Rapidly rising cases of some sexually transmitted diseases, including a 26% increase in new syphilis infections reported last year, are prompting US health officials to call for new prevention and treatment efforts.
“It is imperative that we … work to rebuild, innovate and expand (STD) prevention in America,” the US Centers for Disease Control and Prevention Leandro Mena said Monday in a speech at a sexually transmitted medical conference . disease.
Infection rates for some STDs, including gonorrhea and syphilis, have been rising for years. Last year the rate of syphilis cases reached its highest level since 1991 and the total number of cases reached the highest level since 1948. HIV cases are also on the rise, a 16% increase over the last year.
An international outbreak of monkeypox has further exposed the country’s worsening problem, which is mostly spread through sex.
David Harvey, executive director of the National Coalition of STD Directors, called the situation “out of control.”
Mena said officials are working on new ways to tackle the problem, such as home-test kits for some STDs that will make it easier for people to know they are infected and take steps to prevent spreading it to others.
Another expert said a core part of any effort to increase condom use should be work.
“It’s very simple. More sexually transmitted infections happen when people have more unprotected sex,” said Mike Saag, an infectious disease specialist at the University of Alabama at Birmingham.
Syphilis is a bacterial disease that manifests as genital sores but can eventually cause severe symptoms and death if left untreated. When antibiotics became widely available in the 1940s, new syphilis infections decreased in the US. They fell to their lowest until 1998, when less than 7,000 new cases were reported nationwide. CDC was so encouraged by this progress that it launched a plan to eliminate syphilis in the United States.
But, by 2002, cases began to rise again, largely among gay and bisexual men, and they continued. In late 2013, the CDC ended its eradication campaign due to limited funding and rising cases, which surpassed 17,000 that year.
By 2020, the cases had reached around 41,700 and they rose further to over 52,000 last year.
The rate of cases is also increasing, which last year was about 16 per 100,000 people. This is the highest in three decades.
Rates are highest among men who have sex with men, and among blacks and Latinos and Native Americans. While the rate for women is lower than for men, officials said it has been rising dramatically to about 50% last year.
It is linked to another problem: an increase in congenital syphilis, in which infected mothers pass the disease on to their babies, potentially leading to child death or health problems such as deafness and blindness. The number of annual congenital syphilis cases was only about 300 a decade ago; They rose to about 2,700 last year. Mena said out of last year’s figures, 211 were stillbirths or infant deaths.
Experts say that there can be many reasons for the increase in syphilis and other STDs. Testing and prevention efforts have been stifled by years of insufficient funding, and the spread can worsen – especially during pandemics – as a result of delayed diagnosis and treatment. Drug and alcohol use may have contributed to the risky sexual behavior. Condom use is decreasing.
And sexual activity may increase as people emerge from the Covid-19 lockdown. “People are feeling liberated,” Saag said.
The arrival of monkeypox added a huge additional burden. The CDC recently sent a letter to state and local health departments saying their HIV and STD resources could be used to fight monkeypox outbreaks. But some experts say that the government needs to provide more funds for STD work, not divert it.
Harvey’s group and some other public health organizations are pushing for a proposal for more federal funding, including at least $500m for STD clinics.
Mena, who became director of CDC’s STD prevention division last year, called for reducing stigma, broadening screening and treatment services, and supporting the development and access to at-home testing.
“I envision a day where testing (for STDs) can be as easy and cheap as doing a home pregnancy test,” he said.