CDC: Protecting Americans from Sexually Transmitted Diseases
Identifying Americans with STDs and Connecting Them to Treatment
Combining local expertise, community priorities, and CDC’s breadth of experience and information is a winning approach toward high=impact, scalable, and cost-effective sexually transmitted disease (STD) prevention. CDC is the only federal agency that supports and funds health departments in 50 states, seven cities, and two territories to track STD surveillance, engage support services for Americans with STDs and link them to treatment, and aid collaboration between public health and medical providers. For instance, in Los Angeles, CA, surveillance shows that syphilis cases increased 80 percent over the past five years. The Los Angeles County Department of Public Health founded a multi-sector coalition focused on reducing STD disparities among youth. The coalition brings together health department staff, medical providers, faith leaders, teachers, business owners, and youth themselves to fight STDs and improve health in their community.
CDC funding and training supports disease intervention specialists (DIS) in state and local health departments. DIS are the foot soldiers of public health who find Americans unknowingly exposed to STDs and effectively connect them to testing and treatment. Over 1,600 STD DIS work to protect the health of Americans in every state. DIS receive extensive training in investigative skills so they can tackle the toughest cases. While originally established in the 1940s to focus on STD prevention, DIS are also called upon to assist in investigating other urgent public health threats. They have protected Americans from a wide variety of outbreaks and epidemics, including HIV, tuberculosis, Ebola, flu, and Zika. DIS are a skilled and ready workforce, prepared to control emergencies as they arise.
Whenever Americans test positive for syphilis, reports are sent to the health department, which in turn engages DIS to investigate. DIS notify individuals diagnosed with syphilis of their test results, educate them about the disease, and make sure they receive correct and timely treatment. Most importantly for protecting communities, DIS conduct “contact tracing”—identifying and notifying the partners of syphilis patients, so they can also be tested, treated, and cured. This is crucial to preventing the spread of the disease.
Tracking Diseases to Stop STDs Faster
CDC’s STD surveillance data improve our ability to quickly identify STD trends and outbreaks. CDC is modernizing surveillance by funding a special network of 11 STD program sites across the country. The additional data these sites collect improves the understanding of STD transmission and health outcomes. CDC ensures that data sharing between health departments and medical organizations is effective and secure, which allows for a quicker, more precise view of disease trends. Accurate information and effective communication allows those protecting the public’s health to better stop STD transmission.
CDC plays a key role in monitoring antibiotic-resistant gonorrhea, so Americans can continue to have a reliable cure. Gonorrhea is a rapidly changing bacterium with rising antibiotic resistance to the last gonorrhea treatment option available. CDC and regional state Public Health laboratories, in WA, TX, TN, and MD analyze gonorrhea samples from 27 sentinel sites across the nation to ensure that gonorrhea can be successfully treated with the right antibiotic. CDC’s STD laboratory conducts innovative testing of new antibiotics to treat gonorrhea, which has led to clinical trials exploring novel drugs. CDC, in collaboration with state public health laboratories, is developing a software tool to use genetic information of gonorrhea isolates to predict antibiotic resistance, which will save time in detecting drug resistance and selecting the best treatment option. CDC is developing innovative rapid detection and response interventions, such as using transmission network analyses, to address the threat of an untreatable strain of gonorrhea in the United States.
Safeguarding Beyond Curable STDs
Americans who have an STD are at an increased risk of acquiring HIV. One study suggests that in 2015 there were approximately 5,000 STD-attributable HIV cases, at a cost of $1.75 billion. CDC’s support ensures health departments have the capacity to find Americans who are not connected to the health care system and link them to HIV prevention or treatment services. For example, health departments use a strategy known as “network interviewing” — DIS ask people diagnosed with an STD about their social networks and who might need to get tested. In one case, in Richmond, Virginia, network interviewing beginning with one person with syphilis allowed DIS to find and treat six new cases of syphilis and two new cases of HIV. Syphilis can be cured with antibiotics and daily antiretroviral therapy can reduce the amount of HIV in the blood to levels that are undetectable. This is why STD treatment is very effective disease prevention for both individuals and communities.
Turning Science into Practice
CDC examines scientific evidence on cutting-edge technology, prevention interventions, and medicines to treat STDs and works with scientists and programs across the nation to determine what works best in specific situations. For example, CDC recommends expedited partner therapy, which allows medical providers to give patients diagnosed with chlamydia or gonorrhea a prescription for themselves plus one for their partner right away. Studies show that patients whose partners received expedited partner therapy are 29 percent less likely to be reinfected than those who simply told their partners to go to a doctor for treatment. Treating a patient and their partner together is efficient and effective because it stops a cycle of reinfection and prevents the spread of STDs.
CDC’s STD laboratory works with university and industry partners to develop and assess new diagnostic tests and pharmaceutical treatments. Medical and technological updates are reflected in CDC’s STD Treatment Guidelines, which are considered the gold standard for STD care worldwide. Medical providers, health plans, health departments and other organizations follow CDC’s STD Treatment Guidelines to improve STD prevention and care in their communities.
Preparing the Medical Workforce to Address Increasing Rates of STDs
One in three physicians did not receive any training in STDs after medical school. CDC’s National Network of STD/HIV Prevention Training Centers arm clinicians to effectively serve patients at risk for STDs. CDC’s resources support clinical training partnerships between academic institutions, medical and nursing organizations, state and local health departments, and tribal and military health centers. Over the course of a year, Prevention Training Centers provide 500 classes serving over 25,000 medical providers. These trainings ensure clinicians have the most up-to-date, research-based knowledge and skills to prevent, diagnose, and treat STDs. Effective STD testing and treatments help prevent chronic pain and problems like infertility, as well as reducing the spread of STDs in communities.
The CDC-funded Prevention Training Centers have expanded beyond typical trainings to provide online consultations to providers across the U.S. on difficult STD issues. The STD Clinical Consultation Network is available nationally so medical providers from all over the country can ask questions and get expert advice. Over 500 consultations are conducted annually. To expand the reach of accessible, up-to-date STD information, the Denver Prevention Training Center built a mobile app to allow clinicians to request consultations, access useful resources like CDC’s STD Treatment Guidelines, and register for continuing education courses. CDC supports tools like this to bring essential training to scale.