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The premier resource for hospital professionals from Relias Media, the trusted source for healthcare information and continuing education.

STD Rates Continued to Climb Despite Pandemic

By Jill Drachenberg, Editor, Relias Media

Despite the COVID-19 pandemic, sexually transmitted disease (STD) rates continued to surge in 2020, according to a report from the Centers for Disease Control and Prevention (CDC).

In all, 2.4 million infections were reported in 2020. Rates of gonorrhea increased 10% from 2019, and it is the second most-reported infection. Primary and secondary (P&S) syphilis is up 7% from 2019.

Perhaps the most alarming increase is congenital syphilis cases. Rates increased 15% from 2019 — and a shocking 253% surge since 2016. In 2020, 149 congenital syphilis-related stillbirths and infant deaths were reported — an increase of 210% over 2016. Parallel increases in P&S syphilis occurred in women ages 15-44 years (156% since 2016).

Chlamydia remained the most-reported STD in 2020. However, the reported 1.5 million cases is a 13% decline from 2019. This likely is due to the COVID-19 pandemic rather than a reduction in infection, CDC researchers noted. Far fewer STD screenings were performed in 2020, particularly in March and April, as clinics closed to in-person visits and resources were shifted to fight the pandemic surges. In many cases, patients were only tested for STDs if symptomatic; chlamydia usually is asymptomatic and cases are detected through routine screening.

CDC researchers also noted disparities in STD rates among certain populations. Fifty-three percent of reported STD cases in 2020 were among those ages 15-24 years. Thirty-two percent of all cases were among the non-Hispanic Black population, despite comprising around 12% of the United States population. It is unlikely these disparities are caused by differences in sexual behavior. “Rather, [these disparities] reflect differential access to quality sexual health care, as well as differences in sexual network characteristics,” the researchers noted. “For example, in communities with higher prevalence of STDs, with each sexual encounter, people face a greater chance of encountering an infected partner than those in lower prevalence settings do, regardless of similar sexual behavior patterns. Acknowledging inequities in STD rates is a critical first step toward empowering affected groups and the public health community to collaborate in addressing systemic inequities in the burden of disease — with the ultimate goal of minimizing the health impacts of STDs on individuals and populations.”

Much work remains to rebuild resources and programs to treat and prevent the spread of STDs. “STDs are not patiently waiting for the pandemic to end, and neither can we,” Leandro Mena, MD, MPH, director of the Division of STD Prevention at the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, said in a statement. “There is much to be done to rebuild, innovate, and expand STD prevention in the U.S. to close gaps and create lasting change. We must prioritize and focus our efforts to regain lost ground to control the spread of STDs. Despite many challenges, the field remains dedicated to the work by offering innovative solutions to meet people where they are.”

More information on this study, including the effects of the pandemic and funding shortages on STD testing clinics, will be available in the June issue of Contraceptive Technology Update.