‘Out of control’ SOA situation requires change

NEW YORK (AP) — Soaring cases of some sexually transmitted diseases — including a 26% increase in the number of new syphilis infections reported last year — are prompting US health officials to call for new prevention and treatment efforts.

“It is imperative that we … work to rebuild, innovate and expand (STD) prevention in the US,” said Dr. Leandro Mena of the US Centers for Disease Control and Prevention in a speech Monday at a medical conference on sexually transmitted diseases.

The number of infections for some STDs, including gonorrhea and syphilis, has been rising for years. Last year, the number of syphilis cases reached its highest since 1991 and the total number of cases reached its highest since 1948. The number of HIV cases is also increasing, last year by 16%.

And an international outbreak of monkeypox, which is primarily spread between men who have sex with other men, has further highlighted the nation’s worsening problem with diseases primarily spread through sex.

David Harvey, executive director of the National Coalition of STD Directors, called the situation “out of control”.

Officials are working on new approaches to the problem, such as home test kits for some STDs that will make it easier for people to learn they are infected and take steps to prevent spreading it to others, Mena said.

Related video: Why STDs are increasing for people over 55

Another expert said a core part of any effort is to increase condom use.

“It’s quite simple. Sexually transmitted diseases increase when people have more unprotected sex,” said Dr. Mike Saag, an infectious disease expert at the University of Alabama at Birmingham.

Syphilis is a bacterial disease that manifests as genital sores, but can eventually lead to severe symptoms and death if left untreated.

New syphilis infections plummeted in the US from the 1940s, when antibiotics became widely available. They fell to an all-time low in 1998, when fewer than 7,000 new cases were reported nationwide. The CDC was so encouraged by the progress that it launched a plan to eliminate syphilis in the US

But by 2002, cases had started to rise again, mainly among gay and bisexual men, and continued. In late 2013, CDC ended its elimination campaign in the face of limited funding and escalating cases, which exceeded 17,000 that year.

In 2020 there were nearly 41,700 cases and last year they rose even further, to more than 52,000.

The number of cases has also risen, affecting about 16 per 100,000 people last year. That is the highest in three decades.

Rates are highest among men who have sex with men, and among black and Hispanic Americans and Native Americans. While the percentage is lower for women than for men, officials noted that it has increased more dramatically — by about 50% last year.

That is linked to another problem: the rise in congenital syphilis, in which infected mothers pass the virus on to their babies, potentially leading to the death of the child or health problems such as deafness and blindness. Annual cases of congenital syphilis were only about 300 a decade ago; they rose to nearly 2,700 last year. Of last year’s total, 211 were stillbirths or infant deaths, Mena said.

The rise in syphilis and other STDs could have several causes, experts say. Testing and prevention efforts have been hampered by years of inadequate funding, and the spread may have gotten worse – especially during the pandemic – due to delayed diagnosis and treatment. Drug and alcohol use may have contributed to risky sexual behavior. Condom use is declining.

And there may have been an increase in sexual activity as people got out of the COVID-19 lockdowns. “People feel liberated,” Saag said.

The advent of monkeypox added a great deal of burden. CDC recently sent a letter to state and local health departments stating that their HIV and STI drugs could be used to fight the monkeypox outbreak. But some experts say the government should provide more money for STD work, not divert it.

Harvey’s group and some other public health organizations are pushing for a proposal for more federal funding, including at least $500 million for STD clinics.

Mena, who last year became director of the CDC’s STD Prevention Division, called for reducing stigma, broadening screening and treatment services, and supporting the development and accessibility of home testing. “I envision a day when getting tested (for STDs) could be as easy and affordable as taking a home pregnancy test,” he said.

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The Associated Press Health & Science Department is supported by the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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