Record High Number Of STD Infections In U.S., As Prevention Funding Declines

A tinted transmission electron micrograph of Chlamydia trachomatis bacteria (light purple/black) inside a cell. Chlamydia is the most common sexually transmitted disease in the U.S., with more than 1.7 million reported cases in 2017. Biomedical Imaging Unit, Southampton General Hospital/Science Source hide caption

toggle caption Biomedical Imaging Unit, Southampton General Hospital/Science Source

A tinted transmission electron micrograph of Chlamydia trachomatis bacteria (light purple/black) inside a cell. Chlamydia is the most common sexually transmitted disease in the U.S., with more than 1.7 million reported cases in 2017.

Biomedical Imaging Unit, Southampton General Hospital/Science Source

For the fourth year in a row, federal health officials report that there has been a sharp increase in sexually transmitted diseases in the U.S. The Centers for Disease Control and Prevention tallied nearly 2.3 million cases of chlamydia, gonorrhea and syphilis in 2017 — an increase of 200,000 cases over the previous year, and a record high.

Chlamydia, a bacterial infection, remained the most common sexually transmitted disease, with more than 1.7 million reported cases. But health officials are concerned that gonorrhea cases increased a startling 67 percent between 2013 and 2017, and syphilis climbed even faster — 76 percent over those four years.

After many years of success in controlling sexually transmitted diseases, “We’ve been sliding backwards,” says Dr. Gail Bolan, director of the CDC’s Division of STD Prevention. She spoke at a news conference in Washington Tuesday.

“The U.S. continues to have the highest STD rates in the industrialized world,” says David Harvey, executive director of the National Coalition of STD Directors, “and it preys on the most vulnerable among us.”

“Here’s a quote for members of the media,” Harvey said at the press conference. “Ready? It is time that President Trump and Secretary Azar declare STDs in America a public health crisis.”

Harvey argues the root of the problem is that federal funding to prevent and control sexually transmitted diseases has dropped by roughly 40 percent in the past 15 years, which has choked off state and local programs. He called on Congress to appropriate $70 million immediately to address the crisis.

“We all understand that you’ve got to maintain your bridges and your roads — and you see them on TV when they crumble,” says Michael Fraser, executive director of the Association of State and Territorial Health Officers. “You don’t always see a crumbling public health infrastructure.”

One big challenge with these diseases is most people who carry them don’t have any symptoms, so they aren’t aware when they’re passing them along to sexual partners. Current recommendations call for sexually active women under the age of 25 to get tested annually for chlamydia and gonorrhea. Men who have sex with men should also get tested at least annually, she says.

But harried (or embarrassed) doctors often don’t offer those tests. “Everyone needs to ask their doctor, ‘should I be tested for STDs? I hear they’re going up,’ ” Bolan says.

Chlamydia and gonorrhea, if untreated, can leave a woman infertile. Syphilis can spread from mother to fetus, and cause the baby to have birth defects or to be stillborn.

Harvey noted that a thousand babies a year are diagnosed with congenital syphilis, despite mandatory syphilis testing when a woman is first found to be pregnant (the disease can spread to women during pregnancy). Harvey says this statistic is “shocking,” considering that the nation has managed to all but eradicate mother-to-child transmission of HIV.

“We are failing these mothers and their newborns,” he says, “and something needs to be done about it.”

Bolan also worries that Neisseria gonorrhoeae, the bacterium that causes gonorrhea is becoming resistant to the antibiotic azithromycin, which is part of the recommended treatment regimen. Lab tests have found that 4 percent of gonorrhea samples are now resistant, up from 1 percent in 2013.She is concerned that could ultimately lead to infections that are resistant to the last line of defense against gonorrhea — ceftriaxone. “Our nation urgently needs additional treatment options for gonorrhea,” she says.

The press conference was part of a CDC meeting on STD prevention in Washington this week. The agency plans to publish its annual report about sexually transmitted diseases in late September.

You can reach Richard Harris at [email protected]

Why Are STD Rates So High In the U.S.?

Photo: / Jarun Ontakrai

This week, the Centers for Disease Control and Prevention (CDC) released a scary new report. For the fourth year in a row, STDs are on the rise in the United States-and the rates of chlamydia, gonorrhea, and syphilis are higher than they’ve ever been before.

It’s more than just a scary headline, according to experts. The findings are cause for real concern when it comes to your health. “This should definitely be considered a emergency,” says Adeeti Gupta, M.D., a board-certified ob-gyn in New York. “It is alarming that in this day and age we are sliding backward.”

So, why have things gotten so bad? We investigated why STDs have gotten so out of control, and what you need to do to protect yourself in a looming public health crisis.

The Rise of STDs

For the past four years, the number of cases of chlamydia, gonorrhea, and syphilis-the Big Three of STDs-have been steadily creeping up in the U.S., reaching an all-time record high in 2016. But according to the most recent data released by the CDC at the National STD Prevention Conference in Washington, D.C., this week, 2017 blew that record out of the water. There were 2.3 million cases of the Big Three diagnosed last year-200,000 more than the previous record in 2016, the CDC reports. What’s particularly concerning? Gonorrhea diagnoses have gone up 67 percent since 2013 and syphilis cases have increased 76 percent. Overall, the report called out “steep, sustained increases” (31 percent since 2013) that have health officials worried.

To put those numbers in perspective, the U.S. has the highest STD rates in the industrialized world, NPR reports. (FYI, the rate of unintended pregnancies is also “significantly higher” in the U.S. than in many other developed countries, according to the Guttmacher Institute.) Yikes.

As if the jump in STDs weren’t concerning enough on its own, the rise of antibiotic-resistant STD “superbugs” makes the report even scarier. Right now, doctors still have enough tools to treat the Big Three, but certain strains of “super gonorrhea” and drug-resistant syphilis are already a thing.

In simpler terms, untreatable STD superbugs are close to becoming reality. “We expect gonorrhea will eventually wear down our last highly effective antibiotic,” Gail Bolan, M.D., director of the CDC’s Division of STD Prevention, said in a press release about the new stats. “We can’t let our defenses down-we must continue reinforcing efforts to rapidly detect and prevent resistance as long as possible.”

Why Are STDs On the Rise?

There are several factors that have health experts sweating over the rise in STDs.

“What’s most concerning to me is that the numbers are going up, and unfortunately in the United States we are having more threats to women’s health care than ever before,” says Mary Jane Minkin, M.D., a clinical professor of obstetrics, gynecology and reproductive sciences at the Yale School of Medicine.

Last year, the Trump administration cut over $200 million in federal reproductive care funding (which affected programs at Johns Hopkins University, the Children’s Hospital of Los Angeles, and the Chicago Department of Public Health, to name a few)-jeopardizing programs that helped screen for and treat STDs. “My concern is that if we’re doing away with funding for women’s health care and threatening places like Planned Parenthood, which provide STD screenings, many women won’t have access to screenings and treatment,” Dr. Minkin says. (See: All The Ways a Planned Parenthood Collapse Could Hurt Women’s Health)

That’s not the only way politics are having an effect on rising STD rates-insurance coverage (or lack of it) is often a major factor in whether a patient gets screened or not, says Dr. Gupta. “Some women would like to get tested but they are so scared of unknown out-of-pocket costs that they either don’t go or decline testing, even if they have had new partners,” she says. “Many of our patients have been getting billed for out-of-pocket costs for gonorrhea and chlamydia testing because it’s not considered a part of preventative screening anymore.” (For the record, coverage varies by insurance plan, so ask your gyno to check in with your provider. If it’s not covered, that doesn’t mean you should skip it-many health centers like Planned Parenthood provide free or low-cost screenings.)

Even if you don’t have any symptoms, an STD can do serious damage-like causing pelvic inflammatory disease (PID), an infection that occurs when an STD spreads from your vagina up into your reproductive organs. You might not even know you have PID right away, Dr. Minkin says, but it can lead to chronic pain and even infertility, according to the Mayo Clinic.

