Do I have an STD? How to Test for Chlamydia, Gonorrhea, and Syphilis
COVID-19 has disrupted both surveillance and prevention of sexually transmitted diseases, which have been on the rise for several years. The Centers for Disease Control and Prevention’s 2020 surveillance report says the surge likely continued during the pandemic, although authorities don’t have test results or the final tally to prove it.
The CDC said more than 2.4 million cases of chlamydia, gonorrhea, and syphilis were reported in the United States in 2020, down slightly from 2019. These three sexually transmitted infections are “notifiable” , which means that public health officials are supposed to be notified when a case is confirmed. The report doubts that any real decrease, however small, has taken place.
“In 2020, the COVID-19 pandemic has radically disrupted life as we know it, and while there were times when the world felt like it was coming to a standstill, sexually transmitted infections did not. weren’t,” Dr. Jonathan Mermin, director of the National Center for the Prevention of HIV, Viral Hepatitis, STDs and Tuberculosis, said at a press briefing.
The 2020 figures include more than 2,100 cases of congenital syphilis – the designation when babies are born with syphilis. That’s a 235% increase from 2016.
Gonorrhea increased by 10% between 2019 and 2020, while cases of primary and secondary syphilis increased by 7%. While reported cases of chlamydia fell by 13%, the center noted that “chlamydia infections are generally asymptomatic and identified by screening. Therefore, this decline is likely due to a decrease in STD testing and underdiagnosis during the pandemic, rather than a reduction in new infections.
The report says the South has the most cases of gonorrhea and chlamydia, followed by the Midwest. The West had the highest number of primary and secondary syphilis, followed by the South.
Early in the pandemic, health agencies saw fewer sexually transmitted diseases, but the cause was more likely to be less screening than any actual decrease in cases, the CDC said. He noted several disruptions due to the pandemic, including fewer people being screened; resources, including test kits, personnel and laboratory supplies, have often been diverted to fight COVID-19; some people have lost their jobs and therefore their insurance; and in some cases, patients were treated for symptoms during telehealth visits but did not get laboratory confirmation.
The early 2021 syphilis data suggests that the final numbers for the year will also show an increase when the final tally is complete.
The center said young people, certain racial and ethnic minorities, and gay and bisexual men bear the greatest burden of STDs.
“More than half of reported STDs were in young people between the ages of 16 and 24. Racial minorities, including blacks, Hispanics and Native Americans, were disproportionately affected, while 42% of primary and secondary syphilis cases were in gay and bisexual men,” according to a ScienceAlert report.
The CDC notes that sexually transmitted infections are often asymptomatic, but that doesn’t mean they’re mild. Even asymptomatic cases increase the risk of HIV infection. And infections can cause chronic pelvic pain, pelvic inflammatory disease, infertility, and pregnancy complications, including infant death.
The U.S. Department of Health and Human Services has a National Strategic Plan on Sexually Transmitted Infections that calls for prevention, improving outcomes for those infected, reducing health disparities, and improvement of research, among other objectives. Priority populations include adolescents and young adults, gay and bisexual men, and pregnant women.
The plan’s recommendations include setting up clinics for walk-in testing and treatment, working with pharmacies and retail health clinics, and more telehealth options.