Doctors believe that the main reason is that fewer people use condoms.
The sharp increase in cases of some sexually transmitted diseases in the United States, including a 26% increase in syphilis infections reported last year, is causing federal health authorities to call for new prevention and treatment measures.
“It is imperative that … we work to rebuild, innovate and expand prevention (of STDs) in the United States,” said Dr. Leandro Mena of the US Centers for Disease Control and Prevention (CDC). in English), in a speech Monday during a medical conference on sexually transmitted diseases.
Infection rates for some STDs, including gonorrhea and syphilis, have been rising for years. Last year, the rate of syphilis cases reached its highest level since 1991 and the total number of infections reached its highest point since 1948.
HIV cases are also on the rise, up 16% from last year.
And an international outbreak of monkeypox, which spreads primarily among men who have sex with men, has highlighted the serious problem the nation faces with diseases spread primarily through sex.
David Harvey, executive director of the National Coalition of STD Directors, calls the situation “out of control.”
Authorities are working on new approaches to the problem, such as home test kits for some STDs, which will make it easier for people to know they are infected and take steps to avoid infecting others, Mena said.
Another expert noted that a central part of any initiative must be working to promote condom use.
“It’s pretty straightforward. More STDs are reported 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 appears as sores on the genitals, but can lead to severe symptoms and death if left untreated.
New syphilis infections declined dramatically in the United States beginning in the 1940s, when antibiotics became widely available. In 1998 they fell to their lowest level, when fewer than 7,000 new cases were reported nationwide.
The CDC was so encouraged by the progress that it launched a plan to eradicate syphilis in the country.
But in 2002 cases began to rise once more, especially among gay and bisexual men, and continued to rise. At the end of 2013, the CDC ended its campaign to eradicate the disease due to limited funds and the increase in cases, which that year exceeded 17,000.
By 2020, syphilis cases had reached almost 41,700, and last year they skyrocketed even higher, topping 52,000.
The case rate has also increased, reaching regarding 16 per 100,000 people in 2021. It is the highest in three decades.
Rates are higher among men who have sex with men, and among blacks, Hispanics, and Native Americans.
Although the rate for women is lower than that for men, officials said it has been rising more dramatically: roughly 50% in the past year.
That’s tied to another problem: The rise in congenital syphilis, in which infected mothers pass the disease to their babies, which can lead to infant death or health problems like deafness and blindness.
Annual cases of congenital syphilis were only regarding 300 a decade ago, but in 2021 they rose to nearly 2,700. Of last year’s figure, 211 were stillbirths or infant deaths, Mena said.
The rise in syphilis and other STDs may have several causes, according to experts. Testing and prevention measures have been hampered by years of inadequate funding, and the spread may have worsened — especially during the COVID-19 pandemic — due to delayed diagnosis and treatment.
Drug and alcohol use may have contributed to risky sexual behavior. Condom use has been declining.
And an increase in sexual activity may have occurred as people emerged from coronavirus lockdowns.
“People feel liberated,” Saag said.
The arrival of monkeypox added a large additional burden. The CDC recently sent a letter to state and local health departments saying their HIV and STD resources might be used to combat the monkeypox outbreak.
But some experts say the government should provide more funding for STD work, not divert it.
Harvey’s group and some other public health organizations are pushing a proposal for more federal funding, including at least $500 million for STD clinics.
Mena, who became director of the CDC’s STD Prevention Division last year, called for reducing stigma toward those infected, expanding screening and treatment services, and supporting the development and accessibility of home tests.
“I envision a day when getting tested (for STDs) is as easy and affordable as taking a pregnancy test at home,” she said.
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