All of this is compounded by the fact that people just aren’t using condoms enough. Only 24 percent of women used a condom during their last hookup and only 18 percent of women said they used one every single time, according to a report published by the CDC last year. (Reminder: Condoms are the only way to prevent STDs if you’re having sex.)

The report also found a safe sex red flag for women using another form of birth control-rates of condom use were even lower when women were also using a method like the Pill or IUD to prevent pregnancy. This is a major problem, says Dr. Minkin, since IUDs and the Pill-both of which are awesome, and more effective at preventing pregnancy than condoms-don’t protect against STDs. “We need to teach people that if they’re going to have sex, they need to prevent pregnancy, but they also need to prevent STDs,” she says.

Chances are, you *know* this. But before you roll your eyes, the numbers don’t lie. Consider this a PSA for the importance of using condoms every damn time. “It only takes a split second for the STD bug to get in your system,” Dr. Gupta says. “Be safe, always.”

How to Protect Yourself from STDs

The good news here is that gonorrhea, chlamydia, and syphilis are all very simple to detect-and for the moment at least, all three STDs are still treatable. So aside from using condoms, the number-one thing you can do to protect yourself is get tested regularly-“at least once a year, even if you’re in a monogamous relationship,” Dr. Gupta says.

Current guidelines from the CDC no longer recommend getting screened every year unless you’re under 25 or have certain risk factors, but both docs disagree with this and are in favor of yearly STD tests.

“If we had more and better STD screening practices, we’d obviously pick up a lot of this sooner and prevent STDs from spreading further,” says Dr. Minkin. “If you don’t have widespread screening, there are going to be a lot of people walking around with STDs and no symptoms and not knowing-in view of the increasing numbers, screenings should take on increasing importance.” (Related: The Infuriating Reason Young Women Aren’t Getting Tested for STDs)

On top of your regular screenings, you should also get tested after every new partner, Dr. Gupta says, adding that “before having a sexual relationship with anyone, you should ask for documented negative HIV, syphilis, hepatitis B and C, gonorrhea, chlamydia and trichomonas and genital herpes results.” Asking a date to prove they’re clean can definitely be awkward-and kind of a mood killer-but it’s worth it when it comes to protecting your health. (Not sure how to ask your partner if they’ve had an STD test? The experts say, it’s best to just be blunt.)

If you do wind up with an STD though, don’t panic. Get it treated right away and follow up with your doctor to make sure you’re totally cured before your next hookup. (Related: How to Talk to Your Partner About Your STD Status)

  • By Macaela Mackenzie @MacaelaMackenzi

U.S. States With High STD Rates Have One Thing In Common

Maryam says: “It’s expected to continue to increase. People don’t realize the importance of getting screened, providers don’t realize the importance of telling their patients to get screened. The majority of my concern is the lack of awareness around sexually transmitted diseases.”

Recent studies illustrate that there is a connection between the quality of sex education in schools and the incidence rates of sexualy transmitted diseases in U.S states.

States including Alaska and Texas have seen a recent outbreaks of chlamydia in high schools wheras states like New Hampshire with high quality sex education in schools report the lowest rate of sexually transmitted diseases. The rate of unplanned pregnancies in New Hampshire sits at just under 16 births per 1,000 girls.

Contents

  • Highest Rate Of STDs In The U.S.
  • Abstinence-Only Education
  • Miseducation And Confusion
  • The Importance Of Sexual Health Knowledge
  • Worried You Might Have Contracted An STD?
  • The Proof Is In The Sales
  • What Can Be Done To Combat The Rising Prevalence Of STDs?

Highest Rate Of STDs In The U.S.

According to the Centers for Disease Control and Prevention.

  • The District of Columbia has the highest rate of chlamydia, gonorrhea and syphilis in the US.

  • Not far behind D.C. on the list are Alaska, Louisiana and Mississippi.

  • Puerto Rico has the lowest rates of chlamydia in the U.S., Vermont has the lowest rates of gonorrhea.

The latest and largest scale report by the Centers for Disease Prevention (CDC) exemplifies a failure in the U.S public health sector to lower the prevalence of a number of sexually transmitted diseases (STDs).

Rates of STDs has continued to rise dramatically in the last two decades. In particular, the rates (#cases/100,000) of chlamydia in the U.S has more than doubled between 2000 and 2016.

LetsGetChecked can report that this number mirrors an increase in sexual health testing kit sales. The sale of sexual health testing kits were 3.5 times higher in January 2018 than in January 2017, showing an ever increasing need to take preventative health care more seriously.

The most recent report by the CDC has shown that increasing rates of STDs in the U.S shows no sign of slowing down. Chlamydia remains at an all time high, with gonorrhea and syphilis exceeding 2016 rates in 2017.

Abstinence-Only Education

When it comes to the connection between education in schools and subsequent STD rates, Maryam says: “I think it is highly accurate to say that the incidence rates of sexually transmitted diseases is partly related to sexual education in schools and sexual health awareness in general. Sex Ed. in the States may not be standardized, may rely on abstinence only teaching, or lack practical sexual health education. The CDC and public health departments play a key role in evaluating and treating sexually transmitted infections, for these services to remain effective, ongoing governmental support and funding is critical.”

While there may be more attempts out there to normalize sexually transmitted diseases, younger people are still at a higher risk of becoming infected in 2017.

Young people aged between 15 to 24 years account for 62% of chlamydia cases and 52% of gonorrhea cases.

In an era of dating apps such as Tinder, Grindr, Bumble and Scruff, sexual risk-taking behaviours are changing, however Maryam says that there are awareness programs in place that are trying to better the sexual health landscape in the States.

“There are digital media and social media campaigns out there to encourage people to have safer sex and promote sexual health awareness. For instance, Grindr users can now activate an icon on their profile which will indicate whether or not they have H.I.V or are taking precautionary methods against the condition….”

There are now emojis for people who are taking Truvada, men are declaring their status on their profiles and it is increasing awareness around it. There is a good population reach on these sites and we need to normalize it.

Regular STD testing is important for everyone who is sexually active, regardless of age, sexuality or relationship status. 80% of STIs display little to no symptoms, people cannot afford to be presumptive when it comes to their sexual health.

Schools that tell their teenagers that the only way to avoid STDs and unplanned pregnancies is to not have sex at all, unsurprisingly have higher numbers of STD cases and unplanned pregnancies. Schools that teach comprehensive sex education are more likely to have a lower birth-rate and STDs amongst their students.

Maryam says: “There is a stigma around sexually transmitted infections that your risk is based on lifestyle choices or high risk sexual behaviors. It’s important to note that the rates of STDs are increasing in all age groups and in all areas of the US, however the highest rate of STDs are among younger people aged 15-24.”

A lack of knowledge regarding sexually transmitted diseases can translate into adulthood, and the proof is in the numbers, illustrating that more people are purchasing at home sexual health test kits after symptoms present themselves.

Unfortunately, this often seems to be a reactionary practice as opposed to regular screening which would be condusive to better overall health and wellness.

The report further shows that:

  • Chlamydia remains the most widely reported sexually transmitted disease in the U.S.

  • Gonorrhea rates rose by 75% between 2009 and 2016, and by 19% between 2016 and 2017.

  • Gonorrhea rates in those aged over 65 has increased by 73%.

  • Syphilis cases have increased from 31,618 US cases in 2000 to 88,053 in 2016 and 101,567 in 2017.

  • 80% of male syphilis cases were reported by MSM (men who have sex with men).

LetsGetChecked consumer data mirrors that of the CDC, concluding that:

  • Chlamydia is the most common notifiable condition reported by men and women

  • There are almost twice as many cases of chlamydia in women than in men

  • Syphilis is the STD most prevalent among bisexual and gay men.

So, are more people getting screened? The LetsGetChcked data would indicate that more people are using at home testing to test their sexual health.

Feeling like this information is a lot to take in?

