Maggie Fox from NBC News has reported that common sexually transmitted diseases such as syphilis and gonorrhoea have exploded in recent years in USA, in part because of reduced funding for public health clinics. There are more than 1.4 million reported cases of Chlamydia last year which is the highest number of cases of any disease ever reported to the Centres for Disease Control and Prevention (CDC).
CDC reported that the number of syphilis cases reported in 2014 were under 20,000, the highest rate since 1994 and a 15% increase over 2013. They also found 458 cases of syphilis in newborn babies which is a startling 27.5%t increase over 2013. In addition more than 350,000 cases of gonorrhoea were reported which is up 5% from 2013. "Certainly, this is the first time since 2006 that all three of our notifiable sexually transmitted diseases have increased," said the CDC's Dr. Gail Bolan. "Some of the increases are quite alarming." Most of the increases have been seen in young adults, who get infected soon after they first begin having sex.
The CDC estimates that half of the 20 million new sexually transmitted infections that occur every year are among people aged 15-24. Dr Bolan noted that Young people are the most vulnerable and women can lose their reproductive health for a lifetime from infection of Chlamydia or gonorrhoea. While antibiotics can treat the infections, they often do not cause symptoms until damage has been done.
What's going on to cause the increase? There are several factors, the CDC says. Budget cuts are a big factor. Most recently, there have been significant erosions of state and local STD control programs. Most people don't recognize that the direct clinical care of individuals with sexually transmitted diseases is supported by state and local funds and federal funds. Just one example in October, the Illinois Department of Health stopped paying for STD tests at 100 jails and local health departments across the state. Dr Bolan acknowledged that in one year 7% of local health departments said they closed their STD clinics. And 43% said they had to cut back on the hours they could stay open. About a third had to raise fees and co-pays, something that's been shown to keep some people away.
Another big factor is a change in behaviour among gay and bisexual men. The increase in syphilis among gay men is concerning because we have been seeing this increase for almost a decade, Dr Bolan said. It seems to correlate with the advent of HIV treatment. Dr Bolan also added that HIV treatment is not responsible for the change. HIV infection has become a chronic disease that can be managed with the cocktails of powerful HIV drugs that are now available, instead of a death sentence. HIV patients know they can stay healthy if they take the drugs, and that they are less likely to infect someone else and people are excited about it. And some may have stopped using condoms so consistently, because they are no longer afraid of a deadly infection. Unfortunately, HIV treatment has no impact on prevention of other STDs. The non consistent and correct use of condoms is putting people at risk for STDs.
Uninfected people can also take HIV drugs to protect themselves from infection. That might make people think they're even safer from HIV. Researchers across the country found that people at high risk of HIV who took the drugs in a practice called pre-exposure prophylaxis or PrEP almost never caught HIV, but they did catch syphilis and gonorrhoea. There is some data suggesting that there is less condom use in some populations now. As for Chlamydia, Dr Bolan thinks it's mostly a matter of better reporting that's driving the record numbers of reported cases. Chlamydia has been a very common sexually transmitted infection for years.
- Centers for Disease Control and Prevention (CDC)