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Sexually transmitted disease rates remain high in US, likely under-reported because of COVID-19

Reported cases of most sexually transmitted diseases in the United States have reached a record high for the seventh consecutive year after briefly dropping in the first months of the COVID-19 pandemic, health officials said.

In a report released Tuesday, the U.S. Centers for Disease Control and Prevention said reported cases of gonorrhea, syphilis, and congenital syphilis rose in 2020, surpassing the previous year’s all-time high.

At the same time, chlamydia cases declined, according to federal data, resulting in the overall number of reported STDs falling from 2.5 million reported in 2019 to 2.4 million in 2020. CDC officials attributed this decline to decreased STD screening and under-diagnosis during the pandemic, rather than fewer infections. Chlamydia historically represents the largest proportion of STDs in the United States.

Dr. Jonathan Mermin, the top CDC official for STDs, said that the COVID-19 pandemic exacerbated problems the agency has warned about for years, such as declining public health funding for STD prevention.

In 2020, reported cases of gonorrhea and primary & secondary syphilis increased 10% and 7% respectively compared to 2019 levels. Syphilis in newborns in particular has increased dramatically in recent years, rising 15% from 2019 and a whopping 235% since 2016, the CDC said.

“The unrelenting momentum of the STD epidemic continued even as STD prevention services were disrupted,” said Mermin.

Chlamydia cases declined about 13% from 2019, but again this decline was attributed to people being unable to visit their doctors to be diagnosed because of pandemic restrictions. Chlamydia can be asymptomatic in both men and women and only discoverable through routine screenings.

The CDC suggested that multiple other factors contributed to the initial decline in reported STD cases during the first few months of 2020, including health care providers shifting priorities to care for COVID-19 patients, STD test and laboratory supply shortages, people losing health insurance coverage because of unemployment, and telemedicine practices diagnosing cases that weren’t reported to the CDC.

Gonorrhea, syphilis, and chlamydia are each treatable with antibiotics, but can cause severe and lasting illness if left untreated.

Some racial minority groups, gay and bisexual men, and young people continue to experience higher rates of STDs compared to other groups, the CDC said.

According to CDC data, adolescents and young adults ages 15 to 24 accounted for nearly two-thirds of all reported chlamydia cases. Men were infected with gonorrhea more than women, with gay and bisexual men accounting for nearly a third of reported cases.

The agency said these disparities were likely due to differential access to quality health care, rather than differences in sexual behavior.

“The COVID-19 pandemic increased awareness of a reality we’ve long known about STDs. Social and economic factors – such as poverty and health insurance status – create barriers, increase health risks, and often result in worse health outcomes for some people,” said Dr. Leandro Mena, Director of CDC’s Division of STD Prevention.

“If we are to make lasting progress against STDs in this country, we have to understand the systems that create inequities and work with partners to change them. No one can be left behind,” she added.