- Rates of STIs in the U.S. have reached record numbers for the sixth year in a row.
- Experts say this increase may be due to a lack of sexual education and existing disparities.
- The U.S. government has launched a Sexually Transmitted Infections National Strategic Plan for the United States, to enhance and expand STI prevention and care programs.
The Centers for Disease Control and Prevention (CDC) shared in a new report that documented cases of the sexually transmitted diseases chlamydia, gonorrhea, and syphilis in the U.S. hit an all-time high in 2019, the most recent year for which data is available. This marks the sixth year in a row that cases have reached record numbers.
An announcement about the report notes that the rate of STDs, also known as sexually transmitted infections (STIs), has skyrocketed in the past two decades.
“Less than 20 years ago, gonorrhea rates in the U.S. were at historic lows, syphilis was close to elimination, and advances in chlamydia diagnostics made it easier to detect infections,” Raul Romaguera, MPH, acting director of the Division of STD Prevention at the CDC said in the announcement. “That progress has been lost, due in part to challenges to our public health system.”
The report found that there were 2.6 million diagnosed STDs in the U.S. in 2019, compared to about 2.5 million cases in 2018.
“This news isn’t surprising but it’s not the fault of individuals—it represents a larger failure of sexual health education programs in the United States,” Marybec Griffin, PhD, assistant professor in the department of health behavior, society and policy at the Rutgers School of Public Health in New Jersey, tells Get Meds Info. Women’s health expert Jennifer Wider, MD, agrees, telling Get Meds Info that the data is “not incredibly surprising because the numbers have been consistently climbing over the last five years.”
Here’s what you need to know about the report.
Young People Disproportionately Impacted
Health departments across the U.S. reported the following data on STDs, according to the report:
- 1.8 million cases of chlamydia, an increase of nearly 20% since 2015
- 616,392 cases of gonorrhea, an increase of more than 50% since 2015
- 129,813 cases of syphilis, an increase of more than 70% since 2015
Congenital syphilis, a disease that happens when a mother with syphilis passes the infection on to her baby during pregnancy, increased by 279% since 2015. Nearly 2,000 cases of congenital syphilis were reported in 2019, including 128 deaths.
Young people were disproportionately impacted by STIs. More than 55% of cases reported to health departments were in teens and young adults between the ages of 15 and 24. There were also racial disparities. Despite making up 12.5% of the population, about 31% of chlamydia, gonorrhea, and syphilis cases in non-Hispanic Black people. Men who have sex with men were also disproportionately impacted by STDs.
The CDC notes that antibiotic-resistant gonorrhea cases are on the rise. In 2019, more than half of all gonorrhea infections were estimated to be resistant to at least one antibiotic. “Continued monitoring of susceptibility patterns to antibiotics is critical to inform gonorrhea treatment guidelines,” the report says.
Why STD Cases Are Increasing
The report didn’t address the reasons behind this steady increase, but sexual health experts have some theories.
Lack of Education
Griffin says that a lack of comprehensive sexual health education in middle and high schools across the country may be to blame. “The United States has always lagged behind other countries in the provision of sexual health education and every year we add more adolescents that do not have the education they need to protect themselves and make informed decisions,” she says.
The quality of sexual health education also “varies wildly” in the U.S., Griffin says. “Only 30 states mandate sexual health education that includes HIV prevention information,” she points out. “However, these requirements vary and only 18 of these states require that the information is medically accurate.”
That, Griffin says, is a big problem: “We cannot expect people to know how to prevent STIs if they do not get information that is relevant to them—meaning that centers sexual pleasure, consent, sexual orientation, and includes medically accurate STI and pregnancy prevention information.”
American hesitancy to talk about sex and sexual pleasure is a problem, too, Griffin adds. “So many people don’t know that they need to tell their providers about the types of sex they are having—you absolutely should,” she says. “The types of sex you are having impact the types of STI screenings you should get.”
The rise in chlamydia cases may simply be due to more testing, Peter Leone, MD, adjunct associate professor of epidemiology for the Gillings School of Global Public Health and professor of medicine for the School of Medicine at the University of North Carolina, tells Get Meds Info. “We didn’t always have diagnostic tests for it,” he says. “This is really the trend over the last decade.”
Leone is particularly concerned about the increase in cases of congenital syphilis. “That shouldn’t happen,” he says. “It’s a total failure of the system when we see that.”
Certain social and economic conditions, including lack of medical insurance or a consistent and regular health care provider, poverty, drug use, and a high burden of STDs within certain communities, are contributing as well, Wider says.
As for the disparities in STD cases, the CDC says it likely reflects different access to quality sexual health care and differences in sexual network characteristics. The organization cites the example of having a greater chance of encountering an STI in communities with a higher prevalence of STIs compared to lower-risk communities, regardless of sexual behavior patterns.
What This Means For You
If you’re sexually active, talk to your partner about your STD status, and use barrier methods to protect yourself. You should also get tested for STDs regularly.
How to Prevent STDs
The CDC offers some advice for preventing STDs:
- Practice abstinence. This is the most reliable way to avoid STDs, the CDC points out.
- Get vaccinated against HPV. While the vaccine won’t protect against all STDs, it can help lower the risk of contracting certain strains of HPV that can lead to cancer.
- Reduce your number of sex partners. The fewer sexual partners you have, the lower your risk.
- Practice mutual monogamy. Meaning, both you and your partner are monogamous with each other.
- Use condoms. The CDC recommends using a male latex condom every time you have anal, vaginal, or oral sex. “Barrier methods work,” Leone says.
The Department of Health and Human Services has launched a Sexually Transmitted Infections National Strategic Plan for the United States, which is a roadmap for public health, government, community-based organizations, and other stakeholders to develop, enhance and expand STI prevention and care programs at the local, state, tribal, and national levels.
STI prevention groups are also utilizing telehealth options and partnerships with pharmacies and retail health clinics to help make testing and prevention services more accessible.
Griffin recommends that people use the skills they’ve learned from navigating the pandemic to talk about STDs. “We’ve all had practice talking about our behaviors, who we are seeing, and what risks we’ve taken as it relates to COVID-19,” she says. “These are the same types of conversations we should be having with our sexual partners about STIs. Use your new skills to help protect yourself from STIs.”