We’re in the Middle of an STD Epidemic That Could Get Much Worse
Last October, the Centers for Disease Control (CDC) released a sobering report—the annual Sexually Transmitted Disease Surveillance Report—for which the press release read: "STDs Continue to Rise in the U.S."
Using the most recently available data, from 2018, the CDC reported a worrying trend, with combined cases of syphilis, gonorrhea, and chlamydia reaching an all-time high in the United States.
Syphilis, Gonorrhea, and Chlamydia Infection Rates Rise as Antibiotic-Resistance Looms
There were more than 115,000 cases of syphilis reported from 2017 to 2018, with the number of primary and secondary cases reaching more than 35,000, which is the highest number seen since 1991. It amounted to a 14% increase.
Gonorrhea increased 5% to more than 580,000 cases, which was likewise the largest number reported to the CDC since 1991. Chlamydia increased 3% to more than 1.7 million cases, making it the highest number ever reported to the CDC. (The CDC does not receive regular updates on the spread of other sexually transmitted infections like HPV or herpes.)
The CDC also said men who have sex with men are disproportionately affected by both syphilis and gonorrhea. Gay and bisexual men accounted for 54% of all syphilis cases in 2018. Making these numbers even more alarming is the rise in antibiotic-resistant strains of all three STDs, especially gonorrhea.
"STDs can come at a high cost for babies and other vulnerable populations," said Jonathan Mermin, M.D., M.P.H., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, in a press statement. "Curbing STDs will improve the overall health of the nation and prevent infertility, HIV, and infant deaths."
Infant mortality is one of the tragic results flagged by the CDC, with syphilis cases among newborns increasing 40% to more than 1,300 cases.
HIV Rates Rise Among Certain Demographics
Untreated STDs can also increase the risk of contracting HIV. While new rates of HIV infection rates have fallen in recent years among some demographics, they have plateaued and even increased among more vulnerable groups, like those experiencing poverty, and Latino gay and bi men. Experts attribute preventative resources not reaching these communities as the cause for that disparity.
The Trump administration has pledged to end new HIV infections in the U.S. by 2030, but some of the president's actions have already undermined that goal, like going after the Affordable Care Act, also known as Obamacare; halting research over the use of fetal tissue; and cutting funding to HIV/AIDS programs.
What's Being Blamed for the Rise?
In addition to federal cuts to research, cuts in local- and state-level STD programs was also cited by the CDC as a contributing factor to the alarming numbers, with more than half of local programs reportedly experiencing budget cuts. This has resulted in clinics closing, reduced screenings, loss of staff, and a reduction in patient follow-up care.
The center also pointed to "drug use, poverty, stigma, and unstable housing, which can reduce access to STD prevention and care," as well as "decreased condom use among vulnerable groups, including young people and gay and bisexual men."
Observers have also pointed to dating and hookup apps, which make meeting up and having sex easier, as another possible factor in the rise in STD rates. Additionally, at least one study has shown a link between PrEP usage, which is effective in preventing HIV, and higher rates of infection of other STDs.
What's Being Done?
In addition to encouraging increased screenings, as well as condom and dental dam usage, the CDC is responding to the crisis by developing a Sexually Transmitted Infections (STI) Federal Action Plan (STI Plan).
A page on the HHS website describes it as a "collaborative effort by partners from the U.S. Departments of Health and Human Services, Department of Defense, Department of Education, Department of Housing and Urban Development, and the Department of Veterans Affairs with input from nonfederal stakeholders from a variety of sectors."
"Representatives of those federal agencies serve on the Federal STI Steering Committee and subcommittees and confer regularly to develop actionable strategies to address the rising rates of STIs in the United States," it adds.
The CDC has urged "state and local health departments... to strengthen the local public health infrastructure needed to prevent and control STDs, and ensure resources are directed to the most vulnerable populations." Considering the Trump administration's less-than-stellar record on HIV/AIDS, advocates will have cause to scrutinize the details of the plan to see if it lives up to the CDC's own recommendation of ensuring resources are appropriately allocated.
The STI Plan is expected to be released later this year.