‘Out of control’ STD situation prompts call for changes

Sharply rising cases of some sexually transmitted diseases—including a 26% rise in new syphilis infections reported last year—are prompting U.S. health officials to call for new prevention and treatment efforts.

“It is imperative that we … work to rebuild, innovate, and expand (STD) prevention in the U.S.,” said Dr. Leandro Mena of the U.S. Centers for Disease Control and Prevention in a speech Monday at a medical conference on sexually transmitted diseases in New York City.

Infections rates for some STDs, including gonorrhea and syphilis, have been rising for years. Last year, the rate of syphilis cases reached its highest mark since 1991 and the total number of cases hit its highest since 1948. HIV cases are also on the rise, up 16% last year.

And an international outbreak of monkeypox, which is being spread mainly between men who have sex with other men, has further highlighted the nation’s worsening problem with diseases spread mostly through sex.

David Harvey, executive director of the National Coalition of STD Directors, called the situation “out of control.”

Officials are working on new approaches to the problem, such as home-test kits for some STDs that will make it easier for people to learn they are infected and to take steps to prevent spreading it to others, Mena said.

Another expert said a core part of any effort must work to increase the use of condoms.

“It’s pretty simple. More sexually transmitted infections occur when people are having more unprotected sex,” said Dr. Mike Saag, an infectious disease expert at the University of Alabama at Birmingham.

Syphilis is a bacterial disease that surfaces as genital sores but can ultimately lead to severe symptoms and death if left untreated.

New syphilis infections plummeted in the U.S. starting in the 1940s when antibiotics became widely available. They fell to their lowest number ever by 1998, when fewer than 7,000 new cases were reported nationwide. The CDC was so encouraged by the progress it launched a plan to eliminate syphilis in the U.S.

But by 2002 cases began rising again, largely among gay and bisexual men, and they kept going. In late 2013, CDC ended its elimination campaign in the face of limited funding and escalating cases, which that year surpassed 17,000.

By 2020, cases had reached nearly 41,700 and they spiked even further last year, to more than 52,000.

The rate of cases has been rising, too, hitting about 16 per 100,000 people last year. That’s the highest in three decades.

Rates are highest in men who have sex with men, and among Black and Hispanic Americans and Native Americans. While the rate for women is lower than it is for men, officials noted that it’s has been rising more dramatically—up about 50% last year.

That ties to another problem—the rise in congenital syphilis, in which infected moms pass the disease on to their babies, potentially leading to death of the child or health problems like deafness and blindness. Annual congenital syphilis cases numbered only about 300 a decade ago; they surged to nearly 2,700 last year. Of last year’s tally, 211 were stillbirths or infant deaths, Mena said.

The increases in syphilis and other STDs may have several causes, experts say. Testing and prevention efforts have been hobbled by years of inadequate funding, and spread may have gotten worse—especially during the pandemic—as a result of delayed diagnosis and treatment. Drug and alcohol use may have contributed to risky sexual behavior. Condom use has been declining.

And there may have been a surge in sexual activity as people emerged from COVID-19 lockdowns. “People are feeling liberated,” Saag said.

The arrival of monkeypox added a large additional burden. CDC recently sent a letter to state and local health departments saying that their HIV and STD resources could be used to fight the monkeypox outbreak. But some experts say the government needs to provide more funding for STD work, not divert it.

Harvey’s group and some other public health organizations are pushing a proposal for more federal funding, including at least $500 million for STD clinics.

Mena, who last year became director of the CDC’s Division of STD Prevention, called for reducing stigma, broadening screening and treatment services, and supporting the development and accessibility of at-home testing. “I envision one day where getting tested (for STDs) can be as simple and as affordable as doing a home pregnancy test,” he said.

Please enable JavaScript to view this content.

Story Continues Below

Editor's note: You can comment on IBJ stories by signing in to your IBJ account. If you have not registered, please sign up for a free account now. Please note our updated comment policy that will govern how comments are moderated.

8 thoughts on “‘Out of control’ STD situation prompts call for changes

  1. The U.S census bureau collects and publishes comprehensive, detailed data about ethnic origin for people in the United States. While this may be contributing to dividing our nation, the data continues to be collected. All health treatment facilities request demographic/race/origin data when treatment is provided as part of intake processes. It may be prudent to analyze and process this data to determine if the increase in STD’s may correlate to recent influxes of illegal aliens, more recently termed “migrants” coming through our southern border at record rates. This could be important information so that programs to educate and communicate ways individuals can practice safe sex and improve hygiene in order to reduce STD cases, can be more effectively targeted at ethnic groups that may be suffering from greater STD cases than other groups. For example, the 500 million $ proposed to be spent on funding STD clinics may need to include funding for employing numerous interpreters at each clinic in order to effectively communicate what patients must do to be treated successfully and prevent further disease. Not approaching a solution in this manner would result in another failed, federally funded program that passes money out with little limited results, which would be yet another waste of taxpayers money.

    1. It wasn’t well-stated and it certainly isn’t a thesis. A thesis actually has work put into it. This was a long rant of speculation. There’s no data, no supporting evidence of any kind to support their case. It took a 5-second Google Scholar search to find academic papers on the rise of STIs, which has been a trend over the last six years. There isn’t even a correlation to immigration rates and STIs.

    2. I’m not sure the evidence supports Mark H’s claim all that much either. The overwhelming majority of immigrants in the US come from Latin American and Caribbean countries. And only one of them, Haiti, has HIV infection rates on par with the countries faring the worst in Subsaharan Africa.

      A 16% rise in HIV cases year over year should be a crisis, but then, so should the astronomical increases in crime, in suicides, in cancer rates, and all the other evidence of civilizational collapse. But these things get treated like third-tier news because of the political entities in charge.

      Let’s not exonerate our own people. For the better part of the last 15 years, the messaging on the dangers of HIV have becoming increasingly muted, even as we only have good treatments but no provable cures. That means an entire generation of kiddos now sexually active has grown up hearing far more “love is love” than “don’t be a ho”. The monkeypox outbreak should have been the first clue that the people who are still most susceptible to transmission of many STDs–men who have sex with men (MSM)–have gotten a tad complacent.

      Then again, this means I’m just trading scorn from one “marginalized group” to another, so I’m more than ready to start munching the popcorn when A T. launches his/her/its/their/xir vitriol at me.

  2. What data suggest that illegal aliens or migrants at the souther border of the US have higher rates of STDs than US citizens throughout the nation. However, data exists that certain infections occurred first in Europe then became more common in the US, yet it is doubtful the transmission was via those without documentation at the southern border of the US. What about legal aliens, those who enter the US with valid visas but tend to stay longer and blend in flawlessly with the majority suburban and rural populations — they too might harbor or pass on an STD.

    And [poor] hygiene per se would not effect the STDs highlighted in the article. STD infections are spread via sex. Those with unquestionably impeccable hygiene can contract STDs as well.

  3. “All health treatment facilities request demographic/race/origin data when treatment is provided as part of intake processes. It may be prudent to analyze and process this data to determine if the increase in STD’s may correlate to recent influxes of illegal aliens, more recently termed “migrants” coming through our southern border at record rates.”

    There is no COMPILED data to suggest higher rates of STD’s from illegal aliens. The RAW data may exist to COMPILE such data.

    Improved hygiene results from protected sex as a direct result of less exchange of body fluids.

{{ articles_remaining }}
Free {{ article_text }} Remaining
{{ articles_remaining }}
Free {{ article_text }} Remaining Article limit resets on
{{ count_down }}