“It is imperative that we work to rebuild, innovate and expand (STD) prevention in the US,” Leandro Mena of the US Centers for Disease Control and Prevention said in a speech Monday at a medical conference on sexually transmitted diseases. illnesses. Infection rates for some STDs, including gonorrhea and syphilis, have been rising for years. Last year the rate 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% last year. An international outbreak of monkeypox has further highlighted the country’s worsening problem with mainly sexually transmitted diseases. 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 testing kits 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 a key part of any effort must work to increase condom use. “It’s simple enough. More sexually transmitted infections occur when people have more unprotected sex,” said Mike Saag, an infectious disease specialist at the University of Alabama at Birmingham. Syphilis is a bacterial disease that appears as genital sores, but can eventually lead to severe symptoms and death if left untreated. New syphilis infections plummeted in the US starting in the 1940s when antibiotics became widely available. They fell to their lowest level since 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 by 2002, cases began to rise again, mostly among gay and bisexual men, and have continued. In late 2013, the CDC ended its eradication campaign due to limited funding and the escalation of cases, which that year exceeded 17,000. By 2020, cases had reached nearly 41,700 and rose even further last year, to more than 52,000. The rate of cases has also increased, reaching about 16 per 100,000 people last year. This is the highest in three decades. Rates are higher among men who have sex with men, and among blacks and Latinos and Native Americans. While the rate for women is lower than that for men, officials noted that it has increased more dramatically, about 50 percent last year. This is linked to another problem: an increase in congenital syphilis, in which infected mothers pass the disease to their babies, potentially leading to the death of the child or health problems such as deafness and blindness. Annual cases of congenital syphilis numbered only about 300 a decade ago. they rose to nearly 2,700 last year. Of last year’s tally, 211 were stillbirths or infant deaths, Mena said. The increases in syphilis and other STDs may have several causes, experts say. Testing and prevention efforts have been delayed by years of underfunding, and the spread may have worsened — especially during the pandemic — as a result of delayed diagnosis and treatment. Drug and alcohol use may have contributed to risky sexual behavior. Condom use has decreased. And there may have been a surge in sexual activity as people emerged from Covid-19 lockdowns. “People feel liberated,” Saag said. The arrival of monkey pox added a great burden. The CDC recently sent a letter to state and local health departments saying their HIV and STD resources could be used to fight the monkeypox outbreak. But some experts say the government should provide more funding for STI work, not divert it. Harvey’s team and some other public health organizations are pushing a proposal for more federal funding, including at least $500 million for STD clinics. Mena, who last year became director of the CDC’s Division of STD Prevention, called for reducing stigma, expanding screening and treatment services, and supporting the development and accessibility of home testing. “I envision a day where testing (for STDs) can be as simple and affordable as taking a home pregnancy test,” she said.
