The syphilis epidemic in the United States slowed dramatically last year, with gonorrhea cases falling and chlamydia cases remaining below pre-pandemic levels, according to federal data released Tuesday.
The numbers represented some good news about sexually transmitted diseases, which have seen some alarming increases in recent years due to declining condom use, inadequate sexuality education and reduced testing and treatment when the pandemic hit. of COVID-19.
Last year, cases of the most infectious stages of syphilis fell 10% from the previous year, the first substantial decline in more than two decades. Gonorrhea cases fell 7%, marking a second consecutive year of decline and placing the figure below that of 2019.
“I’m excited, and it’s been a long time since I’ve felt that way” about the national epidemic of sexually transmitted infections, said Dr. Jonathan Mermin of the Centers for Disease Control and Prevention (CDC). . “Something is working.”
Last year, more than 2.4 million cases of syphilis, gonorrhea and chlamydia were diagnosed and reported: 1.6 million cases of chlamydia, 600,000 of gonorrhea and more than 209,000 of syphilis.
Syphilis is especially worrying. For centuries it was a common but feared infection that could deform the body and cause death. New cases plummeted in the United States beginning in the 1940s, when antibiotics were widely used to combat the infection. In 2002, however, cases began to increase again, disproportionately affecting men who have sex with other men.
According to the new report, cases of syphilis in its initial stages, the most infectious, decreased by 13% among gay and bisexual men. This is the first such decline since the agency began reporting data on this group in the mid-2000s.
However, there was a 12% increase in the rate of cases of unknown or advanced syphilis, a reflection of people infected years ago.
Cases of syphilis in newborns, transmitted by infected mothers, also increased. There were nearly 4,000 cases, including 279 stillbirths and infant deaths.
“This means that pregnant women are not being tested often enough,” said Dr. Jeffrey Klausner, a professor of medicine at the University of Southern California.
What is causing some of the sexually transmitted disease trends to improve? Several experts indicated that one of the factors is the increasing use of an antibiotic as the “morning after pill.” Studies have shown that taking doxycycline within 72 hours of unprotected sex reduces the risk of developing syphilis, gonorrhea, and chlamydia.
In June, the CDC began recommending doxycycline as a morning-after pill, specifically for gay and bisexual men and transgender women who have recently been diagnosed with an STD. But health departments and organizations in some cities had been giving the pills to people for a couple of years.
Some experts believe the 2022 Asian smallpox outbreak – which primarily affected gay and bisexual men – may have had a lingering effect on sexual behavior in 2023, or at least on people’s willingness to get tested when sores appear. strange
Another factor may have been the increase in the number of health workers testing for infections, tracing contacts, and putting people in reach of treatment. Congress provided $1.2 billion to expand staffing over five years, including $600 million for states, cities and territories that receive CDC funding for STD prevention.
Last year saw the “most activity with such funding in the entire United States,” said David Harvey, executive director of the National Coalition of STD Directors.
However, Congress ended the funding early as part of last year’s debt ceiling agreement, cutting $400 million. Some people have already lost their jobs, a spokeswoman for Harvey’s organization said.
Still, Harvey said there were reasons to be optimistic, including the growing use of doxycycline and a push for at-home STD testing kits.
Additionally, there are reasons to think that the next Presidential Administration could get behind STD prevention. In 2019, then-President Donald Trump announced a campaign to “eliminate” the HIV epidemic in the United States by 2030. Federal health officials later clarified that the real goal was a huge reduction in new infections: fewer than 3,000 a year. .
The CDC estimates that there will be nearly 32,000 new HIV infections in 2022. But a boost in public health funding for HIV could also help reduce other sexually transmitted infections, experts said.
“When the government invests resources and money, we see decreases in STDs,” Klausner said.
