Reported cases of sexually transmitted diseases (STDs) in the United States decreased during the early months of the COVID-19 pandemic in 2020, but most resurged by the end of that year. Ultimately, reported cases of gonorrhea, syphilis, and congenital syphilis surpassed 2019 levels, while chlamydia declined, according to new data published today by the Centers for Disease Control and Prevention (CDC). The data provide the clearest picture yet of COVID-19’s impact on the U.S. STD epidemic.
The newly released 2020 STD Surveillance Report found that at the end of 2020:
Reported cases of gonorrhea and primary & secondary (P&S) syphilis were up 10% and 7%, respectively, compared to 2019.
Syphilis among newborns (i.e., congenital syphilis) also increased, with reported cases up nearly 15% from 2019, and 235% from 2016. Early data indicate primary and secondary syphilis and congenital syphilis cases continued to increase in 2021 as well.
Reported cases of chlamydia declined 13% from 2019.
Chlamydia historically accounts for the largest proportion of reported STDs in the United States. The decline in reported chlamydia cases is likely due to decreased STD screening and underdiagnosis during the pandemic, rather than a reduction in new infections. This also contributed to an overall decrease in the number of reported STDs in 2020 (from 2.5 million reported cases in 2019 to 2.4 million in 2020).
The Centers for Disease Control and Prevention (CDC) reports that some racial/ethnic groups are at higher risk for getting HIV than others.
CDC data shows that Black/African American communities account for a higher proportion of new HIV infections as compared to other races and ethnicities. In 2018, Black/African Americans accounted for 13% of the US population but 42% of new HIV diagnoses.
Similarly, in the same 2018 report, the CDC notes adult and adolescent Hispanics/Latinos made up 27% of the 37,968 new HIV diagnoses in the United States.
Why? Because these communities are impacted by demographic factors such as discrimination, stigma, and institutionalized health disparities—all of which affect their risk for HIV.
So what can we do?
People who know they’re infected can get into treatment and become HIV undetectable—which means the level of virus in the body is so low that it can’t be passed on to a sex partner. And people who know they’re not infected can take steps to prevent future infection by practicing safer sex (like using condoms) and taking the HIV prevention medication known as PrEP.
The first step, then, to preventing HIV is to get tested.
The good news is that anyone who resides in Pennsylvania can now get a free HIV self-test kit delivered in the mail.
“We created getmyHIVtest.com to make test kits available to anyone in the state who might be at risk for HIV,” explains Raymond Yeo, one of the project’s coordinators at the University of Pittsburgh. “Knowing your HIV status is key in the preventing HIV in our communities—especially those most at risk for new infections.”
The website, www.getmyHIVtest.com, provides easy-to-follow instructions and online form where PA residents can order their free kit, which typically arrives—in an unmarked package—within five to ten business days. Recipients of the kit are asked to provide basic demographic information and to take a follow up survey as a means to improve the program in the months ahead.
“This is a big development in the fight against HIV in Pennsylvania and we need all the input we can get,” added Yeo. “It’s unrealistic to think we can test everyone in the state so it’s important that we find ways to get our test kits into the hands of the people who need them the most.”
The Department of Health and Human Services announced that the Office for Civil Rights will interpret and enforce Section 1557 and Title IX’s prohibitions on discrimination based on sex to include: (1) discrimination on the basis of sexual orientation; and (2) discrimination on the basis of gender identity. Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in covered health programs or activities. The update was made in light of the U.S. Supreme Court’s decision in Bostock v. Clayton County and subsequent court decisions.
“The Supreme Court has made clear that people have a right not to be discriminated against on the basis of sex and receive equal treatment under the law, no matter their gender identity or sexual orientation. That’s why today HHS announced it will act on related reports of discrimination,” said HHS Secretary Xavier Becerra. “Fear of discrimination can lead individuals to forgo care, which can have serious negative health consequences. It is the position of the Department of Health and Human Services that everyone – including LGBTQ people – should be able to access health care, free from discrimination or interference, period.”
Discrimination in health care impacts health outcomes. Research shows that one quarter of LGBTQ people who faced discrimination postponed or avoided receiving needed medical care for fear of further discrimination.
An open letter from Deron C. Burton, MD, Acting Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the Centers for Disease Control and Prevention…
March 10 is National Women and Girls HIV/AIDS Awareness Day (NWGHAAD), sponsored by the U.S. Department of Health and Human Services’ (HHS) Office on Women’s Health. As we continue our work toward ending America’s HIV epidemic, we acknowledge the challenges the COVID-19 pandemic has presented. For some women, the impact of COVID-19 has made it more difficult to access HIV services. On NWGHAAD, join us in making sure all women have continued access to HIV testing (including self-testing), prevention, and treatment and care. Together, we can prevent new HIV infections and help women with HIV stay healthy.
In recent years, we have seen progress toward reducing HIV diagnoses among women in the United States and dependent areas. From 2014 to 2018, HIV diagnoses decreased 7% among women overall, including a 10% decline among Black/African American women. While these numbers are encouraging, there is still much work to do to address gender and race-related disparities. In 2018, more than 7,000 women received an HIV diagnosis. Black/African American women made up 57% (4,097) of those diagnoses, followed by White women (21%; 1,491) and Hispanic/Latina women (18%; 1,269). Making the most of the full toolkit of HIV prevention and treatment strategies can raise awareness and help to prevent new HIV infections among women.