U.S Medical Director Dr. Robert Mordkin breaks it down for you:

Miseducation And Confusion

Founder of The STD Project, Jenelle Marie offers us an example of the confusion that young people face when it comes to sexual health. Marie sat down with a 19 year old woman from South Carolina who contracted Herpes (HSV1) through genital contact even though she still identified as a virgin. “No one ever told me you could contract an STD by having oral sex,” she said. “I thought I was being responsible, because I was saving myself for marriage. I come from a very religious background and that’s what I was taught. Good girls don’t practice safe sex, they don’t have sex until marriage.”

When asked if she believed more thorough sex education in school would have influenced her behaviour, she answered firmly: “Yes, definitely. No one told us to use some kind of barrier with oral sex; they didn’t want us to have sex at all. Why would they tell us how to do it safely?”

According to Health Research Funding, only 13 out of 50 states require information provided in a sex education class to be medically accurate and contain verifiable facts.

So, why continue to teach abstinence?

Critics of this right-wing funded programme say that abstinence-only education isn’t about prevention or education. It’s an anti-sex campaign masquerading as a health campaign.

Maryam says:

“Things that might hinder someone’s access to screening their sexual health include access to healthcare, poor socioeconomic conditions and needing to face your local doctor, especially if you live in a smaller town.”

The Importance Of Sexual Health Knowledge

Regardless of political viewpoint, where there is a lack of information on sexual health more people are likely to contract sexually transmitted diseases. More STD screening is needed in these abstinence-only ‘hot-spots’.

Comprehensive sex education has been proven to:

  • Increase the age that teens have sex
  • Help prevent STDs
  • Help prevent unplanned pregnancies

Maryam says:

“People are more comfortable with talking to providers especially in urban centres, I feel like people think it is less appropriate in rural towns. Social media is making it easier for people to get tested, and I think a lot more people would buy a test if they didn’t have to go to the GP, who could know your mom or pop.”

Comprehensive information regarding sexual health should be mandatory and easily accessible for everyone. A good place to start is where children are first introduced to these important topics, at school.

There are a few more elements that come into play when it comes to awareness around sexual health screening.

Public discourse continuously blames three pillars for the rise in STD rates in the U.S.

Politics

The Mexico City Policy, also known as the global gag rule instigated by Donald Trump is said to be igniting rising rates of STDs. The legislation terminates U.S federal funding for non-governmental organizations that provide abortion counselling or referrals. Ultimately, the policy restricts funding STD testing, HIV testing and treatment, contraception, sexual health campaigns and workshops.

Economics

Following the U.S syphilis epidemic in the 1990s. The CDC claimed that they would work to eradicate the disease, and in the early 2000s, the rate of syphilis had fallen to 24% before doubling back to a prevalence rate of 48% by 2016. The CDC has been the most renowned collector of U.S health data since 1942 with the intention of breaking down medical barriers.

Last February, CDC Director Brenda Fitzgerald, reported “complex financial interests that have imposed a broad recusal limiting her ability to complete all her duties.” The Trump administration or underlying misinterpreted funding scandals are said to be the cause of the slow down in better quality public health funding at this time, a definite draw back to the attempted eradication of sexually transmitted diseases in the U.S.

Societal Sexual Health Choices

New methods of birth control may have caused a waning desire to use condoms between partners however, thus causing a further spread and rise of sexually transmitted diseases amongst those who have not been tested. There are also those who believe that being in an monogamous relationship acts as a get out of jail free card for infectious diseases.

In a study carried out by LetsGetChecked, it was found that 65% of college students had never visited a sexual health clinic. The majority of this demographic claim that they felt too embarrassed, or that they didn’t require screening. The arrival of dating apps have unquestionably added to the prevalance of sexually transmitted diseases.

Amongst MSM (Men Who Have Sex With Men), numerous reports have shown that using PrEP (pills that can prevent HIV), may be inadvertently leading to a rise in other sexually transmitted diseases as the gay community feels comforted by the HIV prevention and forgo using further protection, illustrating a rise in new syphilis and gonorrhea cases, especially amongst the MSM.

In research study cases, we read a lot about the term “risk sexual behaviours”, but do we know what is definied as “risky”?

Maryam says that demographics who fall into the category of partaking in “high risk sexual behaviour” include:

  • Men Who Have Sex With Men (MSM)
  • People who have 2-3 sexual partners in one month
  • People who have unportected sex
  • People who attend Chem sex parties (group sex parties which involve alcohol and/or drugs.)

Worried You Might Have Contracted An STD?

Regardless of what state you live in, if you think you might have been exposed to an STD, the most important thing is to get checked.

If you do have a sexually transmitted infection, getting checked early and accessing treatment is important for your health and to make sure you don’t pass the infection on to someone else.

With many STDs such as chlamydia causing long-term complications like infertility if left untreated, getting checked if you think you may have been exposed is essential.

According to the data collected by the CDC you are at a higher risk of contracting a sexually transmitted disease if you are a female between the age of 15 and 24. Of the 15-24 year old demographic, one in four females have had a sexually transmitted disease, most commonly chlamydia or HPV.

Regardless of your age, you are at higher risk of contracting an STD, quite simply, if you are having sex. If you are not using protection, you are putting yourself in a high risk situation, regardless of the duration or type of sex you are having.

You need to get tested if you are experiencing symptoms associated with particular STDs, if you are entering into a new sexual relationship or if you have received a notification from a previous sexual partner that they are infected.
The only real way to lower your risk is through awareness. Do you think you have contracted an STD? At LetsGetChecked, you can purchases tests that covers the most common sexually transmitted diseases, including:

Chlamydia

Chlamydia is an infection caused by the bacterium Chlamydia trachomatis. Chlamydia can be contracted through sexual contact and at birth. Chlamydia is generally asymptomatic and is most common in women, between the ages of 15 and 24 years old. Chlamydia is congenital, meaning it can be passed from mother to child.

Gonorrhea

Gonorrhea is a bacterial infection caused by the bacterium Neisseria gonorrhoeae. Gonorrhea is transmitted through sexual contact, it can also be passed on through child-birth infecting the eyes of newborn babies. Gonorrhea commonly causes a yellowish discharge in men, it is generally asymptomatic in women.

Trichomoniasis

Trichomoniasis is caused by infection with the protozoan parasite Trichomonas vaginalis and is transmitted through sexual contact. Trichomoniasis is often responsible for a green or frothy discharge in men and women.

HIV

HIV stands for Human Immunodeficiency Virus. HIV is a blood-borne virus that can be passed on through unprotected anal and vaginal sex, sharing HIV contaminated syringes, and mother to child transmission during birth and breastfeeding. HIV attacks immune cells and can develop into AIDs in the later stages.

Syphilis

Syphilis is a chronic bacterial infection by the bacterium Treponema Pallidum. Syphilis is transmitted through sexual contact. If left undiagnosed and untreated, syphilis can eventually cause damage to the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. In extreme cases, it can cause gradual blindness, mental illness, and even death.

Gardnerella

Gardnerella vaginalis causes Bacterial Vaginosis (BV), Gardnerella develops as a result of an overgrowth of anaerobic bacteria in the vagina. Gardnerella is one of the leading causes of unusual vaginal discharge and odor.

Mycoplasma

Mycoplasma genitalium is a bacterium found in the urinary tract, it is transmitted through sexual contact. It may cause abnormal discharge, pain during sex and abdominal discomfort. In men, it can cause a burning pain in the genitals.

Ureaplasma

Ureaplasma urealytica is a bacterium that infects the urogenital tract. It can cause premature birth or spontaneous abortion. Ureaplasma has been found in up to 70% of sexually active adults. The infection can be transmitted sexually.

Herpes Simplex I & II

Herpes is a sexually transmitted infection caused by the herpes simplex virus (HSV). After the initial infection, HSV remains dormant in certain nerve cells of the affected area of the body for life. The dormant virus may reactivate and cause recurrences.

The Proof Is In The Sales

LetsGetChecked can reveal that between January and July of this year, the number of sexual health testing kits sold has increased 5 fold (or 600%). The highest number of sexual health kits were sold in June, compounding numerous studies that suggest that rates of sexually transmitted diseases rise in Summer months.

