Pennsylvania state health officials are reporting increased amounts of sexually transmitted infections, in particular syphilis, prompting officials to encourage the public to take steps to decrease their risk.
Pregnant women should be screened at first and third trimester because of the sharp increase in the number of babies born with the disease in the United States. Nationally, cases of congenital syphilis increased by 185 percent between 2014 and 2018. In 2019, five congenital syphilis cases were reported in the state of Pennsylvania, following seven cases reported in 2018. These reported cases of congenital syphilis in the state represented the highest number of cases in more than 25 years.Early syphilis in Pennsylvania is currently at the highest rate in more than 20 years. Over the last five years, early syphilis reported in women of child-bearing age (women aged 15 to 44) increased 114 percent, from 78 cases in 2015 to 167 cases in 2019.
“Sexually transmitted diseases are serious diseases that impact many Pennsylvanians each year,” Acting Secretary Beam said. “It is essential that all residents are aware of the risks and dangers associated with STDs. Many of these diseases can be easily diagnosed and treated, which is why we encourage all residents to talk to their doctor about getting tested so we can further prevent diseases and keep our residents healthy.”
While the eyes of the nation are on the coronavirus pandemic, another threat to public health has been steadily growing in the United States. We’ve been battling rising rates of sexually transmitted infections (STI) for the last several years. In fact, 2020 marks the fifth consecutive year of increasing rates of gonorrhea, chlamydia and syphilis in the U.S., due in part to significant funding cuts to more than 50% of the nation’s public health STI programs. And now the COVID-19 pandemic has placed an even greater burden on our strained public health system and supply chains, shifting focus from one major public health issue to another.
We can’t risk losing one critical resource that will be essential to ending the STI epidemic — the availability of free and confidential STI testing for adolescents. Prior to the pandemic, national public health efforts were scaling up to improve STI and HIV testing, and quickly link youth to prevention services. Rapid identification and treatment of STIs not only has public health benefits in terms of lowering transmission, but when left untreated, STIs increase the risk of infertility, severe pelvic infection, chronic pelvic pain, ectopic pregnancy and HIV transmission.
While accounting for 25% of the population, adolescents and young adults comprise over 50% of STIs in the U.S. each year. Black, Latinx, and LGBT youth face the greatest burden of infections and risk of complications. Fortunately, significant advances have been made over the last several decades to improve rates of STI and HIV testing among adolescents and young adults. The American Academy of Pediatrics now recommends HIV screening by the age of 16-18 years for all youth regardless of their sexual activity.
Combined cases of syphilis, gonorrhea, and chlamydia reached an all-time high in the United States in 2018, reaching 2.4 million cases. This marked the fifth consecutive year of sharp increases in STDs. For more than a century, sexually transmitted disease (STD) clinics have provided critical prevention and care for these common infections. Today, data show that STD clinics serve a high volume of racial/ethnic minorities, gay and bisexual men, and transgender people, and that they have become a primary source of both STD and HIV prevention services for people without regular access to healthcare.
As a result, STD clinics will play a vital role in the nation’s ambitious federal initiative Ending the HIV Epidemic: A Plan for America (EHE). However, these clinics are vastly under-resourced. An FY2020 investment from the HHS Minority HIV/AIDS Fund (MHAF) aims to address that by bolstering training and technical assistance (T/TA) efforts so STD specialty clinics can better provide HIV prevention services.
Leveraging the infrastructure and expertise already in place through this dynamic collaborative, the HHS MHAF investment will allow the NNPTCs to provide effective T/TA to enhance and scale up HIV prevention services, like pre-exposure prophylaxis (or PrEP) and post-exposure prophylaxis (or PEP) provision, in STD specialty clinics. Activities could include, for example, providing onsite or distance-based (web or phone) consultations, guidance to conduct clinic assessments, in-person site visits, and resources. These efforts will strengthen the clinical, laboratory infrastructure, and health delivery systems of STD specialty clinics serving a high proportion of racial/ethnic and sexual minorities in EHE jurisdictions.
Bruce W. Furness, M.D., M.P.H., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues developed and evaluated a quality improvement initiative (Transforming Primary Care for LGBT People) to enhance the capacity of 10 federally qualified health centers (FQHCs; 123 clinical sites in nine states) to provide culturally affirming care.
The researchers found that FQHCs reported increases in culturally affirming practices, including collecting patient pronoun information (42.9 percent increase) and identifying LGBT patient liaisons (300.0 percent increase). Based on sexual orientation and gender identity (SOGI) from electronic health records among nine FQHCs, SOGI documentation increased from 13.5 to 50.8 percent of patients. Screening of LGBT patients increased from 22.3 to 34.6 percent for syphilis, from 25.3 to 44.1 percent for chlamydia and gonorrhea, and from 14.8 to 30.5 percent for HIV among the eight FQHCs reporting the number of LGBT patients.
