STDs continue to surge during pandemic, CDC says
Click Here to Manage Email Alerts
The years-long surge in STDs in the United States continued in 2020 during the first year of the COVID-19 pandemic, and there are indications that cases are still increasing, the CDC warned Tuesday.
For the first time in 7 years, the overall number of reported STD cases was lower than the previous year, but the CDC attributed the drop-off to a decline in reported cases of chlamydia — the nation’s most common STD — that was likely a result of pandemic-related interruptions to screening.
“This affirms once again that America isn’t taking the STD crisis seriously,” David C. Harvey, MSW, executive director of the National Coalition of STD Directors (NCSD), said in a statement. “We can only fight this out-of-control epidemic with new funding and the kind of urgency that reflects the enormity of this crisis.”
Overall, 2.4 million cases of the three nationally notifiable STDs — chlamydia, gonorrhea and syphilis — were reported in 2020, down from 2.5 million in 2019, according to new surveillance data released Tuesday to coincide with STD Awareness Week.
The data continue to show a disproportionate impact on Black Americans, and an alarming rise in cases of congenital syphilis.
“In 2020, the COVID-19 pandemic dramatically disrupted life as we knew it, and while there were moments when it felt like the world was standing still, sexually transmitted infections were not,” Jonathan Mermin, MD, MPH, who heads the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, said during a press briefing.
Reported cases of chlamydia declined 13% from 2019 to 2020, but cases of gonorrhea and syphilis increased 10% and 7%, respectively, the CDC noted. Mermin said the decline in reported cases of chlamydia is “concerning” because it is often asymptomatic and detected only through in-person screening.
Experts have warned that the pandemic has caused widespread disruptions to the nation’s STD programs, with attention and personnel being diverted to the COVID-19 response.
“The unrelenting momentum of STDs continued as prevention and treatment services were disrupted,” Mermin said.
According to the new CDC data, cases of congenital syphilis — which have steadily increased in recent years — were up nearly 15% from 2019 to more than 2,100 cases in 2020. Cases have increased 235% since 2016. Researchers have linked the rise in congenital syphilis to numerous factors, including barriers to care.
The CDC said early data indicate that reported cases of syphilis and congenital syphilis cases continued to rise in 2021.
“In spite of the alarming data published today, it is important to emphasize that we have to, as a nation, tackle this STI epidemic,” Leandro Mena, MD, MPH, director of CDC’s Division of STD Prevention, said during the briefing.
According to the new surveillance report, the South had the highest rates of reported chlamydia and gonorrhea in the country in 2020, followed by the Midwest, and was second to the West in reported cases of primary and secondary syphilis.
According to the report, 32% of all STD cases in 2020 occurred among non-Hispanic Black people, who make up only around 12% of the U.S. population.
“The COVID-19 pandemic increased awareness of something we’ve long known about STDs: Social and economic factors — such as poverty and health insurance status — create barriers, increase experiences with health risks, and often result in worse health outcomes for some people,” Mena said. “If we are to make lasting progress, we have to understand the systems that create inequities and work with partners to change them.”
The NCSD last month criticized President Biden’s new budget proposal as having “flat funding” for STDs despite ongoing record-high levels of infection. It called on Congress to increase funding and support a new STD funding program at the Health Resources and Services Administration.
“We can absolutely change the trajectory of the STD crisis, but we can’t win the fight against STDs unless Congress and the Biden administration recognize the gravity of this epidemic,” Harvey said Tuesday.
References:
CDC. Sexually transmitted disease surveillance 2020. https://www.cdc.gov/std/statistics/2020/default.htm. Accessed April 12, 2022.
National Coalition of STD Directors. Biden budget fails to address STD crisis. https://www.ncsddc.org/biden-budget-fails-address-std-crisis/. Accessed April 12, 2022.
STDs increased during the first year of the COVID_19 pandemic. https://www.cdc.gov/nchhstp/newsroom/2022/2020-STD-surveillance-report.html. Published April 12, 2022. Accessed April 12, 2022.
Perspective
Back to Top
Although the headline might seem old, we should not shrug off as acceptable or “a new normal” that the U.S. is again recording increases in STIs. In fact, the CDC’s new surveillance report is even less reassuring than previous reports. The 2020 data almost certainly underestimate the STI burden given reduced testing (both screening — best evidenced by an observed decline in chlamydial infections — and evaluation of symptoms), so it’s likely that more STI went undetected and untreated, and effectively transmitted, than ever before.
Another stark finding is that in 2020, almost all U.S. states (47!) reported at least one case of congenital syphilis, and 149 stillbirths and infant deaths were observed. Again, this may be the tip of the iceberg: Most congenital syphilis likely results in spontaneous abortion, an outcome that is not typically tracked in the STI context. The latter trend in early 2021 indicates that last year will be even worse.
Now is not the time to stop advocating for our communities’ access to professional and informed sexual health care, and for continued investment in biomedical prevention, like vaccines.
Collapse
Press Conference.
Read more about
Click Here to Manage Email Alerts