New York City is still not back to operating all of its sexual health clinics, three years after the pandemic significantly curtailed the low-cost to free services that are considered vital to low-income and uninsured communities.

Of the city’s eight brick-and-mortar sexual health clinics, three are yet to resume services since being shut down and repurposed for COVID-19 testing and vaccinations, according to the city health department. The health department has attributed the closures to staffing shortages, a widespread problem across city agencies.

The struggle to fully reopen the clinics has become more glaring as Mayor Eric Adams seeks to roll out an initiative for city-run sexual health clinics to dispense free abortion pills. The mayor announced the effort Tuesday during a wide-ranging address in which he pledged to make women’s health a cornerstone of his agenda.

“It's time we made New York City the future of women's health, and that is exactly what we are going to do,” Adams said.

Last year’s outbreak in mpox (previously known as monkeypox) cases also raised questions about the operating status of the city-run clinics. At the time, half were not offering sexual health services. None of the clinics are currently open on Saturday, an option that had existed before the pandemic.

“The monkeypox outbreak demonstrated how vital sexual health services are to the health security of New York City,” said Dr. Jay Varma, a senior health adviser for former Mayor Bill de Blasio who oversaw the revitalization of city-run sexual health clinics.

“It’s critically important that the city both restore sexual health services back to the level they were before the pandemic and further enhance access through the use of mobile clinics, which were so effective during the monkeypox response.”

Patrick Gallahue, a spokesperson for the city’s health department, acknowledged the current closures of three sexual health clinics. He said that many of the clinics had adapted its services to respond to COVID and the recent mpox outbreak.

“However, in recent months, the city brought many of our sexual health clinics back online with expanded services like rapid testing for sexually transmitted infections and HIV PrEP continuity of care,” he said in a statement. “We’re proud to make these services available to New Yorkers and we look forward to having more online soon.”

Gallahue did not provide a timeline for when the closed clinics would resume sexual health services, but said that reopenings are dependent on staffing.

Adams has frequently argued that the staffing crisis has been felt in various sectors, including government. Nationwide, hospitals and clinics have also been coping with a shortage of health care workers made worse by the pandemic.

The city’s plan to offer free abortion pills was slated to begin Wednesday in the Bronx.

But city officials said the timeline for offering the abortion pill at the three other designated clinics would take up to a year. Two of them – one in Crown Heights and another in Central Harlem – are still closed for sexual health services.

City health officials have touted the abortion pill rollout at the clinics as tackling an economic and cultural barrier for the most marginalized New Yorkers who may worry about both the cost and stigma of receiving an abortion.

The city has been offering medication abortions at its 11 public health hospitals, but patients are typically asked if they have insurance.

“We never take a single question about your insurance or your status,” city Health Commissioner Dr. Ashwin Vasan said on Tuesday, speaking about the city’s health clinics.

Vasan added that the city-run clinics have “historically played a really important role in this city in providing care and sexual health services to people who often are pushed through the cracks of our reimbursable health care system.”

Some public health advocates agreed with Vasan, but noted the irony of the city keeping some of the clinics closed.

“You can’t be committed to the mission without funding the actual implementation required,” said Joseph Osmundson, a microbiologist at NYU and an LGBTQ activist on public health policies.

According to Osmundson, the city’s sexual health clinics have long struggled to receive funding and adequate staffing even amid rising rates of sexually transmitted diseases.

But he said the latest clinic closures are “worse than it’s been.”