A study carried out by Denver Metro Health Clinic surmises: “Seasonal variation in human behaviour has a major effect on disease incidence. For example, in temperate climates living indoors predisposes to respiratory infections during the winter, while outdoor activities in summer promote the spread of various enteric diseases from a common source.”

Increased opportunities to socialize may promote the increased likelihood of contracting a sexually transmitted disease, along with more free time when universities break for the Summer and people tend to take their leave from work when the weather is better.

LetsGetChecked can report that sales for sexual health testing kits were 3.5 times higher in January 2018 than in January 2017, showing an ever increasing need to take preventative measures when it comes to sexual health.

What Can Be Done To Combat The Rising Prevalence Of STDs?

Education and preventative healthcare are the answers for combating the rising prevalence of STDs in the U.S and further afield.

The most affected demographic demonstrate an increasing need for better quality sex education in schools.

If condoms haven’t been used, it’s also essential to know what symptoms to monitor when you become sexually active to prevent the further spread or development of sexually transmitted diseases.

The most common symptoms associated with sexually transmitted diseases in men and women include:

  • Painful urination
  • Pain during sexual intercourse
  • Rash on the genitals and/or anus
  • Itching or irritation on the genitals and/or anus
  • Unusual lumps or bumps around the genitals and/or anus
  • Change in color of the male or female discharge
  • Abnormal discharge in terms of smell, consistency or volume
  • Strong vaginal odor
  • Painful erections

Findings from the latest 2018 report which is yet to be published by the CDC will shine a light on whether the epidemic continues. In the meantime, LetsGetChecked can report that the sale of sexual health tests only continue to rise.

Maryam says:

“The highest rate of sexually transmitted diseases are in the industrialized world. Screening and education is unfortunately reflected across class and personal economic, the type of sex you have and how it is transmitted. If people are going to have sex, they need to protect themselves.”

The only way to know if you have a sexually transmitted disease is to get tested. LetsGetChecked offer an efficient, convenient and confidential service that offers you support at every step of the way.

Read: At Home STD Testing: What You Need To Know Before You Pick A Test

Written by Hannah Kingston | Medically Approved By Dr. Maryam Mahmood

STIs

  • One in two sexually active persons will contract an STI by age 25.1
  • The Centers for Disease Control and Prevention (CDC) estimates that nearly 20 million new STIs occur every year in this country, half of those among young people aged 15–24. 2
  • Even though young people account for half of new STI cases, a recent survey showed only about 12% were tested for STIs in the last year.3
  • CDC estimates that undiagnosed STIs cause 24,000 women to become infertile each year.4
  • The total estimated direct cost of STIs annually in the U.S. about $16 billion.5

HPV

  • Researchers estimate that at least 80% of sexually active people will have an HPV infection at some point in their lifetime.6
  • CDC data for 2013–2014 show that about 42% of men and 40% of women aged 18-59 had genital HPV at that time.7
  • HPV is responsible for approximately 31,500 cases of cancer each year, including nearly all cases of cervical and anal cancer, about 75% of vaginal cancer, 70% of oropharyngeal cancer, and 69% of vulvar cancer.8
  • Within 6 years of the introduction of the first HPV vaccine, there was a 64% decrease in HPV prevalence among females aged 14 to 19 years and a 34% decrease among those aged 20 to 24 years.9

Herpes

  • Herpes infection is common. About 1 in 8 people aged 14-49 in the U.S. has genital herpes.10
  • About 1 in 2 people ages 14-49 in the U.S. are infected with HSV-1, which is the typical cause of oral herpes. However, increasing numbers of genital herpes cases are caused by HSV-1.11
  • Symptoms of genital herpes often go unnoticed. Most people with genital herpes—close to 90%—don’t know they have the infection. 12
  • Globally, researchers estimate that about two-thirds of the population under age 50—more than 3.7 billion people–are infected with HSV-1. Some 140 million people aged 15-49 are infected with genital HSV-1, primarily in the Americas, Europe and Western Pacific.13

Chlamydia, Gonorrhea and Syphilis

  • In 2015, rates of the three most common reportable STIs—chlamydia, gonorrhea and syphilis—reached a record high level. The approximately 1.5 million reported cases of chlamydia represent the highest number of annual cases of any condition ever reported to CDC.2
  • While CDC and the U.S. Preventive Services Task Force recommend annual chlamydia screening for sexually active young women ages 15-24, fewer than half of eligible women are screened according the guidelines.14
  • Young people ages 15 to 24 years old accounted for 65% of chlamydia diagnoses and 50% of gonorrhea diagnoses in 2015.2
  • During 2014–2015, rates of syphilis in both men and women increased in every region of the country.15
  • From 2013–2015, the reported gonorrhea infections increased each year. In 2015, a total of 395,216 cases were reported for a rate of 123.9 gonorrhea cases per 100,000 population.15
  • In women, undiagnosed and untreated chlamydia and gonorrhea can lead to pelvic inflammatory disease. (PID). According to CDC, 1 in 8 women with a history of PID experience difficulties getting pregnant.16

Hepatitis

  • CDC estimates that approximately 850,000 persons are living with hepatitis B in the U.S., although other studies have estimated this number to be as high as 2.2 million.17
  • The rate of new hepatitis B infections has declined by approximately 82% since 1991, when routine vaccination of children was first recommended.18
  • Of the more than 3 million people living with Hepatitis C, 3 out of every 4 are “Baby Boomers,” born from 1945-1965. Baby boomers are five times more likely to have Hepatitis C than other adults.19
  • According to CDC, 1.1 million people in the US are living with HIV, and 1 in 7 of them don’t know it.20
  • In 2015, 39,513 people were diagnosed with HIV infection in the U.S. in 2015.20
  • In 2013, an estimated 42% of Americans living with diagnosed HIV were aged 50 and older, 25% were aged 55 and older, and 6% were aged 65 and older.21
  • Pre-exposure prophylaxis, or PrEP, involves talking a daily medication to prevent HIV infection in people who are HIV-negative. When taken consistently, PrEP has shown to reduce HIV infection risk by up to 92%.22
  1. Cates JR, Herndon NL, Schulz S L, Darroch JE. (2004). Our voices, our lives, our futures: Youth and sexually transmitted diseases. Chapel Hill, NC: University of North Carolina at Chapel Hill School of Journalism and Mass Communication.
  2. CDC Fact Sheet: Reported STDs in the United States 2015 National Data for Chlamydia, Gonorrhea, and Syphilis.
  3. Cuffe, Kendra M. et al. Sexually Transmitted Infection Testing Among Adolescents and Young Adults in the United States Journal of Adolescent Health 2016, 58(5), 512-519
  4. Centers for Disease Control and Prevention. Sexually Transmitted Diseases in the United States, 2008
  5. CDC Fact Sheet: Incidence, Prevalence, and Cost of Sexually Transmitted Infections in the United States.
  6. Chesson HW, Dunne EF, Hariri S, Markowitz LE. The estimated lifetime probability of acquiring human papillomavirus in the United States. Sex Transm Dis. 2014 Nov;41 (11):660-4.
  7. Prevalence of HPV in Adults Aged 18–69: United States, 2011–2014. NCHS Data Brief No. 280, April 2017
  8. Saraiya M, et al. US assessment of HPV types in cancers: implications for current and 9-valent HPV vaccines. Journal of the National Cancer Institute 2015;107:djv086.
  9. Markowitz, LE et al. Prevalence of HPV After Introduction of the Vaccination Program in the United States. Pediatrics Feb 2016, peds.2015-1968.
  10. McQuillan G, Kruszon-Moran D, Flagg EW, Paulose-Ram R. Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016. NCHS Data Brief, no 304. Hyattsville, MD: National Center for Health Statistics. 2018.
  11. Bradley H, Markowitz LE, Gibson T, McQuillan GM. Seroprevalence of herpes simplex virus types 1 and 2—United States, 1999-2010. J Infect Dis. 2014 Feb 1;209(3):325-33.
  12. Fanfair RN, Zaidi A, Taylor LD, Xu F, Gottlieb S, Markowitz L. Trends in seroprevalence of herpes simplex virus type 2 among non-Hispanic blacks and non-Hispanic whites aged 14 to 49 years-United States, 1988 to 2010. Sex Transm Dis. 2013 Nov;40(11):860-4.
  13. Looker KJ, Magaret AS, May MT, Turner KME, Vickerman P, Gottlieb SL, et al. (2015) Global and Regional Estimates of Prevalent and Incident Herpes Simplex Virus Type 1 Infections in 2012. PLoS ONE 10(10): e0140765.
  14. The State of Health Care Quality Report, 2016. The National Committee for Quality Assurance.
  15. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2015. Atlanta: U.S. Department of Health and Human Services; 2016.
  16. Pelvic Inflammatory Disease (PID)—CDC Fact Sheet
  17. Centers for Disease Control and Prevention. Surveillance for Viral Hepatitis—United States, 2015.
  18. Centers for Disease Control and Prevention. Hepatitis B FAQs for Health Professionals.
  19. Centers for Disease Control and Prevention. Hepatitis C and Baby Boomers (1945-1965)
  20. Centers for Disease Control and Prevention. HIV in the United States: At a Glance.
  21. Centers for Disease Control and Prevention. HIV Among People Aged 40 and Older.
  22. Grant RM,et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010 Dec 30;363(27):2587-99.

