Last Wednesday, the Centers for Disease Control and Prevention (CDC) released sexually transmitted disease (STD) surveillance data for 2012, and the news is not good. Cases of chlamydia, gonorrhea, and syphilis—the three disease that must be reported to the CDC—all continued to rise. In fact, there were over 1.4 million cases of chlamydia reported to the CDC in 2012, the most ever. There were also 334,826 cases of gonorrhea and 15,667 cases of primary and secondary syphilis.
When looking at the rates, syphilis is the most alarming, as there were five cases per 100,000 individuals, which represents an 11 percent increase over the previous year. Gonorrhea rates increased 4 percent from the year before, to 107 cases per 100,000 individuals.
Rates for chlamydia were more stable, increasing only 0.7 percent since 2011. Still, there were 456 cases per 100,000 individuals.
To understand the scope of this epidemic, however, we have to remember that this data represents reported cases, but many cases of these STDs go undiagnosed and unreported. We also have to remember that other common STDs, such as trichomoniasis or human papillomavirus (HPV), are not reportable and, therefore, not included in the new data.
The data also makes it clear that some populations—specifically, men who have sex with men (MSM) and young people—are significantly more affected than others. For example, the CDC notes that men who have sex with men account for 75 percent of all primary and secondary syphilis cases. Though syphilis can be treated, if not caught it can lead to serious health conditions such as blindness or stroke. Moreover, infection with syphilis increases the risk of individuals both acquiring and transmitting HIV. In fact, data suggests that as many as 40 percent of MSM with syphilis are also
infected with HIV.
More than half of all cases of both chlamydia and gonorrhea are seen in young people between the ages of 15 and 24. The CDC reports that 24 percent of chlamydia cases occur in young people ages 15 to 19, and 34 percent in those ages 20 to 24. Similarly, 30 percent of gonorrhea cases occur in young people ages 15 to 19, and 39 percent in 20- to 24-year-olds. These are both curable STDs; however, if left untreated they can cause long-term health problems. In particular, the CDC estimates that undiagnosed STDs cause 24,000 women to become infertile each year. In addition, as RH Reality Check has been reporting over the last few years, gonorrhea has become resistant to many antibiotics used to treat it in the past, and there are now only a few drugs that work to cure some strains of this bacteria. Public health experts are concerned that without the introduction of new antibiotics, gonorrhea may become difficult, if not impossible, to cure in the future.
“The ever-increasing rates of sexually transmitted diseases continue to threaten the health and well-being of millions of Americans, particularly youth and men who have sex with men,” said William Smith, executive director of the National Coalition of STD Directors, in a statement. “The long-term consequences of these diseases impact the health of the individual, burden our larger health care system, and drastically hinder our continued fight against HIV and AIDS.”
“Simply put, STD public health programs do not have enough resources to address all the serious problems that face them. As a result, thousands, if not millions, of Americans at risk for STDs are not able to be reached, which has long-term human and economic costs,” said Smith. “STD programs desperately need additional funding to address these rising rates and meet our STD epidemics effectively.”
In addition to increasing the resources available to STD programs, there are steps that should be encouraged
at the individual level to thwart the epidemic. First and foremost, sexually active individuals need to be reminded of the risks of STDs as well as measures they can take to reduce risk—most importantly, condom use. Research has shown that condoms are highly effective at preventing all three of the STDs included in this data.
Regular screenings also can
help keep individuals from unknowingly passing the infection on to others, while preventing their own long-term conditions. The CDC recommends that all women age 25 and under get screened for chlamydia annually, and that MSM and women with risk factors, such as a new partner or multiple partners, be screened for chlamydia, gonorrhea, syphilis, hepatitis B, and HIV each year. MSM who have multiple or anonymous partners should be screened at three- to six-month intervals.