Dear Partners in Prevention,
Today, during the second annual STD Awareness Week, CDC released Sexually Transmitted Disease (STD) Surveillance, 2019. Reported cases of chlamydia, gonorrhea, and syphilis have increased for the sixth consecutive year – reaching a new, all-time high. These infections remain common, costly, and challenge the health and wellness of millions of people across the United States.
In 2019, U.S. health departments reported:
- 1.8 million cases of chlamydia, an increase of nearly 20 percent since 2015;
- 616,392 cases of gonorrhea, an increase of more than 50 percent since 2015; and
- 129,813 cases of syphilis (all stages), an increase of more than 70 percent since 2015.
Congenital syphilis, an incredibly harmful infection has increased a staggering 279 percent since 2015. In 2019 alone, there were nearly 2,000 cases of congenital syphilis reported, including 128 deaths. In addition to infant morbidity and mortality, STIs can also lead to long-term health consequences, like infertility, and they can facilitate HIV transmission.
STIs are common, but not everyone is equally affected
Social inequity often leads to health inequity and, ultimately, manifests as health disparities. Even when STI rates reached historic lows, disparities have persisted because of the social, cultural, and economic conditions that make it more difficult for sexually active people to stay healthy. And while reported STDs have once again become increasingly common, racial and ethnic minority populations, adolescent and young adults, and gay and bisexual men still bear the brunt of these deeply entrenched social determinants of health.
Less than 20 years ago, gonorrhea rates in the U.S. were at historic lows, syphilis was close to elimination, and advances in chlamydia diagnostics made it easier to detect infections. That progress has been lost, due in part to challenges to our public health system.
COVID-19 highlights both needs and opportunities in the STI field
The 2019 numbers and trends presented here do not yet reflect the impact of the COVID-19 pandemic; however, we know from recent STI field surveysexternal icon that COVID-19 is having a profound impact on state and local health STI programs. The recently published National Academies of Sciences, Engineering, and Medicine (NASEM) consensus study report, Sexually Transmitted Infections: Adopting a Sexual Health Paradigmexternal icon, highlights that the “COVID-19 pandemic has exposed weaknesses in public health preparedness due to weak infrastructure, an under-capacitated and under-resourced workforce, and limited surge capacity.” These are challenges STD prevention efforts have faced for many years. Preliminary 2020 data suggest we likely will see continued concerning trends which demand immediate attention, even in the current environment. We must continue to meet the challenges by finding new solutions; adapting quickly to meet the ever-changing landscape of the healthcare system; and collaborating to share information, strategies, and science.
Fortunately, this is also a time of momentum in our field. HHS’ Sexually Transmitted Infections National Strategic Plan for the United Statespdf iconexternal icon – the nation’s first-ever plan of its kind for STIs – has provided a roadmap for public health, government, community-based organizations and other stakeholders to develop, enhance and expand STI prevention and care programs at the local, state, tribal and national levels. In addition, STI prevention partners across the nation are leveraging innovative approaches, like telehealth/telemedicine; partnerships with pharmacies and retail health clinics; and STI express clinics, to meet patients where they are with the testing and prevention services they urgently need.
During these unprecedented times, we recognize what we collectively face looks different than ever before, and that you are working through exceptional fatigue and exhaustion. We are lifted by your dedication and compassion, and though we can never thank you enough, we truly appreciate all you do every day.
It is our sincere hope these new data should create a sense of urgency and mobilize the resources needed, so that future reports can tell a different story.
Raul Romaguera, DMD, MPH
Acting Director, Division of STD Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
US Centers for Disease Control and Prevention