Impact of COVID-19 on STIs
The COVID-19 pandemic led to disruptions in STI-related prevention and care activities, including reduced STI screening and redirection of STI program resources to COVID-19 activities. Because STIs often do not show symptoms, and screening is necessary for timely diagnosis and treatment, changes in access to sexual health care, as well as disruptions in public health services, can affect the number of infections diagnosed and reported. Consequently, trends for STI surveillance data collected during the pandemic that are presented in Sexually Transmitted Infections Surveillance, 2022 should be interpreted cautiously.
The impact of the COVID-19 pandemic on STI surveillance data was most acute in March and April 2020, when the number of reported STIs rapidly fell during the initial shelter-in-place orders. Case counts began increasing in late-2020, which may have reflected increases in service utilization as health care clinics re-opened and people sought care when available. Increases in diagnosed and reported cases could also reflect higher disease transmission. For example, due to reduced access to care, those with an STI may have had their infections longer, providing more opportunities to transmit infection to their sexual partners. Additionally, following the initial shelter-in-place orders, sexual behaviors like the frequency of new sex partners may have changed, causing STIs to spread in sexual networks.
In 2022, the total number of STIs reported was higher than the number reported in 2020; however, the number of chlamydia cases reported in 2022 is still lower than the number of cases reported prior to the COVID-19 pandemic. Most people with chlamydia usually have no signs or symptoms and many cases are identified through screening at routine preventive care visits. Therefore, it is likely chlamydia was disproportionately affected by reduced screening during the pandemic, resulting in undiagnosed infections. Additionally, in response to reduced staffing resources, many health departments prioritized the diagnosis and treatment of syphilis and gonorrhea. This likely further reduced the number of chlamydia cases processed and reported.
Sexually Transmitted Infections Surveillance, 2022 underscores that STIs continue to persist as a significant public health concern. The COVID-19 pandemic significantly affected trends in diagnosed and reported STIs – resulting in likely underreporting of infections and possibly increased STI transmission. It’s likely that such effects will persist for several more years and we may never know the full impact of the pandemic on STIs. What is clear, however, is that STI prevention and control efforts remain as important as ever.
Additional Information
- Impact of COVID-19 on STDs. 2020 STD Surveillance Report. Available at: https://www.cdc.gov/std/statistics/2020/2020-SR-4-10-2023.pdf
- Impact of COVID-19 on STDs. 2021 STD Surveillance Report. Available at: TBD
- Pagaoa et al. Trends in Nationally Notifiable Sexually Transmitted Disease Case Reports During the US COVID-19 Pandemic, January to December 2020. Sex Transm Dis. 2021 Oct; 48(10): 798–804.
- Wright et al. Impact of the COVID-19 Pandemic on Centers for Disease Control and Prevention-Funded STD Programs. Sex Transm Dis. 2021 Oct 12.
- Summary of key findings: https://www.cdc.gov/std/program/327850-A_FS_COVID19_STD_Impact_508_FINAL.pdf
- Abstract: https://pubmed.ncbi.nlm.nih.gov/34654769/
Current COVID-19 information: https://www.cdc.gov/coronavirus/2019-ncov/index.html