STD epidemic continues to worsen, CDC says

Key points to remember:

• More than 1.64 million cases of chlamydia were reported to the CDC in 2021, making it the most common STD in the United States
• Primary and secondary syphilis cases increased by 28.6% from 2020 to 2021.

Final surveillance data released by the CDC on Tuesday confirmed that reported cases of chlamydia, gonorrhea and syphilis increased between 2020 and 2021 in the United States, totaling more than 2.5 million.

It was the last in a series of dire warnings on the continued increase in the three nationally notifiable STDs and the seventh time in 8 years that the total number of reported cases was higher than the previous year.

In a statement, the CDC said the United States “must deepen its engagement” to end the outbreak.

“It’s not business as usual – it’s a rapidly deteriorating public health crisis in a dangerous time,” David C. HarveyMSW, who leads the National Coalition of STD Directors, said in a statement. “Rates of STIs will continue to rise unless we take drastic action.”

Syphilis rates have jumped nearly 32% for all stages from 2020 to 2021, and the alarming increase in congenital syphilis continued, also with a 32% increase in cases, according to the CDC.

A total of 176,713 cases of syphilis have been reported, including 53,767 cases of primary and secondary (P&S) syphilis – a 28.6% increase – and 2,855 cases of congenital syphilis, including 220 stillbirths and infant deaths related to congenital syphilis.

Chlamydia was the most common STD in the United States in 2021, with a total of 1,644,416 cases reported to the CDC, an increase of 3.9% from 2020. Rates were highest among adolescents and young adults, with 58% of all chlamydia cases occurring in people. aged 15 to 24.

Yet chlamydia rates have not returned to pre-pandemic levels, demonstrating that STD testing likely continued to be affected by COVID-19-related disruptions in 2021 because, according to the CDC, chlamydia is generally asymptomatic. and case rates are “strongly influenced” by screening coverage.

A total of 710,151 cases of gonorrhea have been reported, making it the second most common STD in the United States. The CDC noted that gonorrhea rates have increased 118% since an all-time low in 2009. Cases have increased more than 4% from 2020 to 2021.

Data from the report also showed that there were significant disparities in the rates of reported STDs, especially among gay and bisexual men, young people and some racial minority groups.

According to the report, 50.5% of reported STD cases occurred in adolescents and young adults between the ages of 15 and 24. The report showed that 31% of all chlamydia, gonorrhea and P&S syphilis cases were reported in non-Hispanic blacks, even though they made up only about 12% of the US population, while Indians d America or Alaska Natives accounted for 3.6% of all congenital syphilis cases despite contributing less than 1% of all live births in the United States

Moreover, as demonstrated in previous years, men who have sex with men also continued to be disproportionately affected by STDs, including gonorrhea and P&S syphilis.

“United States STI epidemic shows no signs of slowing down. The reasons for the ongoing increases are manifold – as are the solutions,” Leandro Mena, MD, MPH, Director of the CDC’s STD Prevention Division, said in a statement. “For the first time in decades, we see promising new STD interventions on the horizon, but they alone will not solve this epidemic.”

Mena did not mention specific interventions, but studies continue to show that doxycycline can prevent STDs when taken after unprotected sex, and a large NIH trial is testing a meningococcal B vaccine against gonorrhea.

“It will take many of us working together to use new and existing tools effectively, to increase access to quality sexual health care services for more people, and to encourage continued innovation and prioritization of STD prevention and treatment in this country,” Mena said.

The references:

The STI epidemic in the United States showed no signs of abating in 2021 – cases continued to rise. https://www.cdc.gov/media/releases/2023/s0411-sti.html. Published April 11, 2023. Accessed April 11, 2023.

Rates of STIs in the United States have reached a new high. https://www.ncsddc.org/us-sti-rates-hit-another-high/. Published April 11, 2023. Accessed April 11, 2023.