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It should be unsurprising that STDs are on the rise — again

The CDC has reported that the U.S. has reached record numbers for the sixth year in a row. This report documented cases of the sexually transmitted diseases chlamydia, gonorrhea, and syphilis in the U.S. hit an all-time high in 2019, the most recent year for which data is available. They reported 2.6 million diagnosed STDs in the U.S. in 2019, compared to about 2.5 million cases in 2018. It notes that the rate of STDs, also known as sexually transmitted infections (STIs), has skyrocketed in the past two decades.

Raul Romaguera, MPH, acting director of the Division of STD Prevention at the CDC, said in the announcement, “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.”

But rather than point toward individual agency and decisions, experts think that the increase is likely due to a lack of sex ed. 

“This news isn’t surprising, but it’s not the fault of individuals—it represents a larger failure of sexual health education programs in the United States,” says Marybec Griffin, Ph.D., assistant professor in the department of health behavior, society, and policy at the Rutgers School of Public Health in New Jersey. She explains that a lack of comprehensive sexual health education in middle and high schools across the country may be to blame. “The United States has always lagged behind other countries in the provision of sexual health education, and every year we add more adolescents that do not have the education they need to protect themselves and make informed decisions.”

Here’s the rundown on the report:

Health departments across the U.S. reported the following data on STDs:

  • 1.8 million cases of chlamydia, an increase of nearly 20% since 2015
  • 616,392 cases of gonorrhea, an increase of more than 50% since 2015
  • 129,813 cases of syphilis, an increase of more than 70% since 2015

Congenital syphilis, a disease that happens when a mother with syphilis passes the infection on to her baby during pregnancy, increased by 279% since 2015. Nearly 2,000 cases of congenital syphilis were reported in 2019, including 128 deaths.

Unsurprisingly, STIs disproportionately impact young people.

Of all the cases reported to health departments across the nation, more than 55% were in teens and young adults between 15 and 24 years old. 

There were also racial disparities despite making up 12.5% of the population. About 31% of chlamydia, gonorrhea, and syphilis cases are diagnosed in non-Hispanic Black people. Homosexual men were also disproportionately impacted by STDs.

One mitigating factor may be improved detection. Some believe that’s particularly true for chlamydia. Peter Leone, MD, adjunct associate professor of epidemiology for the Gillings School of Global Public Health and professor of medicine for the School of Medicine at the University of North Carolina, says, “We didn’t always have diagnostic tests for it. This is really the trend over the last decade.” 

Regardless, he’s most concerned by the congenital syphilis. “That shouldn’t happen,” Dr. Leone says. “It’s a total failure of the system when we see that.”

Certain social and economic conditions, including lack of medical insurance or a consistent and regular health care provider, poverty, drug use, and a high burden of STDs within specific communities, are contributing as well. 

The CDC says it likely reflects different access to quality sexual health care and differences in sexual network characteristics. It cites an example of a greater chance of encountering an STI in communities with a higher prevalence of STIs than lower-risk communities, regardless of sexual behavior patterns.

To counteract this alarming trend upward, The Department of Health and Human Services has launched a Sexually Transmitted Infections National Strategic Plan for the United States, which is strategic for public health, government, community-based organizations, and other stakeholders to develop and expand STI prevention and care programs at the local, state, tribal, and national levels.

If you’ve read all of that and are left shaking your head, you’re not alone. Joe would have been the first to point out that the overwhelming number of STI’s can be prevented by simply following the Bible’s directions. More education and more funding are all good ideas, but when do we get to point out that there isn’t an “investment” big enough to prevent natural consequences to sin?