The number of U.S. residents diagnosed with a sexually transmitted infection (STI) hit a record high in 2018, with almost 2.46 million reported cases of chlamydia, gonorrhea, syphilis, and other STIs, according to a CDC report released Tuesday.
STI cases rise to record high
According to the report, the rate of STIs has increased steadily since 2014, with reported syphilis cases increasing by 71% between 2014 and 2018, reported gonorrhea cases increasing by 63%, and reported chlamydia cases increasing by 19%:
The rate of gonorrhea cases in particular hit a 28-year high, with 583,405 cases reported. According to the report, the gonorrhea rate is highest among men, and in particular among men who have sex with other men (MSM).
CDC also said more than 115,000 cases of syphilis were reported in 2018, marking a 13% increase since 2017 and hitting the highest overall number of syphilis cases reported since 1991. Further, between 2017 and 2018, the rates of primary and secondary syphilis, the most infectious stages of the disease, increased by almost 14%, to 35,000 cases, the report found. The report stated that most of those cases were among MSMs, however rates also increased among women by 30% during that time period.
According to the report, this increase correlates with a spike in the number of babies born with congenital syphilis. When pregnant women with syphilis do not receive treatment, their babies might be born with congenital syphilis, resulting in stillbirths, preterm birth, and physical and mental disabilities, The Hill reports. The report found 1,306 cases of congenital syphilis, up by 40% since 2017.
Experts blame lack of funding
In the report, the authors blamed budget cuts at both the state and local levels for the increase in STI cases, as the cuts resulted in staff reductions and clinic closures, which in turn led to fewer screenings and patient follow-ups.
According to data from the National Coalition of STD Directors, CDC's annual STI prevention budget decreased in purchasing power by 40% between 2003 and 2018. Health departments used to track down everyone who tested positive for chlamydia, gonorrhea, or syphilis to ensure they and their sexual partners received treatment, Kaiser Health News reports. However, nowadays, most local departments—faced with increasing caseloads and limited funding—track only syphilis cases, and sometimes track only syphilis cases involving women of childbearing age or women who are pregnant, according to KHN.
Gail Bolan, CDC's director of STD prevention, in the report wrote, "The resurgence of syphilis, and particularly congenital syphilis, is not an arbitrary event, but rather a symptom of a deteriorating public health infrastructure and lack of access to health care."
Bolan added that the current public health infrastructure "is exposing hidden, fragile populations in need [who] are not getting the health care and preventive services they deserve. This points to our need for public health and health care action for each of the cases in this report, as they represent real people, not just numbers."
Jeffrey Klausner, a professor at the University of California, Los Angeles who ran San Francisco's STI program for over a decade, said, "A lot of the funding for day-to-day public health work isn't there." He added, "It takes money, it takes training, it takes resources, and policymakers have just not prioritized that."
According to The Hill, the National Coalition of STD Directors has urged Congress to increase funding for STI prevention services by $70 million, saying it would be the "bare minimum" for CDC to support an effective response to the current STI outbreak. David Harvey, executive director of the group, said there is an STI "crisis" in the United States "because prevention programs were sold short for years. Our first line of defense is underfunded and overwhelmed, leaving Americans vulnerable to ST[I] outbreaks, and that's exactly what we're seeing."
Harvey added, "ST[I]s have real health and human costs. Babies dying from preventable conditions, like congenital syphilis, is not an outcome we can accept. This is a heartbreaking symptom of our nation's ST[I] crisis. Without a radical shift in how we prioritize sexual health in the United States, we can only expect things to get worse" (Borter, Reuters, 10/8; Hellmann, The Hill, 10/8; AP/Modern Healthcare, 10/8; Barry-Jester, Kaiser Health News, 10/8).