Rise in STD infections exacerbated by stigma and lack of funding, health workers say

Nischelle Buffalow stood among fellow Buffalow Family and Friends volunteers as those in need signed up for health care and COVID-19 vaccinations and picked up food midday Wednesday in a South Norfolk shopping complex.

Her organization’s newest partnership is providing condoms and information about sexually transmitted infections, along with the Chesapeake Health Department, to curb a growing nationwide problem.

“The population will come to us, where they may not come to the health department, because the population knows us,” she said. As she spoke, a line of cars snaked across the parking lot.

The rise of STIs and sexually transmitted diseases is the result of a storm made up of sometimes asymptomatic illnesses, the stigma of getting screened and public health funding needs, according to community and national health workers.

“This is the seventh year of record-breaking STD levels across the country,” said Stephanie Arnold Pang, senior director of policy and government relations for the National Coalition of STD Directors.

From 2016-20, gonorrhea cases increased by 45%; cases of syphilis by 52%, according to Arnold Pang.

Congenital syphilis, which can cause woman to have miscarriages, stillbirths and other child defects is up 235%, she said. In Virginia, there were no such cases in 2011. It grew to 15 cases in 2020, according to the most recent Virginia Department of Health data.

“And it’s completely preventable,” Jenny Mahn, director of clinical and sexual health for the National Coalition of STD Directors said.

The number of cases of STDs also continues to rise in Virginia, according to the most recent health department data from 2020 and preliminary data from last year.

To deal with the increase, more funding has been allotted to VDH through the American Rescue Plan Act. Virginia is set to receive $4.5 million between last June and December 2025.

VDH has created 38 new jobs to bolster front line STD screeners and coordinators. These new positions with include one in Chesapeake, one in Norfolk, three in the Peninsula health district, two in Portsmouth, one in the Three Rivers health district, two in Virginia Beach and one in the Western Tidewater health district.

Staff of the National Coalition of STD Directors said federal funding should be made available not just for prevention, but for STD clinics to bolster efforts by health groups.

“We’re not funding public health to the level we need,” Arnold Pang said.

The pandemic stretched health departments and organizations that were providing any type of STD screening or care even thinner as COVID-19 outreach and treatment eclipsed the issue, according to Buffalow.

In South Norfolk, Buffalow said more funding could help bolster their 100% volunteer operations to partner with more clinics and the health department. Those expanded partnerships could help people who may be carrying STDs unknowingly or suffering from the effects of an infection, she said.

“I think funding plays a part in everything,” Buffalow said.

That includes setting up more clinics in communities with increasing STDS that can retain staff through reasonable workloads and fair compensation. Buffalo said that helps build trust in the community and can help break down stigma that is associated with having or potentially having an STD. Transportation to clinics and money concerns about getting tested can also be a buffer to getting STDs treated, she said.

Black teenagers and younger adults are most at risk for getting STDs, according to national and VDH data.

In 2020, Black Virginians accounted for roughly 60% of all new gonorrhea cases.

Lack of awareness of the prevalence of STDs and how to avoid them, the stigma around potentially having an STD leading to overlooked screening, lack of testing opportunities and lack of funding for public health are all factors that exacerbate the problem, according to Arnold Pang and Mahn.

Oana Vasiliu, the director of STD prevention and surveillance for the Virginia Department of Health said housing instability and poverty also play a role.

“All these things can affect a person’s ability to access STI services that include prevention as well as care, testing and treatment,” she said.

The Eastern Health Region, which includes Hampton Roads, recorded the highest numbers of STDs in Virginia, according to the most recent VDH data from 2020.

“We have people moving into the community, people visiting as tourists, we have a bunch of in and out,” said Choya Page, communicable disease supervisor for the Chesapeake Health District.

Overall, gonorrhea and syphilis cases are going up across Virginia while chlamydia cases seem to have fallen in 2020, but the drop is likely artificial, according to Vasiliu.

“We think that is probably a result of a decrease in screening that happened throughout 2020,” she said.

In 2019, 47,450 cases of chlamydia were found in Virginia, while in 2020, the first year of the COVID-19 pandemic, there were 40,068 — a drop of over 15%.

There were over 14,400 cases of chlyamdia, an illness that can lead to permanent damage in women’s reproductive systems, found in Eastern Region residents in 2020. The region with the second highest amount of cases was the Central Region, which includes Richmond, Piedmont and Southside health districts.

Over 40% of the gonorrhea cases detected in Virginia during 2020 were in residents of the eastern health region, according to VDH data. Gonorrhea is a common infection that goes to mucous membranes in reproductive organs and areas of men and women, according to the Centers for Disease Control and Prevention.

A complication of the infection is it is asymptomatic for men, who could pass it to women without even realizing they are carrying it. The infection is widespread and to beat it, medication is needed.

But the high levels of gonorrhea and one-size-fits all approach for nonspecific antibiotics has helped the infection gain immunity, according to staff of the National Coalition of STD Directors

“Gonorrhea has developed resistance to nearly all the antibiotics we use for its treatment,” Mahn said. “This is a public health threat.”

The CDC recognized Gonorrhea’s increasing resistance to antibiotics as an “urgent health issue” in a video on its website.

In December 2020, the U.S. Department of Health and Human Services created the first STI National Strategic Plan as a “road map” to improve sexually transmitted infection screening, treatment and care at the local, state and national level by 2025, according to the HHS website.

Efforts such as Chesapeake’s to provide free condoms and information on STD clinic services open to anyone are one piece of the puzzle to addressing the multiple difficulties in tackling the continued swell of infections, according to health district staff.

The challenges are myriad and even as nuanced as how to track down a dating app user with a pseudonym to let them know they are spreading an STD, Page said.

“STDs are a public health crisis and we need engagement from all providers, individuals and all levels of the government to fight it together,” Arnold Pang said.

Ian Munro, ian.munro@virginiamedia.com