Infections reach epidemic levels, highlighting the importance of testing and treatment.
The numbers of sexually transmitted diseases in California are nearing record levels, following a national trend that has medical professionals calling for more testing, treatment, and condom use.
And the recently released California statistics for syphilis, gonorrhea, and chlamydia have a frightening adjunct: The number of babies born with syphilis spiked 896% from 33 in 2012 to 329 in 2018, according to the California Department of Public Health (CDPH). Congenital syphilis can cause lifelong birth defects, blindness, hearing loss, and death.
Hardest hit by the STD epidemic are young people from ages 15 to 24, especially women, African Americans, and men who have sex with men. The CDC estimates that 25% of adolescent girls now have an STD.
The rising numbers are a reminder that prevention is paramount, said Jacek Skarbinski, MD, an infectious disease specialist at Kaiser Permanente medical centers in Oakland and Richmond. Sexually active people should see their doctors regularly, get tested and use condoms, he said. Kaiser Permanente follows the Centers for Disease Control and Prevention (CDC) guidelines for testing of adults and adolescents ages 15 to 65. The guidelines also call for screening pregnant women, and increased frequency of testing for men who have sex with men, and persons with HIV.
Lower Condom Use
“People have started using condoms less because they have other prevention strategies for HIV such as the preexposure prophylaxis, but unfortunately, condoms and frequent testing are the only prevention strategies for gonorrhea, syphilis and chlamydia,” said Dr. Skarbinski.
The 25,344 adults in California who tested positive for syphilis, a disease which can lead to neurological problems, grew 647% from 2000 through 2018, according to the CDPH. The number of cases in 2018 is slightly less than the 26,843 cases reported in 1945.
Gonorrhea, which can result in pelvic inflammatory disease and infertility in women and painful urination for men and women, grew 264% to nearly 80,000 from 2000 to 2018. And the number of chlamydia cases, which can also lead to infertility in women, grew 140% to 232,181 cases in 2018, which is the highest ever reported in California.
Weak Public Health Programs
Dr. Skarbinski said a reduction in public funding for education, testing, and treatment is partly responsible for the rise in numbers. He echoed a call by the CDC to “strengthen the local public health infrastructure” to help curb the epidemic.
“We are losing our ability to control these infections, not because we don’t have the tools, but mostly because we’ve cut the funding to our public health programs,” Dr. Skarbinski said. “On top of that, there has been this increase in condom-less sex, particularly in certain high-risk groups like with men who have sex with men. So, you see the numbers go up.”
Other societal factors like poverty, lack of health insurance, drug use, and unstable housing are contributing factors. In addition, many sexually active young people under age 24 don’t see doctors regularly because they feel relatively healthy, and if they have an STD, they may not have any symptoms.
Dr. Skarbinski said the alarming rise in STDs does not mean that people should abstain from sex to avoid an infection. But they should use condoms and get regular STD screening.
“We expect people to have sex,” he said. “It’s a natural human function, and we want people to be sexually active in a healthy fashion. If you’re going to be sexually active, the risks are STDs and HIV, so we want our members to receive care to keep them healthy.”