pederson said in a statement to WW that she has not yet reached a final decision on the STI clinic’s future. She’ll propose a budget April 24, with the final budget to be approved in early June.
“Any cuts proposed by the department are provisional and meant to give myself and our board a range of options to consider,” she said. “We appreciate the patients, community members, and partner organizations who have contacted our office and testified to share their support for the services provided by the STI clinic. I share their passion for impactful public health initiatives and prevention efforts, especially as we see these services eroded at the federal level.”
Krinsley says in her experience that primary care providers can miss an STI’s early symptoms before they’re so obvious they require urgent care, which comes with a higher co-pay when patients have insurance. Symptoms can also go away without the infection resolving, leaving unsuspecting patients unaccounted for to risk spreading infections.
“HIV and syphilis can kill you down the line,” Krinsley says. Closing the clinic “is just not going to work very well. It’s just going to lead to a lot more disability and death, and it’s just so short-sighted because it’s going to lead to an increase in costs.”