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Let's Talk About Sex...ually Transmitted Diseases

The number of sexually transmitted diseases continues to increase in the United States. Even in the midst of the COVID-19 pandemic, 2.5 million cases of STDs were reported in 2021. According to the Centers for Disease Control and Prevention (CDC), chlamydia, gonorrhea, and syphilis cases increased the most. Congenital syphilis cases alone surged 32% and caused 220 stillbirths and infant deaths.

The CDC urges an increased in condom use, STD testing, and sex education to help combat the surging number of cases. Additionally, many people don’t feel at risk, and their attitudes towards STDs—also called sexually transmitted infections or STIs—keep them from being tested and getting treatment.

“Embarrassment and misinformation may be allowing an epidemic of sexually transmitted diseases to flourish in the United States,” says Andrew Pavia, MD, chief of the Division of Pediatric Infectious Diseases at University of Utah Health. “There can be a sense of shame or stigma about STDs that get in the way of good care.”

High-Risk Populations

Historically, some populations are more at risk for STDs. Younger men and women, men who have sex with other men, and historically disadvantaged groups traditionally have higher rates of infection. 

“If you’re sexually active outside of a long-term mutually monogamous relationship you may be at risk,” Pavia says.

Another group that may be overlooking their STD status—and definitely shouldn’t be—is pregnant people. STDs, like chlamydia, gonorrhea, syphilis, and trichomoniasis, can be treated and cured with antibiotics that are safe to take while pregnant. Infections that aren’t treated can be passed on to the fetus and can lead to serious health complications or even death.

“Pregnant women should get tested for HIV, hepatitis B, syphilis, gonorrhea, and chlamydia,” Pavia says. “Syphilis in infants is on the rise in Utah and the US. If undetected, it can have devastating consequences for the infant, but effective treatment is available.”

The same is true for HIV. With proper treatment of HIV during pregnancy, Pavia says there is essentially no chance of transmission from an HIV-positive woman to her child, and she can have a healthy baby. 

Infants aren’t the only ones at risk for long-term health complications from STDs. Leaving an infection undetected and untreated can cause serious problems—even if there are no symptoms. 

“The long-term complication that impacts the greatest number of people is infertility related to untreated chlamydia. And untreated syphilis in adults can attack the brain, spinal cord, eyes, or the heart. Hepatitis C or hepatitis B cause chronic liver problems if untreated and can lead to cirrhosis and liver cancer."
Andrew Pavia, MD

Health Care Inequalities

While STDs impact everyone, there are inequities in health care. A decrease in funding for public health may have decreased access to affordable and confidential STD care for many people. The COVID-19 pandemic increased this awareness of social and economic barriers.

Research has shown that STDs disproportionately impact women and disadvantaged groups, including Black, Hispanic, and Native American people.

STD's are Preventable

Stopping the spread of STDs isn’t only about detection and treatment but also prevention. Condoms are still effective protection for most STDs, but for one common STD, there is a vaccine. 

The human papillomavirus (HPV) vaccine is one of the most important vaccines for you and your child. About 13 million people in the United States are infected with HPV each year, and there is no cure. 

“HPV can cause cancer of the cervix, throat, penis, and anus—but the HPV vaccine is extremely effective,” Pavia says. “Sadly, many of the people who could benefit haven’t been vaccinated yet.”

Ignoring the spread of STDs in the United States won’t make them go away. In fact, lack of education and discussion about STDs could be a reason they continue to rapidly spread. 

“We need to change course and be open about discussing sexual health, the need for STD testing, where testing is available, and how simple treatment can be,” Pavia says. “Starting these discussions is the first step in making changes and reducing harm.”

You can learn more about the CDC’s guidelines for STD testing here.