While the coronavirus pandemic savaged the country, another infection spiked, too, with nasty consequences: The nation set new records in 2019 and likely in 2020 for cases of sexually transmitted diseases or infections, illnesses that once were on the brink of control.
As Raul Romaguera, acting director of the federal Centers for Disease Control and Prevention’s division of STD prevention, wrote of the troubling trend:
“Less than 20 years ago, gonorrhea rates in the U.S. were at historic lows, syphilis was close to elimination, and advances in chlamydia diagnostics made it easier to detect infections. That progress has been lost, due in part to challenges to our public health system.”
Politicians for years have slashed at federal and state public health programs, particularly those targeted at battling STIs among the sexually active. Blue-nosed critics counter factually have argued that reproductive health programs encourage licentious behaviors. Too many political zealots have contended that health care is a privilege not a right in the world’s wealthiest nation.
The anti-science postures and poor public health funding have cost the country dearly, not only with the pandemic but in efforts to corral STIs. Here is what U.S. News and World Report found in new CDC data on the infections:
“[T]he U.S. has seen a nearly 20% increase since 2015 in chlamydia cases, which totaled more than 1.8 million in 2019. Additionally, gonorrhea cases have increased by more than 50% since 2015 to over 616,000 cases in 2019. And there were nearly 130,000 cases of syphilis in the U.S. in 2019, marking an increase of more than 70% since 2015. Together, those STDs accounted for approximately 2.6 million cases in 2019, up from approximately 2.5 million in 2018.
“Concerningly, congenital syphilis – which is passed from a mother to her baby during pregnancy – has increased by 279% since 2015. In 2019, 128 infants died of congenital syphilis, and there were nearly 2,000 reported cases.”
Federal officials aren’t buying the ostrich theories of dealing with these illnesses: Ignoring them by underfunding public education, prevention, and treatment programs is unwise, because human sexuality won’t stop — including during the pandemic.
“The report additionally notes significant disparities in the rates of reported STDs, with more than 55% of reported cases in 2019 occurring among adolescents and young adults 15 to 24 years old. Meanwhile, approximately 31% of chlamydia, gonorrhea and primary and secondary syphilis cases were among non-Hispanic Black individuals, although they accounted for only 12.5% of the U.S. population, according to the report. Men who have sex with other men were also disproportionately impacted by STDs, the report says.
“These disparities likely aren’t caused by differences in sexual behavior, but ‘rather reflect differential access to quality sexual health care, as well as differences in sexual network characteristics,’ the report says.”
Dr. Karen Smith, a former director of the California Department of Public Health, explained to the Kaiser Health News service why, even with expanded health insurance and access to private doctors, a need persists for public health STD programs, including testing and treatment clinics.
“’Honestly, I think everyone thought they weren’t going to be necessary. We sort of all assumed that if you’ve got health insurance and you’ve got access to a doctor, that’s all that you need. It turns out that that’s not really all that you need.’ People still had affairs they didn’t want to talk about with their family doctor. And some family doctors didn’t want to probe into patients’ sex lives. Young people, in particular, prefer clinics geared to them, out of their parents’ purview. ‘That loss of anonymous care really was a problem,’ Smith said.”
In my practice, I see not only the harms that patients suffer while seeking medical care, but also the damage that can be inflicted on babies and children. It is unacceptable for babies to die of a preventable disease like syphilis and for infants to struggle in their earliest days with the harms of STDs. Mothers who are poor and in communities of color should receive prenatal care, including public health help with STDs if needed, so their kids start life with the best chances available to them.
The diseases can be treated readily for now. But we increase the risk to us all by letting them and other infections flourish. We must be grownup and discuss our challenges with our sexual and reproductive health, without stigmatization. STDs also can be tricky to detect — another argument for specialized public health clinics to do so. If left untreated, the diseases can be damaging and debilitating. Experts have expressed growing concern about antibiotic-resistant strains of gonorrhea burgeoning as STIs rage.
We have much work to do to halt the ever-rising threat to our health of STDs.