A new report from the Centers for Disease Control and Prevention (CDC) shows that sexually transmitted disease (STD) rates for 2015 were the highest ever recorded, with men who have sex with men (MSM) accounting for most new gonorrhea and syphilis cases.
The annual Sexually Transmitted Disease Surveillance Report released yesterday showed more than 1.5 million chlamydia cases reported in 2015, 395,216 cases of gonorrhea, and 23,872 cases of primary and secondary (P&S) syphilis. The largest increase in cases reported from 2014 to 2015 occurred in P&S syphilis cases, which jumped 19% from 2014 to 2015. Gonorrhea increased by 12.8%, and chlamydia by 5.9%.
"Chlamydia, gonorrhea, and syphilis are curable, but the new numbers make it clear that many Americans are not getting the preventive services they need," Donnica Smalls, MA, a health communications specialist with the CDC, told CIDRAP News. "We know that this is the second year in a row that all three reportable STDs have increased substantially."
Researchers called the trends "alarming," especially because young people ages 15 to 24 were the most likely to report new gonorrhea (50% of all infections) and chlamydia (65%) infections in 2015.
"We have reached a decisive moment for the nation," said Jonathan Mermin, MD, MPH, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, in a CDC press release. "STD rates are rising, and many of the country's systems for preventing STDs have eroded. We must mobilize, rebuild and expand services—or the human and economic burden will continue to grow."
The report said more than half of state and local STD programs experienced budget cuts in the last 10 years, and more than 20 health department STD clinics closed in 2015. The closures prevent early treatment for these STDs, many of which can be cured with antibiotics. The CDC estimates STD cases cost the healthcare system nearly $16 billion each year.
STDs affect women, newborns
Besides incurring high healthcare costs, STDs can have devastating health consequences, including stroke, miscarriage, stillbirth, and congenital infection.
The CDC's report said that although both men and women suffer when STDs are untreated, undiagnosed STDs are the cause of infertility in more than 20,000 women each year. Gonorrhea and chlamydia are often asymptomatic in women, and 10% to 20% of women who contract these STDS will go on to develop pelvic inflammatory disease (PID), which can cause infertility, miscarriage, and pelvic pain.
Moreover, the report showed a rise in congenital STD infections, which are passed from mother to child during birth. Chlamydia and gonorrhea can both cause premature delivery, premature rupture of the membranes, and low birth weight if left untreated in pregnancy.
Women's rate of syphilis diagnosis increased by more than 27% from 2014 to 2015. Congenital syphilis increased by 6% (a total of 487 cases). Though women still account for only 10% of syphilis cases, the rate of reported P&S syphilis cases among women increased to 1.1 per 100,000 females in 2014, and then increased 27.3%, to 1.4 cases per 100,000 females during 2015.
"The health outcomes of syphilis—miscarriage, stillbirth, blindness or stroke—can be devastating," said Gail Bolan, MD, director of the CDC's Division of STD Prevention. "The resurgence of congenital syphilis and the increasing impact of syphilis among gay and bisexual men makes it clear that many Americans are not getting the preventive services they need. Every pregnant woman should be tested for syphilis, and sexually active gay and bisexual men should be tested for syphilis at least once a year."
Disease increase in MSM
MSM are most vulnerable to STDs, according to the report. They have the highest rate of new gonorrhea infections, including antibiotic-resistant gonorrhea. And gay and bisexual men account for 82% of new syphilis cases. Syphilis can make a person more prone to HIV infection, according to the CDC.
MSM in the lower socioeconomic brackets are most at risk for STDs, which highlights a bigger problem shown in the report: The uninsured and the poor have higher rates of infection than their insured and middle-class peers.
"STD prevention resources across the nation are stretched thin, and we're beginning to see people slip through the public health safety net," said Mermin.
Oct 19 CDC full report
Oct 19 CDC press release