One of humanity’s favorite activities also has become riskier than ever in health terms, experts say, as U.S. cases of sexually transmitted diseases are increasing so much that one expert describes the situation as “out of control.”
In official terms, reported syphilis cases rose 26% last year, hitting their highest rate in three decades and their highest total number since 1948, the Associated Press reported. HIV cases spiked by 16% last year. As with syphilis, reported gonorrhea cases keep increasing.
And, of course, the nation is struggling — and perhaps containing — a coast to coast outbreak of monkeypox, with the infection once best known for its presence in less developed nations spreading mostly by men having intimate relations with multiple other men.
The AP quoted Dr. Leandro Mena of the U.S. Centers for Disease Control and Prevention as telling experts at a medical conference this:
“It is imperative that we … work to rebuild, innovate, and expand (STD) prevention in the U.S.”
But the news service also noted that David Harvey, executive director of the National Coalition of STD Directors, described STD infections as “out of control.”
The news service offered this historical context about the public health challenge in dealing with syphilis cases, even before the pandemic and its reductions in or outright shutdowns of programs to treat and prevent STDs, notably syphilis:
“Syphilis [see CDC illustration above] 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 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.”
The spike in women’s syphilis cases further has fueled problems with congenital infections passed from mothers to their babies, “potentially leading to death of the child or health problems like deafness and blindness,” the AP reported, adding:
“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.”
Not good. In my practice, I not only see the harms that patients suffer while seeking medical services, but also the clear benefits they may enjoy by staying healthy and far away from the U.S. health care system. It is, according to research conducted in pre-coronavirus pandemic times, fraught with medical error, preventable hospital acquired illnesses and deaths, and misdiagnoses.
Sexual health, and the maintenance of same, is an important part of our well-being that can’t be ignored. We can’t let bluenoses rule and we cannot stigmatize others. 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. This includes the use of condoms, as appropriate. Those who qualify for monkeypox shots should discuss them with their doctors and get them, if recommended to do so.
We should discard unworkable notions, like abstinence-only sex education initiatives for the young (they don’t work), and finger-wagging and forgoing of vaccinations against the human papilloma virus (HPV) for teens (these are proven to reduce throat and cervical cancers). Mena and others say that experts are developing better at-home testing for STDs, and they encourage appropriate funding for public health programs, including those providing sexual health services.
We have a lot of work to do to slash the prevalence of STDs and their terrible harms.