Public health advocates are continuing to sound the alarm on STD rates as they continue to rise for the fifth straight year in the U.S. 

“Trends have continued to worsen over the past year,” said Matthew Prior, Director of Communications for the National Coalition of STD Directors. “There are no signs of slowing down.”

Jeffrey D. Klausner, Professor of Medicine and Public Health at UCLA agreed saying “this is a continuation and long standing trend since the great recession.”

Klausner said the federal government has no plan to combat the STD epidemic. 

“They told us a plan was underway,” he said. “Where is this plan? This is great time to release the plan.”

A recent report from the Centers for Disease Control showed in 2018, about 2.4 million cases of STDs were diagnosed. It marks the highest number ever reported, by more than 100,000 (the record previously set in 2017).

Chlamydia, which makes up the lion’s share of infections, increased 3 percent over last year to more than 1.7 million cases – the most ever reported to the CDC.

“The rates of STDs we see nationally are a disaster for our collective health and an expensive lesson in the need for consistent, non-judgmental and effective public health services,” said Whitney Engeran-Cordova, senior director for public health for AIDS Healthcare Foundation.

The numbers above include a 19 percent increase in chlamydia since 2004; 63 percent increase in gonorrhea since 2004; a 71 percent increase in primary and secondary syphilis since 2004; and a 185 percent increase in congenital syphilis (babies born with syphilis) since 2004.

Congenital syphilis rates are especially alarming to public health advocates.   

“How many more babies have to die from syphilis that someone says this is an emergency?” Klausner asked. “A dozen vaping related deaths and it’s on the front page of the news and TV every day.” 
-Jeffery Klausner, Professor of Medicine & Public Health @ UCLA

 Klausner also cites stigma surrounding STDs as a major obstacle in combating the epidemic. 
Professor Jeffrey Klausner MEDiCiNE AND PUbiC HEAlTH UClA

“Stillbirths are still very stigmatized,” he said. “Everyone blames the mother, like she did something wrong.” 

Congenital syphilis is very dangerous to a fetus. According to the CDC up to 40 percent of babies born to women with untreated syphilis may be stillborn, or die from the infection as a newborn.

It can also cause miscarriage, prematurity, and low birth weight. 

“Any death associated with a case a syphilis or congenital syphilis is a public health failure and shouldn’t happen,” Prior said. 

The NCSD is urging the federal government to allocate an additional 70 million to combat the STD crisis.

“That’s a fraction of less than one percent of the entire CDC budget. STD funding has remained pretty stagnant over the past 15 years,” Prior said. “When you adjust for inflation it’s really a 40 percent reduction in buying power from 15 years ago.”

Last year SFGN wrote extensively about the growing STD epidemic. 

In regards to syphilis public health officials went from “plans to eliminate [the STD] to a public health crisis,” Adam Sukhija-Cohen, the Director of Advocacy and Policy Research for the AHF previously told SFGN. “This is an insane resurgence.”

Sukhija-Cohen noted last year that at the turn of the century public health officials were preparing for the elimination of syphilis in the U.S. but then “the CDC budget has decreased by a third since early 2000s.”

There are many factors involved in why STD rates are increasing.

Here are the reasons the CDC listed in a press release announcing the dire STD numbers. 

•          Drug use, poverty, stigma, and unstable housing, which can reduce access to STD prevention and care

•          Decreased condom use among vulnerable groups, including young people and gay and bisexual men

•          Cuts to STD programs at the state and local level – in recent years, more than half of local programs have experienced budget cuts, resulting in clinic closures, reduced screening, staff loss, and reduced patient follow-up and linkage to care services

But many public health advocates cite the decrease in federal funding as a main cause. 

Prior though commended President Donald Trump for his push to end the HIV epidemic and the recent increases in HIV funding, but also warned “we won’t end the HIV epidemic on the back of an exploding STD epidemic.”

Prior noted that STDs drive about 1 in 10 new cause new cases of HIV. 

Locally Stephen Fallon, Executive Director of Latinos Salud is also seeing the discrepancy between HIV and STD funding.   

“Latinos Salud holds several grants for HIV testing, prevention and linkage services. Funding for STD testing has long fallen short of our needs,” Fallon said. “Our agency's lab fees for examining multiple STD specimens per client have at times exceeded $10,000 per month, while our grants allow us to allocate scarily one-quarter of that amount to STD screening.”

The STD screenings for 2019 cost Latinos Salud more than $120,000 through September. The organization had a grant that covered the costs through April. 

“After that, we’re allowed to write off a portion under our HIV grants,” Fallon explained. 

Despite the costs Fallon said Latinos Salud is committed to tackling the STD epidemic locally.  

“We chose to continue offering our STD screening free of charge, by investing its general revenue to underwrite the costs,” he said. 

Fallon also noted that the Florida Department of Health in Broward County just renewed a small contract that “will help us with these costs through mid-2019.”

Fallon said last year his organization diagnosed 527 clients with gonorrhea, chlamydia or syphilis, and as of October of this year they have already diagnosed over 400. 

“By getting clients into immediate treatment, and curing these contagious STDs, we are breaking the cycle of new infections,” he said. “Also, since STDs ‘amplify’ the odds of transmitting HIV, stopping STDs helps curb our new HIV infections in the community.”

Gay and bisexual men are disproportionately affected by the STD crisis. 

According to the CDC report men who have sex with men (MSM) made up 54 percent of all syphilis cases in 2018, while gonorrhea diagnoses have nearly doubled among men over the past five years (the CDC fact sheet doesn’t state how many of those cases are MSM). 

Last year Klausner told SFGN STDs requires a public response. 

“STDs are public health issues. They are not controlled with better primary care. It takes special knowledge, special training, and special management.” He added this year. “We have to shift the issues away from personal responsibility to public accountability. We need robust public health programs. We can control these infections. They are readily treatable. But for public health to work, it has to be funded.” 

Last year Klausner pointed to the Broward Wellness Center, a joint venture between the Florida Department of Health and AHF, as a very effective model.

“Broward has the newest and most advanced testing and treatment program in the United States. That’s a breakthrough in terms of sexual health services. There is no reason, other than funding, that this couldn’t be replicated in urban areas around the United States,” Klausner said last year.

AHF’s Engeran-Cordova added, “In Broward County we have an unparalleled partnership with the health department. We are seeing and treating record numbers of patients daily at our Broward Wellness Center with innovative strategies to diagnose and treat people faster and more effectively. It should be a model for not just Florida but beyond.”