The CDC’s study on STD rates in the United States in 2017 will be published in full this fall, at which time more details, such as demographic information about who is most affected, will be available. But when I asked Gail Bolan, the director of the CDC’s Division of STD Prevention, how exactly these two trends in sexual behavior were happening at once, she explained that the sexual behaviors known to be contributing to widespread STD transmission have almost nothing to do with how much sex people are having—rather, it’s riskier sex that’s being had.

Two factors Bolan identifies as potentially contributing to the record-high rates of reported STDs are a rise in condom-less sex and a rise in high-risk sexual behaviors associated with opioid use and addiction.

“Among gay and bisexual men as well as heterosexual , there are some behavioral surveys that are suggesting that condom use is on the decline,” Bolan says. Among communities of men who have sex with men, she says, condom use has been on the decline for several years: “A lot of that was related to when lifesaving HIV medications became available … Those are great tools for preventing HIV transmission, but they have no impact on these other STDs.”

More recently, though, Bolan and her team have seen changes in transmission patterns. Over the past ten years, she says, condom-less sex has increased across demographics. “We’re starting to see increases in heterosexual people, especially women and pregnant women, which means these infections are getting into new populations.”

Additionally, Bolan says, other CDC research suggests a link between STD transmission and the risky sex acts often associated with opioid use and addiction. She cites a soon-to-be-published CDC study that found 15- to 24-year-olds who reported injected drug use in the past year were more likely to be diagnosed with chlamydia, syphilis, and gonorrhea than those who didn’t inject drugs. More importantly, she adds, “injecting drugs was also associated with higher rates of forced sex, sex with people who exchange money or drugs for sex, and sex with other people who inject drugs”—which are all “high-risk factors” for STD transmission. (Chlamydia, gonorrhea, and syphilis are really only transmitted through sexual activity, not through blood exposure from sharing needles.)

And as Angela Lashbrook recently pointed out in The Atlantic, another reason STD rates are climbing is because funding cuts have been affecting public-health centers and STD-prevention and -treatment programs throughout the United States in recent years. “When underfunded, these initiatives decrease their hours and staff, and sometimes close altogether, making STD detection and treatment more difficult,” she writes.

The CDC’s findings, coupled with the decline in the frequency of Americans’ sexual encounters, indicate that Americans’ sex lives are changing; when people are doing it, they’re doing it with fewer precautions in place, and with less of a safety net for diagnosis and treatment. As sex has fallen further down the priority lists of many Americans, so perhaps has sexual safety.

We want to hear what you think about this article. Submit a letter to the editor or write to [email protected]

Ashley Fetters is a staff writer at The Atlantic. Connect Twitter

Why? The CDC cites numerous potential reasons, including poverty, drug use, decreases in condom use, and stigma surrounding STDs. Add to that recent cuts to state and local STD programs, resulting in clinic closures and less screening and patient follow-up.

Many experts believe funding cuts are a critical factor, according to Fred Wyand, communications director for the nonprofit American Sexual Health Association.

“The subject of STD rates and why they remain so high is a discussion with much nuance and no single, simple answer,” Wyand noted. “But the public health experts who advise us consistently refer to an eroding STD prevention infrastructure as a key element in driving STD rates.”

The latest CDC figures, published Oct. 8 in the Sexually Transmitted Disease Surveillance Report 2018, show that in 2018:

  • Over 115,000 syphilis cases were reported, including more than 1,300 infections among newborns. Of those infants, 94 died — up from 77 deaths in 2017.
  • Gonorrhea infections increased by 5%, topping 580,000 cases — the highest number since 1991.
  • A record number of chlamydia cases were reported: more than 1.7 million, representing a 3% increase from 2017.

All three diseases are bacterial infections, with potential consequences ranging from infertility to pregnancy complications to increased vulnerability to HIV.

According to Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, “STDs can come at a high cost for babies and other vulnerable populations. Curbing STDs will improve the overall health of the nation and prevent infertility, HIV and infant deaths.”

When it comes to gonorrhea, one of the concerns is its ever-increasing resistance to antibiotics. “It’s a smart bug,” Torrone noted. Right now, the only recommended treatment is a shot of the antibiotic ceftriaxone, plus the oral antibiotic azithromycin.

However, all three STDs are curable with antibiotics, provided they are detected. The CDC has screening recommendations on all three diseases, as well as HIV and hepatitis B.

If your health care provider has not screened you, Torrone said, ask whether you should be. “People should feel empowered to ask, ‘Which STDs should I be tested for?'” she said.

Women, Torrone noted, might assume they are getting any recommended screenings when they see a gynecologist for a pelvic exam. “Hopefully, they are,” she said. “But women can also ask questions to be sure.”

Americans have more STDs than ever — especially in Mississippi, new report says | Biloxi Sun Herald

Sexually transmitted diseases are at an all-time high in Mississippi and across the country, a new report from the Centers for Disease Control says.

The federal agency publishes an annual report on the number of STD cases across the country, and the report released Tuesday for 2016 shows STD cases have risen for the third year in a row after steadily decreasing since 2006.

“Increases in STDs are a clear warning of a growing threat,” said Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. “STDs are a persistent enemy, growing in number, and outpacing our ability to respond.”

The majority of new cases — 1.6 million — were chlamydia, which is the most commonly reported STD and has serious long-term effects for women if left untreated.

Local News at Your Fingertips

Get unlimited digital access for just $3.99 a month to #ReadLocal anytime, on any device.

GET OFFER

“Young women (ages 15-24) account for nearly half (46 percent) of reported cases and face the most severe consequences of an undiagnosed infection,” the CDC said in a press release.

“Untreated STDs, like chlamydia and gonorrhea, put women at increased risk for pelvic inflammatory disease which may result in chronic pelvic pain, infertility and potentially a life-threatening ectopic pregnancy. It is estimated that undiagnosed STDs cause infertility in more than 20,000 women each year.”

Mississippi had a significant jump in chlamydia cases last year, 17,112 to 20,112 from 2015 to 2016. But the state for the first time recently has the highest rate of gonorrhea in the country.

The CDC said the steepest increases in gonorrhea cases across the nation are among men that have sex with other men.

“These trends are particularly alarming in light of the growing threat of drug resistance to the last remaining recommended gonorrhea treatment,” the press release said.

Reasons for the increasing rates include decreasing condom usage, a lack of awareness among doctors and patients, and a falling number of STD clinics, the Los Angeles Times reported.

Mississippi State Department of Health as of July 1 implemented a $25 fee for all STD and HIV tests, the Clarion-Ledger reported. The tests had been free, but the Legislature has been slashing budgets statewide, including for the Department of Health. However, the department has since suspended the fee and the tests are currently free.

