'Something needs to change': As STD rates rise, doctors sound alarm on messaging

Amanda Pérez Pintado, USA TODAY
·5 min read
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We spent the past two years focused on improving hygiene and healthy habits in just about every aspect of daily life.

But that didn't necessarily extend to our sex lives.

Reported cases of sexually transmitted diseases reached an all-time high for the sixth consecutive year in 2019 and though those numbers appeared to decline a bit in 2020, public health experts believe the pandemic helped obscure some of that total.

With STD rates climbing, the country needs to take the STD crisis seriously and change its approach to reverse the trend, said David C. Harvey, executive director of the National Coalition of STD Directors.

"Who is to be held accountable? What are we going to do differently in this country to lower STD rates?" Harvey said. "Something needs to change."

The most recent CDC data, which goes through the end of 2020 and was released this month, shows:

  • Reported cases of gonorrhea increased 10% compared to 2019.

  • Reported cases of primary and secondary syphilis increased 7% compared to 2019.

  • Syphilis among newborns increased 15% from 2019; congenital syphilis has increased by 235% since 2016.

  • Cases of chlamydia dropped 13% from 2019.

The decline in chlamydia cases, which historically account for the largest portion of STDs in the U.S., were largely attributed to the decline in STD screenings overall during the pandemic, according to the CDC.

Young people ages 15 to 24 accounted for over half of reported cases.

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Harvey said tackling the STD epidemic would take increasing "prevention and care dollars to reach Americans at risk" and educating people on condom use.

State and local health departments, Harvey added, should receive resources and support from a federal level to allow for a localized approach that suits communities.

"This is not a one size fits all approach," Harvey said. "The CDC must change how it's responding to this out of control crisis."

Here's what doctors want you to know as STD rates remain high:

When should you get tested?

Women who are under 25 years old, or have new or multiple sex partners should get tested every year for gonorrhea and chlamydia, according to CDC guidelines.

Men who have sex with men should be tested for syphilis, chlamydia and gonorrhea at least once a year, or every three to six months if they have multiple partners. The CDC recommends men who have sex with men be screened for HIV at least once a year.

The agency urges everyone who is pregnant be screened for syphilis, HIV, hepatitis B and hepatitis C starting early in pregnancy.

How often you should be screened for sexually transmitted infections also depends on your sexual practices, such as type of sexual contact and condom use, said Dr. Michael Angarone, an infectious diseases specialist at Northwestern Medicine.

Sexually active individuals with multiple partners per year, Angarone said, should talk to their primary providers about getting screened for STIs every six months or every year. And you should get screened if a partner tells you they've tested positive for an STI.

(The term "STI" refers to infections that are usually transmitted through sexual contact, whereas "STD" refers to the disease that results from an STI.)

What are the symptoms?

Many STIs are asymptomatic, so regular screening is important, said Dr. Philip A. Chan, an infectious disease physician and an associate professor at Brown University.

"It's important to be screened because these other STIs really can have some pretty profound health complications," Chan said. "Not in everyone, but in a subset of people; gonorrhea and chlamydia, for example, can cause infertility.

But some symptoms that could indicate an infection include abnormal vaginal or penile discharge, pain when urinating, vaginal bleeding outside your period, painful intercourse and ulcerations genital area, Angarone said.

STDs are treatable and some are curable. Gonorrhea and chlamydia, for instance, are treatable with medication, and syphilis can be treated with penicillin.

How can you prevent STDs?

Condoms play an important role in preventing STIs and STDs. The CDC recommends using a condom during anal, vaginal or oral sex.

"Condoms are not 100% protective, but wearing a condom is going to decrease the rate of acquisition of an STI or transmission of an STI," Angarone said. "I think wearing a condom is the number one strategy to prevent transmission."

Minimizing the number of sexual partners or being in a monogamous relationship can decrease your risk for STIs, Chan said. Having open conversations with sexual partners and medical providers about STIs is crucial in reducing the risk of getting infected, he added.

Angarone said reducing the number of cases starts with knowledge and awareness around STIs.

"The general public knowing that those numbers have gone up and knowing that we need to be more aware of it, I think should help people get tested, treated, and then hopefully, kind of get those numbers to go back down," Angarone said.

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This article originally appeared on USA TODAY: As STD rates rise in United States, doctors emphasize messaging