News: The United States Is in The Middle of an STD Epidemic

News: The United States Is in The Middle of an STD Epidemic

Rates of chlamydia, gonorrhea and syphilis rose for the 4th year in a row. Are we doing enough to protect ourselves?

The number of sexually transmitted diseases in America has risen for the fourth year in a row, according to the Centers for Disease Control and Prevention (CDC). Data on STD rates for 2017, presented at the National STD Prevention Conference, showed that almost 2.3 million cases of chlamydia, gonorrhea and syphilis were reported for that year, an increase of 200,000 from 2016. Additionally, the CDC’s 2017 Sexually Transmitted Disease Surveillance Report shows that congenital syphilis—which occurs when an infected mother passes the disease to her baby during pregnancy—more than doubled from 2013 to 2017. 

Each of the three diseases showed a significant uptick in cases reported:

  • Chlamydia continues to be the most diagnosed STD, with more than 1.7 million reported cases in 2017, a 22 percent increase from 2013. Forty-five percent of reported cases were among young women aged 15 to 24.
  • Gonorrhea diagnoses rose 67 percent from 2013.
  • Primary and secondary syphilis cases have increased 76 percent since 2013. Men who have sex with other men accounted for over half of all reported cases. Congenital syphilis cases increased from 362 in 2013 to 918 in 2017. 

The CDC also cautions about the possibility of antibiotic-resistant gonorrhea. In the US, there is only one remaining antibiotic, ceftriaxone, that is highly effective against treating the disease. It’s typically prescribed in tandem with azithromycin, a drug given to delay resistance to ceftriaxone. However, researchers are becoming increasingly worried that it is only a matter of time before strains become resistant to this drug combination. Earlier this year, the drug combination failed to treat a case of gonorrhea of a man diagnosed in the United Kingdom, but so far, no strains found in the United States have been completely resistant to treatment.

Who's most likely to get STDs?
“STDs have always been a major problem and concern,” says OBGYN Allyn Alexander, MD of Richmond Women’s Specialists. Dr. Alexander notes that the rise is most pronounced in certain populations, such as men who have sex with men. “The population I see that’s at risk is the [female] 15-24 age group. That has been consistent,” she says. 

Gonorrhea, chlamydia and syphilis might be on the rise, but what about other infections? Alexander says some of the other common STDs, such as herpes, human papillomavirus (HPV) and trichomoniasis, are not routinely reported to the CDC, so it’s possible some of those could have risen as well. Although some data suggests rates of HPV infection are falling, due primarily to the vaccine for the disease, cancers linked to HPV has increased over the last 15 years.

The CDC warns that many STD cases go undiagnosed and untreated, leading to other health issues, such as increased HIV risk and infertility. Some STDs also can result in a higher risk of pregnancy complications, including ectopic pregnancy, miscarriage, premature birth and stillbirth in infants.

Education is key
Education is the number one way to lower the nationwide STD infection rate, according to Alexander. At-risk populations, such as young people and people who engage in risky behaviors, need to “understand the realities,” she says. Unfortunately, this increase in STDs also comes at a time when federal government funding for education, treatment and prevention of these diseases is lacking. The CDC’s budget for STD programming has decreased by 40 percent since 2003. Experts have cited this as one of the reasons for the rise.

Another theory is people are not as worried about HIV anymore as drugs have become more effective and may not be practicing safe sex as consistently. Some have even tried to blame dating apps like Tinder. Whatever the reason, Alexander says education is key in combating STDs.

The HPV vaccine is a simple, effective way to combat a virus that not only contributes to cervical cancer, but can increase the risk of certain mouth and throat cancers.  Unfortunately, some of Alexander’s patients believe the vaccine can protect against all forms of STDs—which is not the case. “The HPV vaccines does wonderful things for cervical cancer prevention, but it’s not broad coverage for all STDS,” she says.

Oral sex, too, is not as safe as some people may think. “Some patients feel they’re not sexually active, but they’re active with oral sex and they end up with genital herpes,” Alexander says. “I think the important thing is to continue having open dialogue and enforcing things we know to be true: that STDs are very prevalent and easily transmissible.”

Tried and true prevention methods
Beyond education yourself on the risks of STDs, there are precautions you can take to stay healthy. Abstinence may be the safest way to avoid getting or giving an STD, but safer safe practices can also aid in protection.

  • “Consistent and correct use of condoms,” says Alexander.
  • Avoid risking sexual behaviors; the safest sex is with a mutually monogamous partner
  • Keep an open dialogue with your partner about sexual behaviors
  • Get vaccinated for HPV
  • Get tested. Speak with your doctor about the when to test and for which diseases. Groups at higher risk include
    • Women under 25 years old
    • Women older than 25 with multiple partners, new partners or partners who engage in risky behavior
    • Men who engage in sex with other men
    • Anyone practicing risky sexual and drug-related behaviors.
  • In addition, the CDC recommends everyone between the ages of 13 and 64 get tested for HIV at least once.

This article was updated on March 3, 2017 and August 29, 2018.