Louisiana has historically had the highest rates of STDs in the nation, said Director of the Division of STD Prevention Gail Bolan in a statement, but the state’s work to reverse that is an example to others.

“By tackling their burden on multiple fronts, Louisiana is gaining ground in spite of an uphill battle,” Bolan said. “For example, with syphilis, they’ve increased testing and reduced time to treatment in public health clinics. In 2016, the number of CS (congenital syphilis) cases decreased for the first time in five years. With expanded extragenital gonorrhea and chlamydia testing, they also diagnosed 165 cases that would have otherwise been missed.”

“These budding achievements are a strong reminder to us all that good prevention remains in reach. Reversing our growing STD burden will take a lot of work, and it won’t happen overnight, but it is worth it.”

For detailed information on how to know if you have an STD, visit www.cdc.gov/std/healthcomm/fact_sheets.htm

Lauren Walck: 228-896-2393, @laurenwalck

STD rates in Mississippi

Where to get tested

Mississippi State Health Department locations:

  • A new survey reveals how few young people discuss sexually transmitted infections with their partners.
  • Women are more likely to get tested and talk about testing.
  • Experts warn that young people are at risk of asymptomatic infections — which could cause serious problems later in life.

Bree was hooking up with a coworker for the first time when she asked, “When was the last time you were tested for STIs?” It’s a standard question for Bree, 18, who gets tested every year, but her partner seemed suddenly flustered. “He said, ‘I’m OK, I don’t think I have any STIs,’ and I said, ‘That’s not the question I asked you,’” Bree recalled. They were on his couch, an hour before they had to head out for a shift at the restaurant where they both worked, and Bree’s partner began to explain that he had never needed to get tested because he always hooked up with “nice girls.” Bree was floored. “I couldn’t believe that he was 20 years old and had been sexually active for a while, but he had never been tested,” she said. “I had to tell him that this wasn’t about him — this is just something that we both have to do for our own safety.”

Her experiences are part of a troubling trend in sexual health — one that could lead to serious long-term health problems for young people with untreated, asymptomatic STIs. A 2016 CDC report shows cases of sexually transmitted infections (STIs) reached an all-time high in the United States and those between the ages of 15 and 24 acquire half of all new STIs. A new Cosmopolitan.com survey reveals that despite this risk, a surprisingly high number of young people don’t talk about STI testing with their sexual partners. And the onus to both talk about testing and get tested falls mainly to women.

Katie Buckleitner
The survey of 1,454 respondents between the ages of 18 and 35, recruited from Cosmopolitan.com’s and Esquire.com’s social media accounts, found that 47 percent said none of their past partners asked about their STI testing results before having sex. And while 58 percent of women say they’ve been tested in the past year, only 33 percent of men said the same. Men were also three times likelier than women to say they’ve never been tested (33 percent versus 11 percent).
Katie Buckleitner

Nearly one-third of survey respondents said they’ve either had an STI or don’t know if they have an STI. The most commonly reported STI was chlamydia (18 percent), followed by HPV (11 percent), genital or oral herpes (5 percent), gonorrhea (4 percent), trichomoniasis (3 percent), and genital warts (2 percent). One percent of respondents said they had pelvic inflammatory disease (PID), scabies, or pubic lice. Women were also twice as likely as men to say they’ve had an STI (36 percent versus 18 percent).

The risks of not getting tested can be devastating. Many STIs can go unnoticed for long periods of time, with no visible symptoms. Left untreated, they can cause serious problems in women, explains Leah Millheiser, ob-gyn and clinical assistant professor of obstetrics and gynecology at Stanford University. “Only 20 percent of women with gonorrhea have symptoms and chlamydia is often a ‘silent’ infection with no symptoms,” she said. “But if they’re left untreated, they can lead to more serious infections that can require hospitalization and cause infertility.”

“It makes me feel like they expect all of the responsibility to fall on me, as the girl.”

Jessica, 22, who began getting tested regularly at a local clinic after one of her friends contracted chlamydia, said she’s continually surprised by how many of her male partners don’t ask about testing or carry condoms. “How hard is it to just go buy a box of condoms?” she said. “It makes me feel like they expect all of the responsibility to fall on me, as the girl — I’m supposed to be taking care of their health and my health. ”

Most men (81 percent) know where to get tested — they’re just not doing it at the same rate their female partners are. Women have a built-in opportunity for testing at regular gynecological visits. When asked why they had their most recent STI test, 24 percent of respondents overall said it was because a doctor suggested it at a routine appointment. Doctors are unlikely, however, to suggest a full STI screen for men who have sex with women because CDC guidelines only recommend an HIV test for sexually active heterosexual men, according to Hayley Mark, who is the chair of the department of nursing at Towson University and a researcher on STI testing practices. This is because men who have sex with women are less likely to get STIs like gonorrhea and chlamydia, and the health stakes are higher for women, because these infections can lead to infertility. “A lot of STI testing is done at publicly funded facilities and you need to put your resources where you will get the most ‘bang for your buck,’” Mark explained. As a result, men are unlikely to get an STI test at an annual physical unless they believe they were exposed or they ask for it.

Katie Buckleitner

Men are also used to their partners initiating a conversation about testing. Although 82 percent of respondents said both partners are responsible for testing, a majority (52 percent) of women say they initiated a conversation about STI testing with their most recent partner, compared to only 27 percent of men.

Gender socialization may help explain this difference, said Hayley Mark. “Because sex and sexuality have such significant implications for women, for example, pregnancy, many women have to become comfortable talking about it,” she said. “Given the implications, women may be more determined to take care of this aspect of their health and their partners.”

The cost of testing isn’t prohibitive for most respondents. Nearly two-thirds (64 percent) of respondents who had been tested for STIs paid nothing for their most recent test, while 15 percent said their test cost $1 to $30, and 20 percent said it cost more than $30. (Information about free or subsidized STI testing is available on the CDC’s website.) Nicole, 25, gets tested for STIs at her annual gynecological appointment and again if she has a new sexual partner. Her insurance policy covers one test per year and each additional test costs about $20 depending on her co-pay, which she views as a worthwhile expense. “I am really, really cautious,” she said. “I’d rather spend the money on the test than something like going out for coffee a couple times a week.”

“If you’re hooking up with a friend … it doesn’t seem as necessary to have that conversation.”

Still, for some, other barriers to testing exist. Ben, 19, doesn’t get tested since he’s on his parents’ insurance and fears they’ll intercept a statement for his tests. He doesn’t always talk to his sexual partners about testing. “If you’re hooking up with a friend and know their sexual history, it doesn’t seem as necessary to have that conversation,” he said, adding that his lack of testing has been OK with his partners, as long as they use protection.

Katie Buckleitner

The survey found that women are generally more conscientious than men not just about STI testing, but about safer sex practices: 31 percent of women said they would have sexual intercourse with a partner who couldn’t remember the last time they were tested, compared to 57 percent of men. Similarly, only 30 percent of women but 61 percent of men said they would have oral sex with a partner who could not remember the last time they were tested.

Katie Buckleitner

Tyler, 30, said he hasn’t been tested in a few years because he’s been in a monogamous relationship but before that was more comfortable having unprotected oral sex than intercourse with a partner who couldn’t remember the last time they were tested. “It’s just not something I do as often, so once I’ve decided I want to have oral with a woman, I am pretty sure I’d be able to trust her,” he said. (The risk of HIV transmission is lower for oral sex than other forms of sex, according to the CDC, but many STIs, including chlamydia, gonorrhea, and herpes, can be spread through oral sex.)

Katie Buckleitner

Women were less likely to distinguish oral sex from intercourse. “All sex has risk,” said Rene, 23. She’s part of a polyamorous community and participates in threesomes, and said it’s common for sexual partners to ask for screenshots of testing results. When partners don’t want to share their testing status, she said, it’s a serious red flag. “If you’re nervous talking about this, maybe you have something to hide.”

Further adding to the risk, a small but significant group — 9 percent of respondents — admitted that they have lied to a sexual partner about the last time they were tested. When asked why they lied, 5 percent of respondents said they didn’t want to delay sex, 3 percent said they couldn’t remember when their last test happened, and 1 percent said they had an STI and didn’t want their partner to know.

