New data from the C.D.C. shows that rates of many sexually transmitted diseases continued to climb in 2020.
Rates of many sexually transmitted infections continued to climb during the first year of the pandemic, the Centers for Disease Control and Prevention said in a statement posted to its website on Tuesday. While overall there were 2.4 million infections recorded in 2020, down from a record high of 2.6 million in 2019, diagnosed cases of certain sexually transmitted diseases surged.
Cases of congenital syphilis, which occurs in newborns who contract the disease from their mothers, reached the highest numbers in 26 years, rising by 235 percent since 2016. Rates of primary and secondary syphilis rose by 7 percent from 2019 to 2020; gonorrhea cases rose by 10 percent in the same time period.
People ages 15 to 24 contracted about half of the reported 2020 infections. Racial and ethnic minority groups, and gay and bisexual men, also experienced disproportionately higher rates of disease.
The C.D.C. data also showed that rates of chlamydia declined by 13 percent, although the agency cautioned that many cases of the disease are asymptomatic and that reductions in routine screening during the pandemic likely contributed to that decrease.
“This is the latest evidence of an ignored epidemic in America,” said David C. Harvey, executive director of the National Coalition of S.T.D. Directors. “The numbers are down slightly because of pandemic disruptions to testing and care, make no mistake about it. These cases are out of control.”
Rates of sexually transmitted infections have risen significantly over the last decade. Infections spiked during the pandemic because of a dearth of accessible screening, test kit and lab shortages, and clinic closures, said Dr. Jonathan Mermin, director for the National Center for H.I.V., Viral Hepatitis, S.T.D., and T.B. Prevention.
Here’s what to know about how to prevent and treat sexually transmitted infections.
How often should you get tested?
The C.D.C. recommends that everyone ages 13 to 64 should be tested at least once for H.I.V. The agency recommends that men who have sex with men get tested for H.I.V. at least once a year.
The agency urges sexually active women who are under the age of 25 or who have new or multiple sex partners to get annual tests for chlamydia and gonorrhea. Sexually active gay and bisexual men should get tested for syphilis, chlamydia and gonorrhea at least once a year, or every three to six months if they have multiple sexual partners.
According to the agency guidelines, pregnant people should also get tested for syphilis, H.I.V., hepatitis B and hepatitis C early in the pregnancy.
Some experts recommend more frequent testing. The National Coalition of S.T.D. Directors recommends getting screened once a quarter if you have multiple sex partners.
There is a directory of clinics offering free or low-cost testing at gettested.cdc.gov.
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Some states offer home testing options through health department websites, but be wary of private home testing options, said Dr. Gale Burstein, a pediatrician in Buffalo who contributed to the C.D.C.’s sexual health guidelines for adolescents. “There have been studies that show some labs that offer home testing are really not credible labs,” she said.
Family planning clinics like Planned Parenthood have in-person and telehealth options for S.T.I. screening. Some urgent care centers also have testing capabilities.
Are there other ways to prevent S.T.I.s if you have multiple sexual partners?
Consistent condom use can be the first line of defense against sexually transmitted infections. Condoms are available for oral sex as well as vaginal intercourse, and the Food and Drug Administration recently approved the first condom for anal sex.
Sexual health experts recommend that people get tested before having sex with a new partner, if possible, in addition to routine S.T.I. screenings. If that’s not possible, people should consider getting tested soon after having sex with someone new.
“If you have an encounter and you’re worried about it, getting tested two to four weeks after is the best thing to do,” said Dr. Michael Angarone, an infectious diseases physician at Northwestern Medicine.
Pre-exposure prophylaxis, or PrEP, is now recommended for anyone who is at risk for contracting H.I.V., he said, which is not limited to men who have sex with men and can include people who have multiple sexual partners.
What symptoms should you watch out for?
Up to 85 percent of S.T.I.s can be asymptomatic, which is why routine screening is crucial, said Dr. Monica Woll Rosen, an ob-gyn at the University of Michigan Medical School. But certain symptoms can indicate an infection, she said, including abnormal discharge, painful intercourse, spotting outside of the menstrual cycle, and bumps or sores surrounding genitalia.
People with syphilis may develop rashes on their bodies and hands, said Dr. Oluwatosin Goje, an ob-gyn and infectious disease specialist at Cleveland Clinic in Ohio. They can also develop ulcers on their genitals, which can present as a scratch or a bump.
If untreated, even asymptomatic gonorrhea and chlamydia can cause inflammation in the pelvis and lead to potential scarring in fallopian tubes and increased risk of infertility, ectopic pregnancies and chronic pelvic pain, she added.
What treatment options are available?
Most S.T.I.s are treatable, especially if they are detected early. Medications are available for gonorrhea, chlamydia and hepatitis B and C. Antiviral therapies are available to help patients manage H.I.V., even though the disease cannot be cured.
There is also no cure for herpes, which people can spread easily even if they do not have lesions. But there are prophylactics and antivirals that reduce the duration of herpes outbreaks and lower the risk of transmitting the virus.
Syphilis can be treated with penicillin, and there are alternative medications for those who are allergic. “It’s very easy to treat,” Dr. Goje said. “We just need to have an early diagnosis.”
