America’s Sexually Transmitted Disease Problem Is ‘Out of Control’

America’s Sexually Transmitted Disease Problem Is ‘Out of Control’

Sexually transmitted diseases in the U.S. are at a crisis point. On Monday, prominent public health experts and government officials raised an alarm over the ongoing annual rise in STDs. Preliminary data recently released by the Centres for Disease Control and Prevention shows that cases of syphilis, gonorrhea, and chlamydia all went up last year.

This week the CDC and the National Coalition of STD Directors are hosting their regular STD Prevention Conference, which occurs every two years and is virtual this year due to the covid-19 pandemic. But while the conference is intended to highlight promising technological advances and initiatives, speakers have been quick to point out that the current status quo is quite dire.

“It is imperative that we… work to rebuild, innovate, and expand [STD] prevention in the U.S.,” said Leandro Mena, director of the CDC’s Division of STD Prevention, in his speech Monday, according to Associated Press reporting. In another speech, David Harvey, executive director of the National Coalition of STD Directors, went as far as to call the problem “out of control.”

Earlier this month, the CDC released preliminary 2021 figures from its ongoing STD surveillance data. There were at least 2.5 million reported cases of chlamydia, gonorrhea, and syphilis in the U.S. during 2021, the three major STDs that doctors and local health departments are obligated to track and report (other serious STDs such as HIV or hepatitis B are tracked as well, but their numbers are analysed and reported elsewhere). These case counts are known to be an underestimate, since not all infections cause symptoms and many people do not get regularly tested for STDs.

Instances of chlamydia in 2021 (around 1.63 million cases) were slightly down from their high in 2019 but were higher than 2020’s total, and cases of gonorrhea and syphilis have continued to climb year after year. There were 696,764 reported cases of gonorrhea in 2021, along with 171,074 cases of syphilis. Rates and cases of congenital syphilis passed down from mother to child in the womb have also increased, with 2,677 cases in 2021. These infections, which are entirely preventable with a timely course of antibiotics, can cause life-threatening complications. At least 139 newborns died from syphilis in 2020.

Gonorrhea has its own set of unique challenges. Though infections often don’t cause illness and are very rarely life-threatening, the bacteria that cause gonorrhea are rapidly gaining resistance to the few frontline antibiotics left available to treat them. And without effective drugs, gonorrhea cases will more often cause serious complications like infertility or blindness in newborns who contract the infection while in the womb.

If all this isn’t bad enough, 2022 has also seen the widespread global emergence of human monkeypox. Though the viral illness can spread to others through any form of prolonged contact, the current epidemic is primarily being transmitted through contact during sex, most often among men who have sex with men with multiple recent partners. The future of monkeypox is uncertain, but many experts fear that it will become a new regularly occurring STD, albeit one that can be managed with an effective vaccine and antiviral treatments.

In his speech, Mena argued that there are still steps that can be taken to reduce the incidence of STDs. These include reducing the stigma associated with STDs, educating and convincing people to adopt safe sex practices like condoms, and making it easier and cheaper for people to get tested. One important way to improve testing, he added, would be the development of at-home tests, similar to those now widely available for covid-19 or pregnancy.

“I envision one day where getting tested [for STDs] can be as simple and as affordable as doing a home pregnancy test,” he said.