‘Out of control’ STD situation prompts call for changes

‘Out of control’ STD situation prompts call for changes

NEW YORK — Sharply rising cases of some sexually transmitted diseases — including a 26% rise in new syphilis infections reported last year — are prompting U.S. health officials to call for new prevention and treatment efforts.

“It is imperative that we … work to rebuild, innovate, and expand (STD) prevention in the U.S.,” said Dr. Leandro Mena of the U.S. Centers for Disease Control and Prevention in a speech Monday at a medical conference on sexually transmitted diseases.

Infections rates for some STDs, including gonorrhea and syphilis, have been rising for years. The number of syphilis cases in the last year was the highest ever since 1991, and it reached the highest total since 1948.. HIV cases are also on the rise, up 16% last year.

And an international outbreak of monkeypox, which is being spread mainly between men who have sex with other men, has further highlighted the nation’s worsening problem with diseases spread mostly through sex.

David Harvey, executive director of the National Coalition of STD Directors, called the situation “out of control.”

Officials are working on new approaches to the problem, such as home-test kits for some STDs that will make it easier for people to learn they are infected and to take steps to prevent spreading it to others, Mena said. Another expert stated that condom use must be a key part of any efforts to reduce STDs.

“It’s pretty simple. According to Dr. Mike Saag of the University of Alabama at Birmingham, more sexually transmitted diseases occur when there is less protection.

Syphilis is a bacterial disease that surfaces as genital sores but can ultimately lead to severe symptoms and death if left untreated.

New syphilis cases dropped in the U.S. after the 1940s, when antibiotics were widely available. They fell to their lowest ever by 1998, when fewer than 7,000 new cases were reported nationwide. The CDC felt so inspired by this progress that it created a plan for eliminating syphilis from the U.S . However, 2002 cases started rising again among homosexual and bisexual men. They kept going. In late 2013, CDC ended its elimination campaign in the face of limited funding and escalating cases, which that year surpassed 17,000.

By 2020 cases had reached nearly 41,700 and they spiked even further last year, to more than 52,000.

The rate of cases has been rising, too, hitting about 16 per 100,000 people last year. This is the highest rate in over three decades.

Rates are highest in men who have sex with men, and among Black and Hispanic Americans and Native Americans. While the rate for women is lower than it is for men, officials noted that it’s has been rising more dramatically — up about 50% last year. This is linked to another issue — congenital Syphilis. Infected mothers can pass on the virus to their children, potentially resulting in death or other health issues like blindness, deafness, and even permanent disability to the baby. Annual congenital syphilis cases numbered only about 300 a decade ago; they surged to nearly 2,700 last year. Of last year’s tally, 211 were stillbirths or infant deaths, Mena said.

The increases in syphilis and other STDs may have several causes, experts say. Testing and prevention efforts have been hobbled by years of inadequate funding, and spread may have gotten worse — especially during the pandemic — as a result of delayed diagnosis and treatment. Drug and alcohol use may have contributed to risky sexual behavior. The use of condoms has declined.

And there may have been a surge in sexual activity as people emerged from COVID-19 lockdowns. “People are feeling liberated,” Saag said.

The arrival of monkeypox added a large additional burden. Recently, the CDC sent a note to all state and local health department stating that they could use their HIV/STD resources to combat the monkeypox epidemic. But some experts say the government needs to provide more funding for STD work, not divert it.

Harvey’s group and some other public health organizations are pushing a proposal for more federal funding, including at least $500 million for STD clinics.

Mena was last year appointed director of the CDC Division of STD Prevention. He called for reducing the stigma and expanding screening and treatment options. “I envision one day where getting tested (for STDs) can be as simple and as affordable as doing a home pregnancy test,” he said.

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The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. All content is the sole responsibility of the Associated Press.

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