America’s sexually transmitted disease rates are out of control
Sexually transmitted infections (STIs) are still on the rise in the United States, according to the latest data from the Centers for Disease Control and Prevention (CDC). On Tuesday the CDC released a report on statistics from 2018, which indicate historic rates of chlamydia and the worst rates of syphilis and gonorrhea since 1991. Most concerningly, the CDC reports a 40 percent increase in congenital syphilis—a potentially fatal and totally preventable condition where infection passes from a parent to a fetus through the placenta—since 2017. This represents the fifth year in a row that STIs have hit all-time highs.
In 2018, Jonathan Mermin, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention noted that rising infection rates showed we were “sliding backward,” with “systems that identify, treat, and ultimately prevent STDs… strained to near-breaking point.” The latest report makes it clear those systems have all but crumbled.
Here’s everything you need to know.
Are STIs and STDs the same thing? Which STDs are on the rise?
First, a little clarification: The CDC uses the acronym “STD” in its reports, which is short for sexually transmitted disease. But when we speak broadly about sexual health, sexually transmitted infection (STI) is actually more accurate. Many infections do not turn into “diseases,” which are afflictions that alter the body’s function. Herpes, for example, fails to cause symptoms in the vast majority of people infected with it.
Generally, STI covers more bases than STD. But since the CDC’s report focuses on people who’ve been diagnosed with infections by a doctor, it sticks with the older, more familiar acronym: STD.
So, for the purposes of understanding the CDC’s reports, STDs and STIs are one and the same. But when the CDC says STD rates are at an all-time high, they don’t necessarily mean all sexually transmitted diseases have hit peak numbers.
The CDC’s annual report focuses on chlamydia, gonorrhea, and syphilis, which are by far the most common infections primarily transmitted through sex (lots of random viruses and bacterial plagues can be transmitted through various forms of sexual activity, as anyone who’s ever dated someone with the flu can tell you, but you won’t catch chlamydia from a cough). HIV is reported separately, and overall case rates have actually remained stable in recent years.
How have infection rates changed?
In 2018 (the CDC’s reports always lag behind by nearly a year, as it takes time to compile and analyze all the data), all three of the most commonly reported STIs saw an increase.
The CDC received 580,000 reports of gonorrhea, which represents a 5 percent increase since 2017 and marks the worst year for the bacterial infection since 1991. Cases have surged by a staggering 63 percent since 2014. Chlamydia broke an all-time record, hitting 1.7 million cases (which amounts to a 3 percent rise since 2017 and a 19 percent rate increase since 2014.
Syphilis is a bit more complex, as the bacterial infection presents in several stages if it’s not treated with antibiotics. But cases of the most infectious first and second stages increased by 14 percent, hitting 35,000—the highest number since 1991.
The CDC is most concerned about the large uptick in congenital syphilis in newborns, which can cause serious health problems throughout adulthood. The CDC received reports of 1,300 cases in 2018, representing a 40 percent increase. Related fatalities also increased by 22 percent. Those 94 infant deaths were completely preventable, as syphilis can easily be treated with antibiotics if patients have access to testing and healthcare.