Many women without HIV can benefit from proven prevention options such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) and the related support services associated with these interventions. Women with HIV should be offered treatment and the appropriate services that help people with HIV get in care, stay in care, and adhere to antiretroviral therapy (ART) so that they become virally suppressed to protect their health and the health of their sexual partners. Condoms provide additional protection for women regardless of status to prevent HIV, sexually transmitted diseases, and unplanned pregnancy. Despite the promise of these tools to help end the HIV epidemic, they only work when the people who need them most can access them. Recent CDC data reveal that only 7% of women who could benefit from PrEP were prescribed PrEP. We must continue to help women get the tools they need to protect their health, including addressing structural barriers such as systemic racism that perpetuate health disparities.
As part of the HHS Ending the HIV Epidemic: A Plan for America initiative, CDC and other federal agencies are working together to prevent new HIV infections by ensuring everyone has access to HIV prevention options, such as PrEP. To address cost barriers, HHS launched Ready, Set, PrEP, a nationwide program that makes PrEP medications available at no cost to people who don’t have insurance that covers prescription drugs. The program also addresses transportation barriers by giving people a choice to have their PrEP medications sent directly to their home or health care provider. For women who don’t qualify for the Ready, Set, PrEP program, Gilead’s Advancing Access Program and other state PrEP assistance programs are available.
To raise awareness about the many HIV prevention options for women, we encourage you to download and use materials from CDC’s Let’s Stop HIV Together campaign. The new materials broaden our portfolio and build on the existing HIV prevention, testing, treatment, and stigma resources. You can also watch our new webisode, “Hey Friend: Let’s Talk Sexual Health,” which features Black women discussing sexual health. On NWGHAAD, keep the conversation going by sharing social media content from our digital toolkit using the #StopHIVTogether and #NWGHAAD hashtags.
Thank you for your continued commitment to HIV prevention during this challenging time. By ensuring women have equal access to quality HIV prevention and care services, we can achieve health equity and end the HIV epidemic.
Injectable long-acting cabotegravir (CAB LA) has been proven safe and highly effective in preventing HIV infection among cisgender women, according to interim results from a major study announced in late January. The findings complement previously established strong results for cabotegravir-based injectable pre-exposure prophylaxis (PrEP) in cisgender men who have sex with men (MSM) and transgender women who have sex men, adding to evidence that injectable PrEP could ultimately have greater real-world efficacy than daily oral PrEP in many populations, thanks to better adherence.
The new data come from HIV Prevention Trials Network (HPTN) Study 084, interim results of which were presented at the biennial HIV Research for Prevention (HIVR4P) conference, which took place virtually this year in late January and early February. “These results complement data from HPTN 083, and confirm cabotegravir as the first safe and effective injectable PrEP agent for cisgender women,” said Sinead Delany-Moretlwe, MBBCh, Ph.D., the protocol chair and director of research at the Wits Reproductive Health and HIV Institute within the University of the Witwatersrand in Johannesburg, who presented the study. “We hope that these results will lead to the expansion of HIV prevention options for at-risk cisgender women globally, and ultimately reductions or elimination of HIV acquisition.”
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.”
Among the principal reasons for recommending initiating antiretroviral treatment (ART) among pregnant patients who are HIV positive is to prevent transmission of the virus to their unborn children. This number was estimated at 1.3 million pregnant pregnant women, as of 2018. However, optimal treatment regimens remain unclear.
An international team of investigators published their study results earlier this month in Lancet HIV showing the superiority of ART containing raltegravir, an integrase inhibitor, compared with efavirenz, a nonnucleoside reverse transcriptase inhibitor. Both drugs are well established in their safety and efficacy for reducing the HIV viral load among nonpregnant patients, but the results of initiating them during pregnancy remain unclear. Is one superior?
Researchers at the National Institutes of Health (NIH) have found that the antiretroviral drugs, dolutegravir and emtricitabine/ tenofovir alafenamide fumurate (DTG+FTC/TAF), may comprise the safest and most effective HIV treatment regimen currently available during pregnancy.
The findings come from a multinational study of more than 640 pregnant women with HIV across 4 continents.
Previous research has demonstrated that antiretroviral therapy (ART) to suppress HIV prevents perinatal transmission of the virus and benefits the health of both mother and child. In the current study, 3 ART regimens were compared, showing that the regimens containing DTG were more effective in suppressing HIV than a commonly used regimen containing efavirenz (EFV).
This story is part of Made In Philly, a series about young residents shaping local communities.
When Shanaye Jeffers was in fourth grade, she often skipped touch football and double-dutch jump rope at recess to read a book on puberty. In fifth grade, she jumped at the chance to do a school project on childbirth.
Most girls don’t know about the inner workings of their bodies, sexual-health experts say — especially black teenage girls, who often face stigma against asking questions at home and are poorly served by sex-education school curriculums tailored for a white majority.
“Sex ed is not serving young black women really at all,” said Jeffers, now a 28-year-old obstetrics and gynecology resident at Thomas Jefferson University Hospital. She’s trying to change that. As Philadelphia site director for Daughters of the Diaspora, a nonprofit founded in 2012 to teach black teenage girls about reproductive health and self-esteem, Jeffers is working to give other girls the same knowledge and passion to take charge of their health that she had as a child.