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STD rates remained high during the first year of the pandemic

A 1971 microscope image shows Neisseria gonorrhoeae bacteria, which causes gonorrhea. (CDC/AP)
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The number of cases of some sexually transmitted diseases increased during the first year of the pandemic, officials said Tuesday, continuing a rise seen over the last decade.

Syphilis and gonorrhea cases increased in 2020, as screening clinics closed and people put off regular doctor visits, according to an annual report published by the Centers for Disease Control and Prevention on Tuesday. Fewer chlamydia cases were recorded than in past years, but experts say that decrease was due to reduced testing rather than a true decline in the disease’s prevalence.

The pandemic further disrupted already-eroding efforts to combat the growing STD problem in the United States, as health-care resources were focused on treating covid-19 patients. Shutdown measures and social distancing led to a brief drop in STD cases in the first months of the pandemic, but rates steadily climbed from there.

“The more you test, the more you find,” said Leandro Mena, director of the CDC’s Division of STD Prevention. “We know there’s much to be done to expand STD prevention in the United States.”

The United States recorded 2.4 million STD cases in 2020, according to the CDC report, slightly lower than the 2.6 million documented in 2019. Some diseases hit record highs despite the slight dip overall.

Congenital syphilis, which affects newborns who contract the disease from their mother, hit a new high of 2,148 cases in 2020, up a striking 235 percent since 2016.

“The consequences of congenital syphilis are the most severe,” Jonathan Mermin, director of the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, said at a news conference Tuesday. The disease can cause lifelong health issues for infants who contract the disease and lead to miscarriages and stillbirths.

Syphilis in newborns has been steeply increasing and spreading across the nation over the last decade: In 2011, only 26 jurisdictions in the United States reported a case, but by 2020, 49 jurisdictions — 47 states, D.C. and Puerto Rico — had at least one case. Mena said congenital syphilis rates are particularly concerning because every case of syphilis in a newborn could be prevented with proper testing and treatment of pregnant patients.

Other diseases also rose in 2020. Gonorrhea increased by 10 percent, and primary and secondary syphilis — the most contagious form of syphilis in adults — increased by 7 percent from 2019 to 2020.

The only disease to drop was chlamydia, which declined 13 percent. But the CDC report warns that the dip may be largely attributed to reduced screenings and delayed care. Because chlamydia is often asymptomatic in both men and women, many people only find out that they are infected through routine screenings. Many of those screening efforts fell by the wayside during the pandemic as the coronavirus overwhelmed the health-care system.

All three STDs are curable with antibiotics but can have severe and long-term health effects if left untreated.

The National Coalition of STD Directors said that the CDC report showed a troubling backward slide in the fight against sexually transmitted diseases in the United States and urged Congress to invest in prevention efforts and clinics dedicated to treating STDs.

“This affirms once again that America isn’t taking the STD crisis seriously,” David C. Harvey, executive director of the group, said in a statement Tuesday. “We can only fight this out-of-control epidemic with new funding and the kind of urgency that reflects the enormity of this crisis.”

Some populations experienced higher STD rates in 2020, including racial and ethnic minority groups, gay and bisexual men, and young people. Mena said efforts to improve access to health care could mitigate these disparities, as well as addressing the discrimination and stigma that prevents some people from receiving adequate care.

“The U.S. is a place where STIs can be prevented,” Mena said, referring to sexually transmitted infections. “This really can become a reality.”

The CDC’s 2020 data showed:

  • Adolescents and young adults ages 15 to 24 accounted for nearly two-thirds of all reported chlamydia cases.
  • There were higher rates of gonorrhea among men than women, and gay and bisexual men accounted for about a third of reported cases.
  • Primary and secondary syphilis rates decreased slightly among gay and bisexual men in 2020, though they still accounted for more than half of all cases.
  • Primary and secondary syphilis rates among women increased sharply, jumping by 21 percent between 2019 and 2020 and 147 percent between 2016 and 2020.
  • Congenital syphilis increased by 15 percent since 2019 and 254 percent since 2016.
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