Posted on Oct 08, 2019, 9 p.m.
In 2018 there were more than 2.4 million reported cases of syphilis, chlamydia, and gonorrhea in America, and that is just the reported cases, many more cases go undiagnosed.
According to a report from the US CDC cases of the three common sexually transmitted diseases reached a new record level in 2018 within America; cases of gonorrhea and cases of primary and secondary syphilis reached their highest levels since 1991.
In 2018 since 2017 America’s over 115,045 cases of syphilis included more than 35,000 cases of primary and secondary syphilis, which is an increase of 14.9%. Since 2017 America’s over 583,000 cases of gonorrhea is an increase of 5%, and since 2017 the reported cases of chlamydia increased 3% to more than 1.7 million, of which close to two thirds were among those aged 15-24 years of age.
Together these 3 sexually transmitted diseases accounted for over 2.4 million cases in America, this represents an all time record high on all three conditions since data was first collected in 1984.
These 3 STDs are treatable through antibiotics, and can have serious consequences if left untreated, including infertility and even death. Despite public health efforts to improve access to treatment and testing the prevalence of STDs continues to climb in recent years, which according to the CDC report represents "an underestimated opponent in the public health battle."
"We are not keeping up on the resurgence of sexually transmitted infections in this country," says Dr. Gail Bolan, director of the CDC's Division of STD Prevention. "Timely detection followed by timely treatment is our main strategy to treat individuals to improve their own health and to reduce transmission in a given community. Clearly, transmission is outpacing our detection and treatment efforts at the moment."
Improved testing may be contributing to the increase in numbers, but it can’t completely explain the surge. Officials suggest that a combination of factors may be linked to the increase including social factors that can affect access to healthcare like shame, stigma, drug use, poverty, unstable housing, feelings of invincibility, lack of knowledge, risky sexual behavior, and slashed funding for STD programs across the nation.
“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.”
"The situation is multifactorial – there's not one simple explanation for why we're seeing the significant increases every year," she says. "The good news is that we're actually doing a better job of documenting cases and understanding what the missed opportunities are in those cases, so we can focus on interventions to close those gaps."
Some of the gaps and missed opportunities are in prenatal care, according to the report there is a 39.7% year over year spike in the rate of congenital syphilis, this occurs when it is passed on from the mother to infant during pregnancy and can cause serious health issues as well as infant death; there were 94 infants deaths and stillbirths due to syphilis according to the report.
41 states reported 1,306 cases of congenital syphilis in 2018 which were mostly concentrated to 5 states: Arizona, California, Florida, Louisiana, and Texas. This is linked to the higher overall rates of syphilis in those states, as well as a nationwide increase among women at 172.7% in primary and secondary syphilis between 2014-2018.
Officials are trying to stay ahead of the curve to prevent cases of congenital syphilis by helping women to seek prenatal care early in pregnancy, and ensuring that doctors are screening for the disease to provide any who are infected with treatment. Those who are pregnant and not infected may be at higher risk of infections such as those living in areas with a higher concentration of syphilis cases, and should be tested again in the third trimester.
"A number of women have been referred to other clinics in the area for treatment and have been lost to follow-up," Bolan says. "We want to make sure that these women are actually linked to treatment, and the treatment is documented so that we can prevent congenital syphilis."
Despite the alarming increase in women, men who have sex with other men saw the greatest increase in share of primary and secondary cases of syphilis in 2018. Rates of all 3 sexually transmitted diseases increased among males and females in all racial and ethnic groups across the nation. Stronger sustained efforts among public health and healthcare systems are needed to curb these rates, starting with providing education other than that of abstinence only.
"This is a failure of the public health system and private health care system, and we have the tools to prevent it. This is affecting the health of our nation," Bolan says. "It takes a village, and we need all sectors really involved in trying to reverse these trends."
“We have an STD crisis in the U.S. because prevention programs were sold short for years,” said David Harvey, executive director of The National Coalition of STD Directors group. “Our first line of defense is underfunded and overwhelmed, leaving Americans vulnerable to STD outbreaks, and that’s exactly what we’re seeing.”
“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."
Recap: Chlamydia has increased 19% since 2014 to over 1.8 million cases. Gonorrhea has increased 63% since 2014 to over 583,405 cases. Primary and secondary syphilis has increased 71% since 2014 to over 35,063 cases. Congenital syphilis has increased 185% since 2014 to 1,306 cases.
Don’t be another statistic, if you are mature enough to have sex do it safely “no glove = no love.” You can’t tell if a person is infected just by how they look, sometimes there may be no visible signs. For those that think, “I don’t need to use a condom, I’ll just get some drugs,” keep in mind that cases of antibiotic resistant gonorrhea are also increasing. No one is immune to STDs, so “don’t be silly, wrap up that willy” because a few moments of being irresponsible are not worth the risk or the consequences.
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This article is not intended to provide medical diagnosis, advice, treatment, or endorsement.