These findings highlight the need for young people to get comfortable with routine STI testing and talking with their partners about STIs. But given the burdens women have been tasked with, men especially need to take responsibility for their own sexual health.

“It’s great for women to be empowered about getting tested themselves,” Dr. Millheiser says, “but it means absolutely nothing if your partner isn’t getting tested.”

Follow Amelia on Twitter.

Katie Buckleitner

The Awkward Conversation You Need to Have With Your Partner Before Sex

7 of Your Most Important STI Questions, Answered

Men Need to Step Up and Get Tested

Amelia Thomson-DeVeaux Amelia Thomson-DeVeaux is a writer and editor based in Chicago.

Americans Are Getting STDs at Record Rates

Sexually transmitted disease (STD) rates in the U.S. are at a record high for the fourth year in a row, according to new data from the Centers for Disease Control and Prevention (CDC).

All told, nearly 2.3 million cases of chlamydia, gonorrhea and syphilis were diagnosed in the U.S. in 2017. That’s 200,000 more cases than were diagnosed in 2016, a year that also had a record-high number of cases, according to the CDC.

“We are now very concerned about this steep and sustained increase that we’re seeing,” says Dr. Gail Bolan, the director of the CDC’s Division of STD Prevention. “We’ve seen an ebb and flow of STDs in decades past, but now we’re at the highest level of our reportable conditions that we’ve seen in two decades.”

Chlamydia remains by far the most common STD in the U.S., with more than 1.7 million cases diagnosed last year. But increases in syphilis diagnoses have been particularly dramatic. Rates have risen by 76% (from around 17,400 cases to more than 30,600 cases) since 2013, according to CDC data. Bolan says that’s in part because transmission patterns are changing.

Get our Health Newsletter. Sign up to receive the latest health and science news, plus answers to wellness questions and expert tips.

Thank you!

For your security, we’ve sent a confirmation email to the address you entered. Click the link to confirm your subscription and begin receiving our newsletters. If you don’t get the confirmation within 10 minutes, please check your spam folder.

“In past years, syphilis was predominantly among men who have sex with men, and in more recent years, we’re now seeing increases in women and heterosexuals,” she says. (Nonetheless, 70% of cases in 2017 were still diagnosed among men who have sex with men, the report says.) “A lot of communities are not aware that they’re a community with high prevalence, so we’ve got to expand our outreach and education to ensure that people are getting the appropriate screening, treatment and prevention messages.”

Gonorrhea diagnoses are also increasing and have grown by 67% (from around 333,000 cases to roughly 555,600 cases) since 2013, the report shows. Even more concerning, Bolan says, is the mounting threat of drug-resistant strains of the disease.

Gonorrhea is a “wily organism,” Bolan says. “As soon as you use one drug, it figures out ways to bypass that antibiotic. We’re now down to the last known effective antibiotic in our pipeline. It’s only a matter of time before the organism’s going to outsmart us.”

That prediction underscores the importance of developing new antibiotics and novel treatment options, such as vaccines, Bolan says. While the CDC has not seen any signs of syphilis or chlamydia developing drug resistance, she says it’s something the agency is actively monitoring. “Any bacteria, and even some viruses, can become resistant, so we’re always concerned,” Bolan says.

Bolan says the new findings emphasize the importance of any sexually active person getting tested for STDs — and practicing safe sex by using condoms — but that young women should be particularly vigilant, as 45% of chlamydia cases were diagnosed among women ages 15 to 24 in 2017. That’s in part because young women are biologically susceptible to contracting the infection, since chlamydia gravitates toward a type of cell that sits outside young women’s cervixes. Those cells migrate inside the cervix with age, and women may develop some immunity over time as well, Bolan explains.

“They have the most to lose,” she says, because these infections can lead to infertility, pregnancy complications and chronic pelvic pain.

More comprehensive community education and outreach, coupled with better screening and treatment practices from doctors — like taking detailed sexual histories from patients, and testing for STDs using more rigorous methods than simple urine tests — may help get STD rates under control, Bolan says. But the problem is a complex one, since certain communities and socioeconomic groups are more susceptible to infection than others, and other public health issues, such as substance use and the opioid epidemic, may compound the problem.

“We know that we still have a long way to go,” Bolan says.

Most Popular on TIME

Write to Jamie Ducharme at [email protected]

5 reasons why 3 STDs are roaring back in America

We don’t talk much about chlamydia, gonorrhea, or syphilis, in part because it can seem like they’re not big health issues anymore. But it turns out more and more Americans may be quietly suffering from these once nearly eliminated STDs.

According to a new report from the Centers for Disease Control and Prevention, there were nearly 2.4 million cases of chlamydia, gonorrhea, and syphilis reported in the United States in 2018 — the highest cumulative number ever recorded.

The leap in cases over the last few years is truly eye-popping. Between 2017 and 2018, the rate of:

  • Gonorrhea cases increased by 5 percent, to 580,000 cases in 2018 — the highest number since 1991.
  • Primary and secondary syphilis cases (the most infectious stages of the disease) increased by 14 percent to 35,000 cases — also the highest number since 1991. The total number of syphilis cases was 115,000.
  • Chlamydia cases grew by 3 percent to 1.7 million cases — the most the CDC has ever reported.

To appreciate just how astonishing the trends are, consider that as recently as a decade ago, these STDs were at historic lows or nearly eliminated. Better screening and diagnostics helped identify cases and get people into treatment. Now, those efforts have been undermined by a lack of funding for STD prevention as well as peoples’ behaviors, which public health officials are scrambling to keep on top of.

Syphilis can show up on the body in sores and rashes. Gonorrhea and chlamydia can lurk with no symptoms. They’re all generally easy to cure with a prompt antibiotics prescription. But when left untreated, they can lead to infertility or life-threatening health complications, particularly in fetuses and infants. That’s what makes screening and access to health care so important.

“STDs can come at a high cost for babies and other vulnerable populations,” said Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “Curbing STDs will improve the overall health of the nation and prevent infertility, HIV, and infant deaths.”

African Americans and men who have sex with men have traditionally been the populations most plagued by gonorrhea and syphilis (and they’re still disproportionately affected). But other groups are now catching up too, especially women and babies in contracting syphilis.

What’s driving surging rates of STDs?

So what’s behind the spread of these diseases here? There’s no single explanation. Like most health trends, it’s complicated. But here are a few ideas, according to experts:

1) There’s been a rise in condomless sex among men who have sex with men.

Gay, bisexual, and other men who have sex with men are generally more at risk for STDs than women and men who have sex with women only. (The majority of new syphilis and gonorrhea cases occurred among men, and in particular, men who have sex with men.) And there’s been some concern about a shift toward not wearing condoms, which may be contributing to the rise in STDs.

The reason for this shift has been explained by everything from the success in treating HIV (and therefore making unprotected sex less scary) to the advent of PrEP (pills that can prevent HIV). A systematic review published in the journal Clinical Infectious Diseases found that some PrEP users are having more risky sex — and are being diagnosed with more sexually transmitted infections.

HIV and syphilis are also interlinked: Some half of men diagnosed with a new syphilis infection also have HIV. And as these diseases spread in particular populations, like men who have sex with men, there’s a greater risk of them moving even further.

“The fear, which I share, is that we won’t contain syphilis among men who have sex with men,” Matthew Golden, director of the Public Health for the Seattle and King County HIV/STD control program, told Vox. And if the epidemic in men who have sex with men keeps growing, and spreads to women as well, “it won’t be possible to contain.”

2) STDs are spreading more broadly and into populations that weren’t traditionally affected — like babies.

The latest CDC numbers show a 40 percent increase in congenital syphilis cases from 2017 to 2018. So more and more women in America are getting syphilis these days, and they’re passing it to their babies. When an expectant mother is infected with the disease and goes undiagnosed and untreated, the bacteria can get into her bloodstream and move through her placenta to her baby. Congenital syphilis is associated with serious health consequences, like stillbirths and neonatal deaths. And newborn deaths linked to congenital syphilis — surged by 22 percent (from 77 to 94 deaths).

