STD epidemic continues to worsen, CDC says
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Key takeaways:
- More than 1.64 million cases of chlamydia were reported to the CDC in 2021, making it the most common STD in the U.S.
- Primary and secondary syphilis cases increased 28.6% from 2020 to 2021.
Final surveillance data released by the CDC on Tuesday confirmed that reported cases of chlamydia, gonorrhea and syphilis increased between 2020 and 2021 in the United States, totaling more than 2.5 million.
It was the latest in a series of dire warnings about the continued rise in the three nationally reportable STDs and marked the seventh time in 8 years that the total number of reported cases was higher than the previous year.
In a statement, the CDC said the U.S. “must deepen its commitment” to ending the epidemic.
“This is not business as usual — it is a rapidly deteriorating public health crisis in a dangerous time,” David C. Harvey, MSW, who leads the National Coalition of STD Directors, said in a statement. “STI rates will continue to rise unless we take drastic action.”
Rates of syphilis surged by almost 32% for all stages from 2020 to 2021, and the alarming rise in congenital syphilis continued, also with a 32% increase in cases, according to the CDC.
In all, 176,713 cases of syphilis were reported, including 53,767 cases of primary and secondary (P&S) syphilis — a 28.6% increase — and 2,855 cases of congenital syphilis, including 220 congenital syphilis-related stillbirths and infant deaths.
Chlamydia was the most common STD in the U.S. in 2021, with a total of 1,644,416 cases reported to the CDC — a 3.9% increase compared with 2020. Rates were highest among adolescents and young adults, with 58% of all chlamydia cases occurring among people aged 15 to 24 years.
Still, chlamydia rates did not return to pre-pandemic levels, demonstrating that STD screening likely continued to be impacted by COVID-19-related disruptions in 2021 because, the CDC said, chlamydia is usually asymptomatic and case rates are “heavily influenced” by screening coverage.
A total of 710,151 cases of gonorrhea were reported, making it the second most common STD in the U.S. The CDC noted that rates of gonorrhea have increased 118% since a historic low in 2009. Cases increased more than 4% from 2020 to 2021.
Data from the report also showed that there were significant disparities in rates of reported STDs, including among gay and bisexual men, younger people and certain racial minority groups.
According to the report, 50.5% of reported cases of STDs occurred among adolescents and young adults aged 15 to 24 years. The report showed that 31% of all cases of chlamydia, gonorrhea and P&S syphilis were reported among non-Hispanic Black people, even though they made up only approximately 12% of the U.S. population, whereas American Indian or Alaska Native people made up 3.6% of all congenital syphilis cases despite contributing to less than 1% of all live births in the U.S.
Additionally, as was shown in previous years, men who have sex with men also continued to be disproportionally impacted by STDs, including gonorrhea and P&S syphilis.
“The U.S. STI epidemic shows no signs of slowing. The reasons for the ongoing increases are multifaceted — and so are the solutions,” Leandro Mena, MD, MPH, Director of CDC’s Division of STD Prevention, said in a statement. “For the first time in decades, we’re seeing promising new STD interventions on the horizon, but these alone will not solve this epidemic.”
Mena did not mention specific interventions, but studies continue to show that doxycycline can prevent STDs when taken after having unprotected sex, and a large NIH trial is testing a meningococcal B vaccine against gonorrhea.
“It will take many of us working together to effectively use new and existing tools, to increase access to quality sexual health care services for more people and to encourage ongoing innovation and prioritization of STD prevention and treatment in this country,” Mena said.
References:
U.S. STI epidemic showed no signs of slowing in 2021 – cases continued to escalate. https://www.cdc.gov/media/releases/2023/s0411-sti.html. Published April 11, 2023. Accessed April 11, 2023.
U.S STI rates hit another high. https://www.ncsddc.org/u-s-sti-rates-hit-another-high/. Published April 11, 2023. Accessed April 11, 2023.
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CDC. Sexually transmitted disease surveillance 2021. https://www.cdc.gov/std/statistics/2021/default.htm. Updated April 11, 2023. Accessed April 11, 2023.
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