Opt-Out STI Testing at Planned Parenthood San Bernardino Uncovers 170 Hidden Cases in Pregnant Women

A new “opt-out” approach to sexually transmitted infection (STI) testing at Planned Parenthood of Orange and San Bernardino Counties (PPOSBC) has led to the early treatment of 170 pregnant women infected with trichomoniasis—a common but often overlooked STI that can increase the risk of premature birth and low birth weight.

Between November 2024 and February 2025, PPOSBC screened 46,140 patients across its nine health centers, uncovering 916 positive cases of trichomoniasis—nearly 2 percent of those tested. According to PPOSBC, 20 percent of those infected were pregnant women, most of whom showed no symptoms.

“Untreated, trichomoniasis has a potential link to premature birth and low-birth weight,” said Dr. Shayne Poulin, MD, a PPOSBC physician based in San Bernardino. “There’s a wide variety of things that can happen when babies are born prematurely—like underdevelopment of the lungs. But by detecting these infections early, we’re giving babies a better chance at being born healthy.”

Before this pilot program, trichomoniasis testing was only offered to symptomatic patients. That changed when improved lab capabilities enabled clinicians to screen for the parasite via urine and vaginal swabs alongside other standard tests for gonorrhea and chlamydia. The shift removed the need for patients to ask for STI testing, a barrier that can deter many from getting tested.

“Opt-out testing means when someone comes in for lets say a urine test during their pregnancy—we ask if we can send it for routine STI testing.” explained Poulin. “They’re free to say no. That’s the opt-out piece. It takes the burden off the patient and increases the rate of testing and treatment.”

PPOSBC’s opt-out strategy has proven particularly effective in reaching underserved communities. The organization reports the highest positivity rates in and around its San Bernardino and Victorville locations—regions long affected by gaps in healthcare access.

“Most of our patients are aged 18 to 35 and are on Medi-Cal,” Poulin said. “The demographics reflect persistent disparities in the Inland Empire, and that’s why we see these pilot efforts as essential—not just medically, but socially.”

According to the California Department of Public Health, STIs like trichomoniasis, syphilis, and gonorrhea are on the rise statewide. Yet routine screening remains inconsistent due to stigma, time constraints, or the siloed nature of healthcare systems.

“I think the challenge of scaling this across California is that health systems operate in silos more than people realize,” Poulin said. “We should all be routinely offering STI testing. It should be part of the conversation in every healthcare setting—not just urgent care or public health clinics.”

At PPOSBC, the approach is designed with convenience and dignity in mind. Clinics are open seven days a week for 10 hours a day, offer walk-in and same-day appointments, and perform all sample collections on-site—including rapid HIV tests, syphilis blood draws, and urine-based STI screenings.

“The message I’d like to send is that, especially at Planned Parenthood, it’s easy to come in and get testing,” said Poulin. “There is no stigma that comes with it. Most things are treatable or curable—and the fear of the unknown can be scary, but we hope they find it to be an easy experience.”

Nicole Ramirez, PPOSBC’s senior vice president of communications, added that the clinics’ responsiveness and compassionate care are helping build trust where it’s needed most.

“Our health centers are averaging 11-minute wait times,” Ramirez said. “What you see in our Yelp reviews is people talking about passionate care—about being taken seriously and not judged. That’s incredibly important in underserved communities.”

PPOSBC operates nine health centers in the region, including Inland Empire locations at 1873 Commercenter West in San Bernardino, 15403 Park Avenue East in Victorville, and 918 West Foothill Blvd., Suite A, in Upland.

To learn more or to schedule an appointment, visit pposbc.org.