On Tuesday, September 26, 2017 the Federal Center for Disease Control (CDC) issued a press statement about Sexually Transmitted Diseases (STDs): “STDs are at a record high, indicating urgent need for addressing protection.” The increase was seen by director Jonathan Mermin, MD, MPH as “a clear warning of a growing threat.”
This announcement was eerily similar to one I’d reported on in 2015 (motifri.com/alt-health-the-garden-grows/). The statistics were alarming even then: In the state of RI between 2013 and 2014, new cases of syphilis rose 79%, gonorrhea cases increased 30%, and the rate of HIV grew 33%. At that time, our government agencies recognized the scope of the problem and Rosemary Reilly, an HIV/AIDS specialist for RIDE, urged all sexually active citizens to get educated for their own safety. The warnings went out. The stats did not go down. So what happened? Why has the problem only continued to escalate?
According to Dr. Philip A. Chan, MD, director of the STD clinic at The Miriam Hospital, the exact reason is not known because there are a number of mitigating factors. More people are insured than ever before and an increase in testing and subsequent increase in new diagnoses (not necessarily new infections) may explain part of the trend; however, this doesn’t fully account for the increases over the last 10 years. In 2016, 716 cases of gonorrhea were diagnosed, up from 402 in 2007. There were 153 cases of syphilis reported, up from
46 cases a decade ago. In 2006, syphilis had nearly been eliminated from the US population, yet today, this ancient scourge is spreading again, largely among gay and bisexual men, who account for 90% of all new cases. Dr. Chan believes that an increase in some risky sexual behaviors coupled with less condom use may be partly responsible. Too few people realize that syphilis can be transmitted through both oral and anal sex. And it is possible that new medications such as PrEP (Pre-exposure prophylaxis) have given people a false sense of security – PrEP can be up to 90% effective for preventing HIV if used as prescribed, but it provides no protection at all from either syphilis or gonorrhea. And although antibiotics can cure these STDs, antibiotic misuse and overuse is leading to antibiotic-resistant strains. The prevalence of sexual hook-up apps such as Tinder and Grindr makes it possible to spread STDs faster.
Dr. Chan also works as a consultant for the Center for HIV/AIDS, Viral Hepatitis, STDs and TB at the RI Department of Health, and it is there that he found some additional disturbing stats: Cases of gonorrhea and chlamydia are high in teenagers between the ages of 15 and 19. A recent article on WebMD stated that youth ages 15 to 24 make up only 27% of the sexual population, yet fully 50% of all new infections each year are diagnosed in this group. Ironically, the roadblock in progress here comes in part from loving parents.
It’s understandable that this is an uncomfortable subject between young adults and parents, but Dr. Chan believes a conversation needs to be started across the state. The message needs to get out: Education doesn’t put the idea of sex in their heads – it is already there. The sex drive of a young human being is strong, but their brains haven’t yet fully matured. In the heat of the moment, especially if alcohol is involved, it’s difficult to stop and consider the consequences of their actions. Telling them to simply abstain may not work. If you look at national statistics, the rate of STDs is highest in states where sex ed is kept out of the schools.
Dr. Chan’s goal is “to get new cases of HIV and other STDs down to zero,” but he knows this isn’t possible without screening, education and awareness. He believes that services should be confidential; they won’t come in for medical guidance or testing if they think their parents are going to find out. Anonymity is essential if sexually active teens and young adults are going to get the help they need.
All sexually active men and women – especially those younger than 25 – should use condoms and be screened annually for STDs. As of now, fewer than 12% of those younger than 25 have been, which could cost them their fertility. Young girls and queer men are far more susceptible to chlamydia. Forty-one percent of high school students have had sex, and of those, 43% admit they did not use a condom the last time they did. And if it makes sense for you, please get frequent HIV screening and talk to your doctor about PrEP and PEP. This daily oral vaccine could save your life and help protect those you love.
For more information on PrEP visit cdc.gov/hiv/basics/prep.html; for local resources on PrEP and testing visit: doitright.org