Syphilis infections increased by 10% compared to 2019, while congenital syphilis increased by 15% and there was a 7% increase in gonorrhea. Most worrying is that congenital syphilis has increased by 235% since 2016. Chlamydia, which accounts for the largest percentage of sexually transmitted infections (STIs) in the United States, was down 13 percent from a year earlier. This has been attributed to the fact that chlamydia are asymptomatic and are usually detected during sexual health testing, which was disrupted during the pandemic. The STD Surveillance Report 2020 found 1,579,885 reported cases of chlamydia, 677,769 cases of gonorrhea, 133,945 cases of syphilis and 2,148 cases of congenital syphilis, resulting in 149 deaths and infants. Overall, 61% of chlamydia cases were between the ages of 15-24, while men who had sex with men (MSM) accounted for 53% of all syphilis cases. Jonathan Mermin, MD, director of the National Center for HIV, Viral Hepatitis, Sexually Transmitted Diseases and Tuberculosis Prevention, said the COVID pandemic came at a difficult time in controlling STDs, thanks to a ” collapsing public health infrastructure “. He added that various factors combined to worsen the incidence of STIs, such as the diversion of public health workers to respond to the COVID pandemic, the lack of health insurance coverage due to unemployment and the reduced frequency of STIs due to fewer Men’s healthcare visits. Indeed, CDC data showed that gonorrhea cases increased by 45% and syphilis cases increased by 52% from 2016. But the increase in congenital syphilis was the most dramatic, and Leandro Mena, MD, director of the CDC STD Prevention Department, hypothesized that the increase was the result of risky behaviors such as injecting drug use, methamphetamine use and injecting partner sex. drugs. Mena also pointed to unstable housing and lack of medical insurance as possible factors and stressed the need to address “prevention gaps for women who may not have health insurance”. He added that MSM and young people “carry the brunt of the epidemic”, including people from racial / ethnic minorities such as blacks, Hispanics, Native Americans / Alaskan Indians and Asians / Pacific Islanders. “Lack of access to regular medical care, discrimination and stigma continue to hamper health care,” Mena said, adding that we need to understand that “the system creates inequalities.” Healthcare providers are playing an increasingly important role in helping to reduce stigma by ‘integrating the prevention of sexually transmitted diseases and sexual health’. [screening] in the practice of routine “and in the creation of a” hospitable environment for all people “. Mermin pointed to “multidisciplinary solutions” – both at community and clinical level – and stressed the need for more affordable STD testing in community-based organizations beyond the clinic. He also called for “new scientific discoveries” in the field of STDs, noting that vaccines against gonorrhea, chlamydia and syphilis are needed. Patients also need “treatments that are easier to get than we have,” and more affordable on-site testing, he said. “There is a lot that needs to be done to rebuild, innovate and expand the prevention of sexually transmitted infections,” Mermin said.
Molly Walker is Deputy Chief Executive Officer and covers infectious diseases for MedPage Today. She is the winner of the J2 Achievement 2020 award for covering COVID-19. Follow
