Mission Statement We provide and protect the health care and information people need to plan their families and their futures.
table of contents Health Care Services
2
New Services
4
Health Care by the Numbers
6
Birth Control
8
Abortion Care
10
The People We Serve
11
Health Care by Clinic Location
12
health care services ABORTION CARE The abortion pill and in-clinic procedures (South Texas Medical Center location only). BIRTH CONTROL Includes condoms, several types of birth control pills, long-acting reversible contraceptives (IUDs and implants), the birth control shot, the vaginal ring, the hormonal patch, and emergency contraception (which prevents pregnancy if taken within five days after unprotected sex). GYNECOLOGY Tests and treatment for vaginal infections and urinary tract infections; pelvic exams; clinical evaluation of menopause and hormonal replacement therapy when indicated; clinical breast exams that can detect abnormalities, including the early signs of breast cancer; mammogram referrals. MALE SEXUAL HEALTH EXAMS Examination of the genitals and perianal region; documentation of growth and development as well as common genital findings including hydrocele, varicocele, and signs of sexually transmitted infections; clinical examination of the testicles to screen for abnormalities that could become cancer and patient instruction on performing self-examination. PREGNANCY TESTING Urine, blood-based testing, and human chorionic gonadotropin (HCG) based testing. HCG-based testing is often a critical test that helps the clinician diagnose an ectopic pregnancy.
REFERRAL FOR PRENATAL CARE AND ADOPTION Planned Parenthood respects all decisions by all people regarding their own pregnancies. We provide patients who decide to continue their pregnancy with information and referrals for prenatal care and adoption services. STI TESTING AND TREATMENT Testing and treatment for sexually transmitted infections, including the latest rapid-based testing for some of the more frequently requested tests that can provide results at the time of visit. STOP CERVICAL CANCER Pap tests, human papillomavirus (HPV) tests, HPV vaccine, clinical evaluation of abnormal Pap test results, and medical treatments to stop the progression of dysplasia and early cervical cancer. PPST provides cervical cancer screenings in accordance with evidence-based standards of clinical care. PPST provides two methods of screening: Pap tests, which check cervical cells for abnormalities that may be indicative of cancer; and human papillomavirus (HPV) testing, which checks cervical cells for the sexually transmitted infection that can cause cancer. Most HPV infections will clear up without causing cancer. HPV can take more than a decade to progress to cervical dysplasia or cancer. Using both Pap and HPV tests — called co-testing — allows women to go longer periods of time between screenings. Co-testing ensures abnormalities will be detected in time to treat them while also reducing the detection of HPV infections that would have gone away on their own. WELLNESS SCREENING Because we know that for many of our patients we are their only regular health care provider, both women and men receive physical examination of chest, heart, lungs, abdomen, as well as testing for glucose (blood sugar), iron and hypertension, as indicated. 2017 SERVICE DELIVERY REPORT | 3
new services
While family planning has remained at the core of PPST’s work since it was founded in 1939, we have continued to expand our services. The care we provide is always evolving based on the latest medical science and the needs of our patients.
TRANSGENDER HORMONE THERAPY In the fall of 2017, health centers began offering hormone therapy to our patients who are seeking medical assistance in order to express their true gender identity. Transgender patients have long come to us for many of the same health care services we provide to our cisgender patients, such as STI testing and treatment, cancer screenings and birth control. By expanding our services to include hormone therapy (estrogen or testosterone) to transgender patients in a gender affirming environment, we are doing our part to better assist and respect this community who have special health care needs. In late 2017, we served 41 patients seeking transgender hormone therapy. 4 | 2017 SERVICE DELIVERY REPORT
PRE-EXPOSURE PROPHYLAXIS (PrEP) People at high risk of HIV infection can take daily medication (brand name: TruvadaŽ) to lower their risk of contracting the virus. According to the Centers for Disease Control and Prevention, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by up to 90% when taken consistently. While PrEP is costly, Planned Parenthood staff can help patients apply for Truvada’s patient assistance program, which helps people pay for the medication. FERTILITY SERVICES PPST has just begun to develop and roll out fertility services as part of our commitment to reproductive justice. Too often couples who are now ready to start their family find they need medical assistance in order to become pregnant. If Planned Parenthood is here to help people postpone pregnancy until they are ready, we must also offer the medical care that some couples may need when they are ready to have the family they desire. Our health centers now offer services to diagnose common causes of infertility, as well as basic treatment options to address these issues. These services include semen analysis, intrauterine insemination, ovulatory dysfunction evaluation and treatment, and evaluation and treatment of uterine abnormalities. 2017 SERVICE DELIVERY REPORT | 5
health care by the numbers Planned Parenthood South Texas is one of the region’s leading providers of high-quality, affordable health care. People trust Planned Parenthood because we offer compassionate, expert care—without shame or judgment.
19,582
Patients Served
The number of individuals, unduplicated, who received family planning and sexual health care in our clinics.
17,481
Women Served
21,807
STI & HIV Testing
Testing for the following sexually transmitted infections: chlamydia, gonorrhea, herpes, syphilis, and HIV.
2,101
Men Served
More than 10% of the people we serve are men.
6 | 2017 SERVICE DELIVERY REPORT
989
Emergency contraception
3,291
Stop Cervical Cancer (SCC)
Total Pap tests, cervical dysplasia procedures, HPV tests and HPV vaccinations provided through the SCC project.