“FQHCs participating in this initiative reported improved capacity to provide culturally affirming care and targeted screening for LGBT patients,” the authors write.
As clinics and health departments across the country have shuttered during the coronavirus pandemic, the nation’s roughly 2,200 disease detectives, the so-called “contact tracers” of infectious disease outbreaks, have been re-deployed to track where cases of COVID-19 — the disease caused by the novel coronavirus — are spreading, to try to stop those outbreaks in their tracks. It’s a necessary shift, but one that may have serious, long-term impacts for the country’s sexual health, and for President Trump’s year-and-a-half-old plan to “eliminate” HIV from the US by 2030.
[…] According to a recent NCSD survey of HIV and STD disease tracers around the country, 83% are forgoing their usual field visits as a result of this pandemic. Two-thirds of the country’s clinics (66%) have also reported decreases in health screenings and testing due to COVID-19.
Vaginal swab samples collected by patients performed similarly to lab-based molecular diagnostics for chlamydia and gonorrhea testing, therefore supporting the use of a new 30-minute point-of-case assay, according to findings published in JAMA Network Open.
“The new binx io CT/NG assay can facilitate a complete paradigm shift in how we offer testing for the two most commonly reported notifiable diseases in the United States — chlamydia and gonorrhea,” Barbara Van Der Pol, PhD, MPH, professor of medicine and public health at the University of Alabama at Birmingham and president of the American STD Association, told Healio. “Rates of infection with chlamydia and gonorrhea continue to rise, suggesting the need for additional tools in order to effectively reduce the burden of disease. Providers can now identify and treat infections (that are predominately asymptomatic) during a single office visit to prevent transmission and development of sequelea.”
[…] “Sample-first collection by clients seeking sexual health care (or who are eligible for routine screening according to the CDC guidelines) immediately upon arrival at the clinic can enable rapid, accurate results that allow the provider to offer both accurate treatment and appropriate counseling,” Van Der Pol said. “This is the first truly rapid molecular assay for chlamydia and gonorrhea. It is a breakthrough development.”
The CDC recommends regular testing for bacterial sexually transmitted diseases (STDs) among all sexually active gay, bisexual, and other men who have sex with men (MSM) because they have a higher risk of infection. Chief among these STDs are gonorrhea, chlamydia, syphilis, and hepatitis C virus (HCV). Those most at risk also should be receiving recommended STD counseling services.
“Having an STD (like gonorrhea) makes it easier to get HIV or give it to others, so it’s important that you get tested to protect your health and the health of your partner,” states the CDC.
Despite these guidelines, there has been a constant uptick in STDs over the past decade, particularly among HIV-positive MSM, even though they are receiving care for their HIV, according to the authors who investigated the receipt of STD testing and associated services among these individuals and published their results online today in Annals of Internal Medicine.
The primary outcome of their study was to determine both deficiencies in bacterial STD testing and what risky behaviors result in these deficiencies among HIV-positive MSM—especially because having an STD increases the risk of transmitting HIV.
The pandemic that has upended life in the U.S. could lead to increased STD rates and setbacks in the fight against HIV as public health resources are shifted to the coronavirus response.
Access to STD and HIV testing and treatment services are dwindling as local health departments shuffle staff to respond to COVID-19 and clinics reduce hours or close altogether and cancel outreach programs.
“We are seeing a complete disruption to STD prevention here in the United States,” said David Harvey, executive director of the National Coalition of STD Directors (NCSD). “We expect to experience even higher STD rates as a result.”
Despite cases of several sexually transmitted infections reaching a record level in the U.S., a large majority of people aren’t aware of how common they are among the nation’s adults, according to newly released survey results.
The poll from the Kaiser Family Foundation found that only 36% of those surveyed were aware that STIs such as gonorrhea, chlamydia, genital herpes, syphilis and human papillomavirus, or HPV, have become more common in recent years, with 38% responding that they “don’t know enough to say.” An even smaller share – 13% – knew that more than half of people in the U.S. will get an STI sometime during their life.
Those results came even as the poll also found that a slight majority (54%) of those surveyed said they personally knew someone – themselves included – who had ever contracted an STI such as gonorrhea, chlamydia or syphilis. Larger shares of women and younger adults said they personally knew someone who has had an STI, according to a KFF report on the survey.
Also, according to CDC research, cases of gonorrhea, chlamydia and syphilis have risen for the fifth consecutive year.Some STIs (including HIV) can go unnoticed since symptoms can be mistaken for minor health problems like a cold or sore throat. Some may have no symptoms at all. The only way to know for sure if you’re infected is to get tested.
If you send us your zip code, we can help find local testing near you. Most are free. You can also ask us questions about basic sexual health, including PrEP. Send a message to m4mInformation@pitt.edu. We’re here to help.