The large increase is being driven by only a handful of states. “Although most states reported at least one case of congenital syphilis, five states – Texas, California, Florida, Arizona, and Louisiana – accounted for 70 percent of cases in the US,” the CDC found.

Early STD detection and treatment can improve mom’s and baby’s outcomes. “There are tools available to prevent every case of congenital syphilis,” said Gail Bolan, director of CDC’s Division of STD Prevention, in a news release. “Testing is simple and can help women to protect their babies from syphilis — a preventable disease that can have irreversible consequences.”

But right now, not enough women in these syphilis hotspots are accessing testing and treatment.

3) With the rise of dating apps, sex is more readily available and more anonymous — and that makes it harder for health investigators to track outbreaks.

Health experts increasingly view apps and sites such as Tinder, Grindr, and OkCupid as enablers of high-risk sex, helping people meet and hook up more efficiently than ever before. The impact of these sites is so profound they are also transforming the way health officials track and prevent outbreaks.

These places, after all, had become important meeting points for men who have sex with men — the group most affected by the HIV epidemic.

“We used to think about what we can do with bathhouses and sex clubs to make sure people’s risk was reduced,” said Dan Wohlfeiler, director of Building Healthy Online Communities, a public health group that works with apps to support STI prevention. These places, after all, had become important meeting points for men who have sex with men — the group most affected by the HIV epidemic.

Today, the public health focus has shifted to what some have called these “digital bathhouses.”

“Many people worry about the impact of dating apps on HIV and STD transmission, but don’t recognize the potential of apps be a key partner for prevention,” said Wohlfeiler, whose organization just launched TellYourPartner.org, an intervention that allows people to notify their partners about a positive STD test via text or email anonymously. “We’ve sat down with owners, brought them data, and worked with them to make changes in their profile options so that users can let others know their HIV status and whether they use condoms, are on PrEP, or have an undetectable viral load.”

4) The numbers may be higher because we may be better at detecting cases in some groups.

The rise in chlamydia — which overwhelmingly causes no symptoms but can lead to infertility in women — may be an artifact of better detection and screening. The CDC keeps finding that rates of chlamydia are highest among young women, the group that’s been targeted for routine chlamydia screening. So an increase could just mean more testing.

5) Cuts to public health funding mean fewer STD clinics.

Public health in the US — which includes operating STD clinics where people can get tested and into treatment — is historically underfunded. (As of 2012, only 3 percent of the health budget went to public health measures; the rest went mostly to personal health care.) And since the global financial crisis, public health funding has really taken a battering. There are 50,000 fewer public health jobs since 2008, and many STD clinics have had to reduce their hours or shut down.

STD clinics were a traditional safety net for people with these diseases. If those clinics continue to be harder to reach or vanish, finding and treating STDs will become even more difficult — and the diseases will continue to spread.

So in some ways, the STD increases across the country may have less to do with a changing sexual landscape and more to do with more limited access to sexual health care. “Once again, STDs are at crisis levels in the United States, reaching all-time highs for the fifth year in a row,” the Partnership to End the HIV, STD, and Hepatitis Epidemics said in a statement. “We cannot end the HIV epidemic on the back of an exploding STD epidemic, nor can we accept the fact that more and more babies are dying in this country as a result of congenital syphilis, an easily treated and highly preventable condition.”

STD rates hit record high in 2018

Rates of sexually transmitted diseases (STDs) reached a record high in 2018, resulting in more babies born with syphilis, according to a report released Tuesday by the Centers for Disease Control and Prevention (CDC).

Combined cases of syphilis, gonorrhea and chlamydia increased for the fifth consecutive year, partly due to cuts to STD programs at the state and local levels and decreased condom use among young people and gay and bisexual men, the CDC said.

ADVERTISEMENT

More than 1,300 babies were born with syphilis last year, a 40 percent increase from 2017. That parallels with an increase in syphilis among women of childbearing age.

“This is a failure of the public health system and private health care system, and we have the tools to prevent it,” said Dr. Gail Bolan, director of the CDC’s STD Division.

In all, there were nearly 2.5 million cases of chlamydia, gonorrhea and syphilis in 2018, a 30 percent increase from 2013. Rates were highest among men who have sex with men and people of color.

STD rates were highest in southern states including Georgia, Louisiana and Mississippi, and rural states like Alaska and South Dakota.

“Most people have no signs of symptoms so they don’t know they’re infected, and it becomes a challenging problem to identify everyone infected and get them treatment,” said Bolan.

Many STD clinics that were effective at treating diseases closed during the 2007-2009 recession and never reopened. Local health departments are also increasingly short staffed. For state governments strapped for money, public health funds are often the first to be cut during economic downturns.

“We’ve seen the erosion of the public health infrastructure,” Bolan said.

ADVERTISEMENT

Patients who are uninsured or underinsured often struggle to find care in the private health care system and at times are unable to get appointments for treatment until weeks after testing positive for STDs.

That raises the risk of patients falling through the cracks, not following up on appointments and potentially spreading the infection.

A record-high 1.8 million chlamydia cases were reported to the CDC in 2018, an increase of 2.9 percent from the previous year, making it the most common STD in the U.S.

Rates increased 19.4 percent between 2014 and 2018.

Chlamydia rates are highest among adolescents and young adults, particularly women, with two-thirds of cases among people between the ages of 15 and 24.

The CDC recommends women younger than 25, and women who are at greater risks for infection, be screened annually for the disease.

And more than 115,000 cases of all stages of syphilis were reported to the CDC last year, a 13 percent increase from 2017 and the highest number since 1991.

That includes more than 35,000 cases of primary and secondary syphilis, the most infectious stages of the disease. In 2018, rates of primary and secondary syphilis increased nearly 14 percent from the previous year.

Most of those cases were among men who had sex with other men, according to the report.

But rates also rose among women by 30 percent from 2017 to 2018. That increase is linked to a spike in the number of babies born with syphilis, with Texas, Nevada and Louisiana seeing the highest rates.

If pregnant women aren’t treated for syphilis, the baby can be born with it, resulting in stillbirths, preterm birth and physical and mental disabilities.

Congenital syphilis is treatable, but the CDC said it suspects some health care providers are failing to screen pregnant women for the disease early in pregnancy, or women are not getting prenatal care.

“The resurgence of syphilis, and particularly congenital syphilis, is not an arbitrary event, but rather a symptom of a deteriorating public health infrastructure and lack of access to health care,” Bolan wrote in her report.

“It is exposing hidden, fragile populations in need that are not getting the health care and preventive services they deserve. This points to our need for public health and health care action for each of the cases in this report, as they represent real people, not just numbers.”

Meanwhile, gonorrhea rates are rising fast, with an 83 percent increase in cases from 2009 to 2018. Rates are highest among men, particularly those who have sex with other men.

In 2018, more than 583,000 cases were reported to the CDC, an increase of 5 percent from the previous year.

Public health groups have sounded the alarm on increasing STD rates for years.

The National Coalition of STD Directors is urging Congress to increase funding for STD prevention services by $70 million, calling it the “bare minimum” it will take for the CDC to support an effective response to an ongoing public health crisis.

“We have an STD crisis in the U.S. because prevention programs were sold short for years,” said David Harvey, executive director of the group. “Our first line of defense is underfunded and overwhelmed, leaving Americans vulnerable to STD outbreaks, and that’s exactly what we’re seeing.”

The government funding bill passed by the Democratic-controlled House included an increased in funding for STD services but it’s unclear if the Senate bill will follow suit.

“STDs have real health and human costs. Babies dying from preventable conditions, like congenital syphilis, is not an outcome we can accept,” Harvey said. “This is a heartbreaking symptom of our nation’s STD crisis. Without a radical shift in how we prioritize sexual health in the United States, we can only expect things to get worse.”

Std rates in us

Leave a Reply

Your email address will not be published. Required fields are marked *