292,715
Weeks of protection
This number combines the weeks of protection for all the contraceptive methods provided in 2017. For example, a pack of pills provides birth control protection for one month, the shot for three months, and an IUD for 5-12 years, depending on the type of IUD.
6,516
Wet Mount
A wet mount is a gynecology test used to determine the cause of vaginal infections, including: yeast infection, trichomoniasis, and bacterial vaginosis.
5,622
Pregnancy tests
1,710
Abortion care
33,918
Total Visits
The number of times patients visited a clinic for any service.
birth control Type of Contraceptive Barrier Method - Male Condom Emergency Contraception
2016
2017
% change
12,899 934
10,086 989
-21.8% 5.9%
Hormonal (non-LARC) Oral contraceptives (monthly pack) Hormonal Contraceptive Patch Hormonal Contraceptive Vaginal Ring Injectable Hormonal Contraception Total non-LARCs
19,121 219 178
17,602 509 292
-7.9% 132.4% 64.0%
4,009 37,360
3,770 33,248
-6.0% -11.0%
LARC Single-Rod Implant Intrauterine Device (IUD) Hormonal Intrauterine Device Total LARCS
306 97 98 501
460 93 156 709
50.3% -4.1% 59.2% 41.5%
Total Contraceptive Units
37,861
33,957
-10.3%
Weeks of Protection 264,083 292,715
10.8%
POPULARITY OF LONG-ACTING REVERSIBLE CONTRACEPTIVES (LARCS) CONTINUES TO RISE
While oral contraceptives remain the most popular form of birth control among our patients, their demand appears to be waning in favor of other forms of contraception. The decrease in oral contraceptives coincides with a continued increase in favor of long-acting reversible contraceptives (LARCs). LARCs can provide protection up to 12 years, so an increase in LARCs means clients require fewer units of contraceptives. Because LARCs offer so many weeks of protection, even though LARCs accounted for only 2% of the total units of contraception provided in 2017, they offered 58% of the weeks of protection. It’s important to note that the increase in LARCs occurred in the four Planned Parenthood clinics in San Antonio that receive Title X funding (a federal family planning contract managed by the Women’s Health and Family Planning Association of Texas). As a condition of this funding, clinics do not charge a fee to patients living at or below 100% Federal Poverty Level. The funding also allows us to purchase LARCs at a significant discount, giving us access to highly effective forms of birth control, which otherwise can be prohibitively expensive. Planned Parenthood’s provision of LARCs brings an incredible public health benefit to the region we serve.
A reduction of funding for LARCs or an inability to buy LARCs at a discount would reduce that public health impact.
2017 SERVICE DELIVERY REPORT | 9
abortion care The decision about what will happen with a pregnancy— whether to parent, end a pregnancy, or choose adoption—is deeply personal, and people have the right to make the decision that is best for them. Planned Parenthood provides patients with accurate information about all of their pregnancy options so they can make their own, fully informed health care decisions. Abortion Care In-clinic Procedures Abortion Pill Total Abortion Care
2016
2017
% change
395 345 740
462 1,248 1,710
16.9% 262% 131.1%
The increase in abortion care at PPST in 2017 is largely due to two reasons: • During a part of 2016 abortion care was paused. • In March 2016 the FAC approved a new drug label that reflects the best and most current evidence-based research about the use and effectiveness of mifepristone.
Abortion Pill
2016
Abortion Pill
2017
73%
47% 53% In-Clinic Procedure 10 | 2017 SERVICE DELIVERY REPORT
27% In-Clinic Procedure
people we serve Age
29.2% 22.8% 18.1% 14.4% 10.6% 4.9% ≤17
18-19
20-24
25-29
30-34
35≼
*95% of our patients are of reproductive age, defined by the Centers for Disease Control and Prevention as between the ages of 15 and 44.
Race & Ethnicity 71%
Latino White
18%
Black
9%
Asian 1% Other 1% *Based on the 88% of patients who answered voluntary questions about their cultural identity.
Sex
11%
89% Female
Male
*Sex is self-identified by the patient. Planned Parenthood serves all clients regardless of gender identity or gender expression.
11514 Perrin-Beitel Rd San Antonio, TX 78217-2113 (210) 590-0202 2346 E Southcross Blvd San Antonio, TX 78223-3226 (210) 333-5454
14.6%
13.9%
920 San Pedro*
8725 Marbach Rd, Ste 215 San Antonio, TX 78227-2378 (210) 674-2222
15.5%
12.7%
2140 Babcock Rd San Antonio, TX 78229-4424 (210) 736-2262
25.5%
San Antonio
Location Localidades
4,998 3,042 2,721 2,483
Clients Served Clientes Atendidos
health care by clinic location servicios de salud por clinica
2,857
870 E Alton Gloor Blvd, Ste B Brownsville, TX 78526-3364 (956) 546-4571
Brownsville
712 North 77 Sunshine Strip, Ste 18 Harlingen, TX 78550-8897 (956) 423-8584
Harlingen
Total Clients Served Total atendidos por las Clínicas
33,918
2,024 1,457
* Clinic moved from Ashby Rd. to San Pedro in April 2017 Clinica se mudó de Ashby Rd. a San Pedro en abril de 2017
920 San Pedro* San Antonio, TX 78212-5838 (210) 736-2475
2346 E Southcross Blvd San Antonio, TX 78223-3226
2017 SERVICE DELIVERY REPORT / Reporte de Prestación de Servicios 2017
7.4%
10.3%
12.7%
13.9%