Experts brace for STD spike, but not just because it’s ‘hot vax summer’



After more than a year in which Americans were invited to practice safe six (feet), infectious disease specialists want to remind them of safe sex.

While different people have responded to pandemic safety guidelines in different ways, for some Americans, confinement meant less sex. But like more vaccines are administered, social restrictions become relaxed – and some people seem ready to make up for lost time by kissing their “hot summer vax. “

Sale of male condoms climbed 23.4% to $ 37 million in the four weeks ending April 18, compared to the same period in 2020, according to market research firm IRI. This increase follows a 4.4% drop in 2020 as a whole.

But while many see the continued reopening of the economy as a sign that Covid-19 is less of a health crisis, there are other viruses and bacteria, such as those that are sexually transmitted. And doctors are warning that an increase in STD cases is on the way. But it’s not just because vaccinated singles are ready to mingle again.

The rates were already rising

Reported STDs in the United States hit an all-time high for the sixth consecutive year in 2019, according to the United States Centers for Disease Control and Prevention, with over 2.5 million reported cases of chlamydia, gonorrhea and syphilis.

These reportable STDs increased by nearly 30% between 2015 and 2019, according to the agency.

Experts told CNN that these worrying trends may be linked to several factors.

Dr Hunter Handsfield, professor emeritus of medicine at the University of Washington’s Center for AIDS and STD, told CNN that one of them could be that people are using fewer condoms. He said this applies particularly to men who have sex with men because they see this layer of protection, as well as the selection of uninfected partners, to be less important now that there is more. tools to prevent HIV, in particular, pre-exposure prophylaxis, or Preparation – pills that people at high risk can take to prevent infection.

Attitudes towards sexuality have also changed.

“People in their teens and twenties now, I think, have different attitudes and beliefs about what constitutes a committed relationship and what isn’t,” Handsfield said.

In addition, there are more resources for meeting sexual partners, including dating apps, who have less than stigma compared to past years.

The CDC notes that high infection levels can also be affected by barriers to prevention and care, such as poverty, unstable housing, or lack of a medical facility.

Add a pandemic that forces health systems to reassign staff from STD prevention to tackling a deadly respiratory virus and these problems are exacerbated.

Numbers don’t tell the whole story

The CDC says preliminary data from 2020 suggests that many of these worrying trends continued into 2020, when the Covid-19 pandemic disrupted STD testing and treatment services.

A CDC study published in the Journal of the American Sexually Transmitted Diseases Association in June gives the first preliminary conclusions of the national impact of Covid-19 on STDs in 2020, with data up to December of last year.

the Analysis While reported STDs declined significantly in March and April 2020, some appeared to reappear by the end of the year.

As of December 12, cumulative totals for 2020 compared to 2019 showed that the number of gonorrhea cases was 7% higher, the number of chlamydia cases was 14% lower, and the number of syphilis cases (primary and secondary) was less than 1%.

In one September press briefingDr. Hilary Reno, medical consultant in the Division of STD Prevention at CDC, explained in detail how the pandemic led to a dramatic drop in STD testing last year.

BJC HealthCare, one of the main hospitals in the Saint-Louis metropolitan area, saw testing decline after the first positive case of Covid-19 in March, Reno said. After the city issued stay-at-home orders, tests for gonorrhea and chlamydia fell 45%. Reno added that this equated to about 4,400 missed gonorrhea and chlamydia tests over a 10-week period in that area.

HIV tests had a similar pattern, with around 5,000 missed tests over the same period, Reno said.

Handsfield told CNN it was difficult to know for sure what really happened to the number of STD cases during the peak of the pandemic.

“The idea that there is a risk of them bouncing back, to me, does make some sense. But it is with this caveat that we really don’t quite know how to interpret the data behind these observations,” Handsfield said.

Testing may also have increased before the pandemic.

Dr Kees Rietmeijer, former director of the STD control program at the Denver Department of Public Health, told CNN that, like Covid-19, “the more you test, the more you find.” But unlike coronavirus cases, the number of negative STD tests is not reported, so the positivity rate is not known.

All the sex is not stopped

One way that sexually transmitted infections resemble Covid-19 is that many cases are asymptomatic, said Dr. Julie Dombrowski, associate professor of medicine at the University of Washington who also does research on HIV and STIs on clinical and public health services.

This means that the decrease in testing resulted in a number of undetected and untreated STDs, which presumably led to continued transmission, Dombrowski told CNN. She noted chlamydia is particularly problematic in this case, as it is usually asymptomatic and can lead to infertility and other reproductive problems.

And while some people may have been less sexually active during the pandemic, not all sex has stopped, so these pre-pandemic infections haven’t just gone away.

Dr Edward Hook, professor of medicine at the University of Alabama at Birmingham, told CNN that part of maintaining sexual health is realizing that these infections are more common than many people realize. think.

“No one wants to think they have a sexually transmitted infection or are going to get one,” he said.

Rietmeijer echoed Hook, pointing out that the approach to treating STDs has focused on the clinical aspect, rather than on individual and societal impacts, such as inequalities in health care and stigma that can prevent people to take preventative measures seriously.

A National Academies of Sciences, report on engineering medicine, that Hook and Rietmeijer work, said that “the national response to STIs must also take into account the root causes of ill health”, which range from racism and poverty to social stigma.

A lack of timely diagnosis or preventive measures can lead to to dangerous consequences.

For example, human papillomavirus (HPV), can cause cervical cancer, head and neck cancer, and anal and penile cancers.

The good news is that STDs are preventable and treatable.

Preventive measures

Vaccines are recommended for protection against hepatitis B and HPV. the HPV vaccine is recommended for tweens aged 11 or 12 and everyone up to 26 years old, although it is approved for anyone up to 45 years old. hepatitis B vaccine is recommended for infants at birth, the series of injections being completed at 6 months. It is also recommended for some unvaccinated adults, such as those who have sex partners with hepatitis B.

the CDC recommends that everyone between the ages of 13 and 64 be tested for HIV at least once. But people at higher risk, which include men who have sex with men, should get tested more often. These men should get tested every three to six months. Anyone else who has unprotected sex should get tested for HIV at least once a year.

All sexually active women under the age of 25 should be tested for gonorrhea and chlamydia annually, according to agency guidelines. All pregnant women should be tested for syphilis, HIV and hepatitis B early in pregnancy. All men who have sex with men should be tested at least once a year for syphilis, chlamydia and gonorrhea. (You can look for a place to get tested near you with the CDC GetTested Tool.)

Hook said that another part of maintaining good sexual health is having a conversation with sexual partners.

“I hope people care about each other’s health as well as theirs,” he said. “More and more, but not enough, we see and continue to encourage couples who are considering or considering engaging in sexual activity, or even couples who have just started sexual activity together, to get tested together. for STIs. “

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