Sex gets riskier as syphilis, gonorrhea, and chlamydia cases spike for fourth year

cdcstd-2-300x238Although Americans may be having less sex, it’s getting riskier than ever, with the federal Centers for Disease Control and Prevention reporting that new cases of chlamydia, gonorrhea, and syphilis spiked for the fourth consecutive year in 2017 to a record high of nearly 2.3 million diagnoses.

“We are sliding backward,” Jonathan Mermin, a doctor and director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, said in a statement. “It is evident the systems that identify, treat, and ultimately prevent STDs are strained to near-breaking point.”

The sustained increases in the three common forms of sexually transmitted diseases worry public health officials for multiple reasons, not the least of which is that the infections, untreated, can result in infertility or pregnancy complications and increase the risk of HIV transmission.

Medical experts also fear rises in STD cases because gonorrhea, in particular, already is becoming antibiotic resistant and “super” versions of it are emerging, with only one commonly available drug treating many strains effectively. The New York Times reported that, according to CDC data, “cases of gonorrhea, which is also prevalent among young people, increased 67 percent from 2013 levels, to a total of 555,608 new diagnoses.”

Dissonances in the STD data indicate the difficulties public officials must confront as they battle the growing infection menace, which may take more time to display its full harms because gonorrhea and chlamydia, for example, can lurk for long spans, doing significant damage to patients before it displays symptoms and can be detected.

The multiyear STD surge is occurring, the Atlantic magazine has noted, even as reliable public health surveys indicate Americans, especially younger people, are decreasing the frequency with which they have sex.

CDC officials emphasized to the New York Times that many of the people who are spreading STDs don’t know they have infections and that the diseases are crisscrossing the country “silently.” Negative behavioral changes and blue-noses also may share blame.

Condoms can help to curb STDs spread. But they’re falling back to disuse, particularly because of the rise of pre-exposure prophylaxis or PREP, a regimen calling for the administration of anti-viral drugs to prevent HIV infection. Men who have sex with men, while adopting PREP — which has shown high protective value — don’t also safeguard themselves against syphilis and gonorrhea by wearing condoms during sex.

Risky and unprotected sex also has become yet another tragic aspect of the opioid crisis, public health officials say. STDs are increasing sharply among those who sell sex to get money to abuse prescription painkillers, as well as synthetic and illicit drugs like fentanyl and heroin, and those who have sex while high on opioids.

The prevalence of smart phone apps and internet sites also has increased STD infections by promoting risky, anonymous sexual encounters, officials say.

In my practice, I see the harms that patients suffer while seeking medical services, and I’ve seen the high value in all of us staying healthy and away from added risks posed by treatments by doctors and hospitals. Sexual health, and the maintenance of same, is an important part of our well-being that can’t be ignored, which is why the puritanical can’t be allowed an excessive say about public health programs.

Promiscuity probably shouldn’t be encouraged but part of the STD spike, experts say, can be attributed to recent, significant cuts in programs to inform, discourage, and treat sexually active adults to avert significant outbreaks of syphilis, gonorrhea, and chlamydia. These diseases also pose major risks and cause big harms when spread to by expectant mothers to their children, as is occurring more often.

This is unacceptable. For the greater public good, we should fund programs that support women’s reproductive and maternal health, HIV prevention, and safe and responsible sexual behavior. We should discard unworkable notions, like abstinence-only sex education initiatives for the young (they don’t work), and finger-wagging and foregoing of vaccinations against the human papilloma virus (HPV) for teens (these are proven to reduce throat and cervical cancers).  We can grow up, discuss and deal with sex, or we may pay a tragic toll for trying to be priggish and ostrich-like.

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