Sexually Transmitted Diseases Continue to Rise in the U.S.

The number of chlamydia, gonorrhea and syphilis cases climb every year. Are we doing enough to protect ourselves?

Medically reviewed in December 2020

The number of sexually transmitted diseases (STDs) in America hit an all-time high in 2018, according to the Centers for Disease Control and Prevention (CDC). Data released in the CDC’s Sexually Transmitted Disease Surveillance Report in October 2019 showed that almost 2.4 million cases of chlamydia, gonorrhea and syphilis were reported in 2018, an increase of more than 100,000 cases from the previous year. Among more notable trends:

  • Chlamydia continues to be the most diagnosed STD, with more than 1.7 million reported cases in 2018. It’s a 3 percent increase from 2017 and the highest number of cases ever reported to the CDC.
  • Gonorrhea diagnoses rose 5 percent from 2017 to 2018, bringing the number of cases to 580,000, the highest number reported since 1991.
  • Primary and secondary syphilis cases rose by 14 percent to over 35,000 cases—also the biggest number reported since 1991. Newborn syphilis cases rose an alarming 40 percent, to more than 1,300 and the total number of syphilis cases was over 115,000.  

Additionally, the number of congenital syphilis cases resulting in death—which occurs when an infected mother passes the disease to her baby during pregnancy—rose 22 percent from 2017 to 2018, from 77 to 94.

The CDC also cautioned about the possibility of antibiotic-resistant gonorrhea. In the U.S., only one antibiotic, ceftriaxone, remains highly effective for treating the disease; to delay resistance, it’s typically prescribed with another drug, azithromycin. However, researchers are increasingly worried it’s only a matter of time before the combination stops working. While no U.S. strains of gonorrhea have completely resisted treatment yet, the drugs failed to treat a 2017 case in the United Kingdom.

Digging into the details
“STDs have always been a major problem and concern,” says OBGYN Allyn Alexander, MD, of Richmond Women’s Specialists in Richmond, Virginia. 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.

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 these rates could have risen along with those of gonorrhea, chlamydia and syphilis. Although some data suggests rates of HPV infection are falling, due primarily to the vaccine for the disease, but cancers linked to HPV have 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, because misconceptions abound.

For example, 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 learning about STD risks, you can take precautions to stay healthy. Abstinence remains the best way to avoid getting or giving an STD, but safe practices can also offer protection. These include:

  • Using condoms consistently and correctly
  • Avoiding risky sexual behaviors
  • Keeping an open dialogue with your partner about sexual behaviors
  • Getting vaccinated for HPV

Make sure to speak with a healthcare provider about STD testing, as well. Groups at higher risk of certain infections include:

  • Women under 25 years old
  • Women older than 25 with multiple partners, new partners or partners who engage in risky behaviors
  • Men who engage in sex with other men
  • Anyone practicing risky sexual and drug-related behaviors.

The CDC also recommends everyone between the ages of 13 and 64 get tested for HIV at least once.

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