Trendspotting: S.T.I.s on the Rise

NewsWire: 6/8/22

• U.S. cases of STIs, namely syphilis and gonorrhea, surged in 2020. After falling in the late 1990s and early 2000s, cases have been on the rise once more. (The New York Times)
  
• NH: The CDC recently released its 2020 data on sexually transmitted infections in the U.S. Not surprisingly, cases fell in the early months of the year amid stay-at-home orders. But by the end of 2020, they were surging, continuing a rise seen over the past decade.
• The number of gonorrhea cases ultimately went up +10% YoY to 678K. Syphilis cases rose +7% to 134K, and congenital syphilis cases rose +15% to just over 2K. (They are now up 7X since 2012.) The number of congenital syphilis cases has now surpassed the rate of pediatric AIDS during the height of the AIDS crisis.
• Chlamydia cases, meanwhile, declined from their all-time high last year. But observers suspect that this was more likely due to a decline in preventative care screenings than an actual decrease in cases. Unlike syphilis and gonorrhea, chlamydia usually has no symptoms.

• Throughout the early 2000s, the U.S. made good progress towards reducing STIs. After cases surged in the 1990s, syphilis was nearly eliminated by 2000. Similarly, high rates of gonorrhea in the 1980s and ‘90s fell drastically by 2000 and reached an all-time low in 2009.
• Why have the declines reversed? With cases falling, lawmakers shifted STI funding to other priorities. Prevention and education efforts stalled, and testing clinics around the country closed. Online dating has made it harder to track and test sexual partners. Skyrocketing rates of opioid abuse have diverted funding away from STI prevention. Public health officials say opioid abuse has also contributed to rising STI rates among users who are engaging in unprotected sex or trading sex for drugs, with the sharpest increases seen among heterosexual women.
• STIs might not seem like a pressing public health issue in the shadow of Covid-19. But according to the CDC, new STIs diagnoses result in $16B in direct medical costs every year thanks to a cascade of problems: sores, rashes, infertility, permanent nerve and heart damage, and in the case of congenital syphilis, severe disabilities or stillbirths. And the frustrating part is that they're largely preventable.