STDs out of control are causing change

NEW YORK (AP) — A sharp rise in some sexually transmitted diseases — including a 26 percent increase in new syphilis infections reported last year — is prompting U.S. health officials to call for new prevention and treatment efforts.

“It is critical that we … work to rebuild, innovate and expand (STD) prevention in the U.S.,” Dr. Leandro Meno of the U.S. Centers for Disease Control and Prevention said in a speech Monday at the Communicable Diseases Medical Conference sexually. .

Rates of some STDs, including gonorrhea and syphilis, have been rising for years. Last year, the number of syphilis cases reached the highest level since 1991, and the total number of cases reached the highest level since 1948. HIV cases are also on the rise, up 16% in the past year.

And an international outbreak of monkeypox, which spreads mostly among men who have sex with other men, has further highlighted the nation’s problem with the predominantly sexually transmitted disease.

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 tests for some STDs, that would make it easier for people to know they are infected and take steps to prevent spreading it to others, Mena said.

Another expert said the bulk of any effort should be to increase condom use.

“It’s pretty simple. “Sexually transmitted infections are more common 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 sores on the genitals, but can eventually lead to serious symptoms and death if left untreated.

New syphilis infections in the US dropped dramatically in the 1940s when antibiotics became widely available. They fell to their lowest level 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 in 2002, cases began to rise again, mostly among gay and bisexual men, and they continued. In late 2013, the CDC ended its eradication campaign due to limited funding and escalating cases, which exceeded 17,000 that year.

By 2020, the number of cases had reached almost 41,700, and last year they rose even more to more than 52,000.

The rate of cases is also rising, reaching about 16 per 100,000 people last year. This is the highest indicator in the last three decades.

Rates are highest among men who have sex with men, and among black and Hispanic Americans and Native Americans. While the rate for women is lower than for men, officials said it has been rising more sharply — up about 50% last year.

This is linked to another problem, the rise of congenital syphilis, in which infected mothers pass the disease to their babies, which can lead to the baby’s death or health problems such as deafness and blindness. Annual cases of congenital syphilis numbered only about 300 a decade ago; last year, that number rose to nearly 2,700. Of last year’s count, 211 were stillbirths or infant deaths, Mena said.

Experts say the rise in syphilis and other STDs can be caused by several factors. Testing and prevention efforts have been hampered by years of underfunding, and spread may have worsened — especially during a pandemic — as a result of delays in diagnosis and treatment. Drug and alcohol use may have contributed to risky sexual behavior. Condom use is declining.

And there may have been a surge in sexual activity as people came out of the COVID-19 lockdown. “People feel liberated,” Saag said.

The arrival of monkey pox added a great additional burden. The CDC recently sent a letter to state and local health departments saying that their HIV and STD resources could be used to control the monkeypox outbreak. But some experts say the government should allocate more funds to STD work, not divert them.

Harvey’s group and some other public health organizations are pushing 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, expanding testing and treatment services, and supporting the development and availability of home testing. “My guess is that someday getting tested (for STDs) will be as easy and affordable as taking a home pregnancy test,” he said.

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