State and local governments beg for help with surprising spike in STDs

By | November 13, 2018

State and local officials are begging Congress and federal agencies to spend more money to halt an alarming rise in sexually transmitted infections, which have climbed steadily over four years to reach a record high.

“We are basically all expressing the same concern and expressing the need for urgent action,” said Dr. Nate Smith, president-elect for the Association of State and Territorial Health Officials. “This is something that is not going to go away on its own.”

There were more than 2.3 million cases of chlamydia, gonorrhea, and syphilis reported in 2017, according to preliminary data from the Centers for Disease Control and Prevention, nearly a 9 percent increase from the year before and a higher rate than those reported in other developed nations.

Even more worrying, nearly 1,000 babies were born with deformities or severe health problems caused by syphilis in 2017. These numbers are a 20-year high and a doubling from four years prior. And untreated chlamydia and gonorrhea can cause women to become unable to have children.

STD Graph for Magazine - 110918

State and local officials blame the soaring STD rates on a lack of federal funding. Over the past 15 years, the purchasing power of federal funding devoted to fighting STDs, which goes to state and local public health programs, has fallen by 40 percent.

Because the problem with STDs has risen so dramatically over a short time, officials say it’s time to invest more federal funding to fight it.

The National Coalition of STD Directors has asked for a $ 70 million a year funding increase in STD prevention and treatment, and for the Trump administration to come up with a federal plan to coordinate the work of health agencies. The group also would like for the Trump administration to declare a public health emergency for STDs, the same way that it did for opioids.

Such a designation would free up federal funds that help officials respond faster.

The funding would go toward STD clinics and toward protecting babies from being affected by syphilis. It would also be invested in the growing problem of drug-resistant gonorrhea, which can lead to long hospital stays, disability, or death. The CDC estimates STDs cost the U.S. $ 16 billion a year.

Smith, who is also director of Arkansas’s health department, said that having more funding would help the state hire more healthcare workers who reach out to sexual partners of those who have been infected and go into vulnerable communities to educate people and offer STD testing. These kinds of interactions with healthcare workers help people receive treatment and talk about protection, he said.

David Harvey, executive director of the National Coalition of STD Directors, said state and local officials are meeting with top federal health officials regularly, and found discussions encouraging.

State and local officials are particularly concerned because data before 2013 indicated that STDs were on the decline. And the latest information paints an incomplete picture. The federal government doesn’t routinely track data for other, even more-common STDs, including herpes and human papillomavirus, which can lead to cervical cancer. HIV rates are reported separately.

More people are using drugs to prevent HIV transmission, and more women are using long-term contraceptives. But it appears that condom use is falling by the wayside, raising STD rates.

CDC data show that gonorrhea diagnosis increased by 67 percent from 2013 to 2017, nearly doubling among men and increasing by nearly a fifth among women. Syphilis diagnosis has nearly doubled, with most cases among men who have sex with men. Chlamydia was the most common condition reported to the CDC in 2017, accounting for 1.7 million diagnoses.

“This is the continuation of a persistent and troubling trend,” Kyle Bernstein, chief of the Epidemiology and Statistics Branch in the CDC’s Division of STD prevention, acknowledged in an email.

Certain politicians are beginning to take notice. Sen. Patty Murray, the top Democrat on the Health, Education, Labor and Pensions Committee, sent a letter to Surgeon General Jerome Adams in October pressing him to respond.

“I write to ask that you take immediate action to raise public awareness of the problem and engage all relevant federal agencies in taking evidence-based steps to address the problem, with particular focus on prevention amongst populations most at risk of contracting STDs,” the Washington Democrat said.

Ahead of budget deliberations earlier this year, 10 Democratic senators and 36 Democratic representatives wrote their respective appropriations leaders to request a funding increase to fight STDs.

The increase was not ultimately included, but Harvey said advocates hope the request will appear in President Trump’s budget request set to come out in February. The federal government currently spends roughly $ 157 million a year to fight STDs.

Officials are also eyeing the possibility of getting STD funding attached to follow-up bills aimed at the opioid crisis. The opioids bill that Trump signed into law in October didn’t tackle STDs, but local officials note that lawmakers said repeatedly that they considered the legislation to be only one of many steps Congress would take. Experts believe that the sheer number of people addicted to opioids such as heroin and prescription painkillers, estimated at 2.1 million people, is contributing to the rise in STD rates, because people are trading sex for drugs.

Meanwhile, agencies are acting on the STD problem administratively. The Food and Drug Administration has rolled out a few proposals to deal with drug-resistant bacteria. The CDC has urged doctors to test women for syphilis not just when they learn they are pregnant but a couple more times throughout their pregnancies.

Smith acknowledged officials are overwhelmed by other public health issues, particularly the opioid crisis, which claimed 40,000 lives in 2017, and with public health issues such as obesity and nicotine addiction, all of which are urgent, pushing the STD surge into the shadows.

“If you look at the numbers it’s really pretty bad… You can’t look at that kind of increase for any transmissible disease and not be very, very alarmed,” Smith said.

Healthcare