Reported cases of chlamydia, gonorrhea, and syphilis have increased for the first time since 2006, according to just-published data by the Centers for Disease Control and Prevention (CDC).1
The approximately 1.4 million cases of chlamydia (456.1 cases per 100,000 population) represent the highest number of annual cases of any condition ever reported to CDC. The number of reported cases of chlamydia rose 2.8% since 2013. Rates of primary and secondary (P&S) syphilis, which are the most infectious stages of syphilis, and gonorrhea grew as well: 15.1% and 5.1%, respectively. In 2014, there were 350,062 reported cases of gonorrhea (110.7 per 100,000) and 19,999 reported cases of P&S syphilis (6.3 per 100,000), the CDC data reflects.1
“The recent sexually transmitted disease [STD] data should be a clarion call that there is a major STD problem on our hands in the United States, one that is grounds for declaring a sexual health crisis,” states William Smith, executive director of the National Coalition of STD Directors in Washington, DC.
CDC surveillance data indicate the numbers and rates of reported cases of chlamydia and gonorrhea continues to be highest among young people ages 15-24. While young men and women are heavily affected by STDs, young women face the most serious long-term health consequences. The CDC estimates that undiagnosed STDs cause more than 20,000 women to become infertile each year.2
According to the 2014 STD Surveillance Report, young people are still at the highest risk of acquiring an STD and most vulnerable to their damaging effects, notes Eloisa Llata, MD, MPH, a medical epidemiologist at the CDC. Young people ages 15-24 continue to represent half of the 20 million new infections each year, though they are only 25% of the sexually experienced population, states Llata. Many STDs go untreated because they often have no symptoms, she says. Individuals who are unaware they’re infected might unknowingly infect others, Llata says.
What are some of the ways the CDC is promoting STD prevention among youth, given the high numbers of STDs found in this age group?
“To break the cycle, it is critical to increase screening and awareness, especially among young people,” states Llata. “Our efforts include recommending the most effective treatments and encouraging expedited partner therapy where appropriate; advancing sound health policy, such as developing disease screening and treatment recommendations that help the most-affected populations gain access to prevention services and overcome barriers; and providing resources to state/local health departments to support on-the-ground STD prevention efforts.”
Greater awareness and action is needed at all levels, says Llata. Individuals, healthcare providers, parents, and community leaders all have a role to plan in protecting the health of America’s youth, she states.To reduce STDs, Americans must take steps to protect themselves, states the CDC.
Testing and treatment, using condoms consistently and correctly, and limiting the number of sex partners, are all effective strategies for reducing the risk of infection in sexually active individuals.
The National Coalition of STD Directors launched “Condoms (STILL) Work!” in October 2014 to raise awareness that in the midst of this crisis, clinicians have a great prevention tool that far from being passé, is “critical” to current and future efforts to prevent infections and create better sexual health, says Smith. The campaign, propelled by a donation of one million condoms from the makers of Trojan brand condoms, allowed the Coalition to award condoms to STD programs across the nation.
“Providers, through underscoring that condoms are important for patients engaging in sex with partners whose STD status is unknown or is known and necessary to prevent infection, must be part of the solution,” says Smith.
Robert Hatcher, MD, MPH, professor emeritus of gynecology and obstetrics at Emory University School of Medicine in Atlanta, made the following comment: “The dramatic increase in STDs reminds all providers of LARC methods that in spite of their effectiveness, it remains important that all young women be offered and encouraged to use condoms, because over half of the time, an uninfected woman is infected by a male partner who is totally asymptomatic.”
The new CDC data also that show rates of syphilis are increasing at fast pace: 15.1% in 2014.1 While rates have risen in men and women, men account for more than 90% of all primary and secondary syphilis cases, the CDC states.
Men who have sex with men (MSM) represent 83% of male cases where the sex of the sex partner is known.1 Syphilis infection can place a person at increased risk for acquiring or transmitting HIV infection; available surveillance data indicate that an average of half of MSM who have syphilis also are infected with HIV.1
In a statement, Jonathan Mermin, MD, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, said, “STDs affect people in all walks of life, particularly young women and men, but these data suggest an increasing burden among gay and bisexual men.”
To better identify and address specific challenges facing gay and bisexual men, CDC is concentrating research efforts to better identify and address such challenges facing gay and bisexual men, as well as developing educational resources for providers and improving efforts to offer more culturally relevant care.
The National Coalition of STD Directors, along with the National Alliance of State and Territorial AIDS Directors (NASTAD), has developed information for working with black and Latino MSM, who are at particular risk for STDs, as well as an optimal care overview for providing care to MSM patients. (Download information at http://bit.ly/1qu4ZFd and the overview from http://bit.ly/1Yg2fdL.)
REFERENCES
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Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2014. Atlanta: Department of Health and Human Services; 2015.
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Centers for Disease Control and Prevention. Reported STDs in the United States. Fact sheet. Accessed at http://www.cdc.gov/std/stats14/std-trends-508.pdf.
