At some point you just want to scream. Last week CDC published STD surveillance data for 2014 that point to the same trends we’ve been worried about for years: 20 million new STDs each year and our most vulnerable populations—particularly young people, women, and men who have sex with men- continue to be hardest hit.
The 19,999 cases of primary and secondary syphilis cases reported in 2014 represent an 15% increase over the previous year, with men who have sex with men enduring a huge burden. Gonorrhea cases increased more than 5% to 350,000 reported cases and while the chlamydia incidence grew by 2.8% to more than 1.4 million cases, CDC believes the true burden of chlamydia is closer to 3 million cases each year. Both gonorrhea and chlamydia are frequently without symptoms (especially with females); without prompt treatment these infections can cause a number of complications including infertility.
We know many factors are behind these alarming increases: mass incarceration, poverty, stigma, homophobia. Add to that the fact that the best STD control programs we develop are limited by a complex array of issues including stable housing, transportation to clinics, and leave time from work. For sexual minorities, finding a safe, caring medical home remains a significant challenge.
After reviewing this surveillance report I asked my friend Hunter Handsfield, MD, Professor Emeritus of Medicine at the University of Washington Center for AIDS and STD and a former member of ASHA’s Board of Directors, for his thoughts as to why the reportable STDs are increasing and he thinks there is a strong policy angle. He told me “A possible important factor in rising STD rates is the declining availability of specialized STD clinics offered by municipal, county and state health departments, a consequence of changing health economics and of some provisions of the Affordable Care Act.”
Dr. Handsfield says that while some communities are successfully bucking this trend, nationwide there has been reduced availability of inexpensive or cost free options for STD testing, treatment, and partner services, especially in economically disadvantaged settings: “In general, STD rates are highest among young women in states or communities where the social and political climate results in simplistic approaches to sexual health—the legacies of “just say no” and similar strategies. Teen pregnancy rates show similar trends. In my opinion, this is not a coincidence.”
I have to say I agree. I’m frustrated by all this, yes, but still optimistic because the people working in the public health field are passionate and committed. It’s never been more vital for those in the fields of sexual health and social justice to maximize our resources by building coalitions and working together.
Also critical is articulating STD prevention messages that highlight condom use along with greater access to testing and vaccines. Also, given that STDs cost this country $16 billion each year, a key message to policy makers is that in addition to being sound health policy, STD and HIV prevention programs save money.
I invite you to learn the facts, get involved, and speak up. For tips on getting started visit the advocacy page of ASHA’s website.
Yours in good sexual health,
Lynn B. Barclay
ASHA President & CEO