Three common sexually transmitted diseases are increasing locally and nationally.
Nationwide, there was a 22 percent increase in chlamydia, a 67 percent increase in gonorrhea and a 76 percent increase in syphilis from 2013 to 2017, according to the Centers for Disease Control and Prevention. In Warren County during the same time, there was a 17 percent increase in chlamydia, a nearly 72 percent increase in gonorrhea and a 40 percent increase in syphilis, based on data provided by the Kentucky Cabinet for Health and Family Services.
Warren County reflects the national trend in the increase of chlamydia and gonorrhea. It’s trickier to consider the increase in syphilis due to the year-to-year variability and low case count – there were seven cases in 2017.
“STDs in general increase because of population behaviors,” said Dr. Rebecca Shadowen, an infectious disease specialist at The Medical Center in Bowling Green.
The act of sex isn’t changing, but the associated behaviors – such as using condoms and testing frequently – have changed. The issue is that it’s challenging to intercept this spread of disease, according to Shadowen.
Until someone develops a tool to intervene, Shadowen said the diseases will continue to exist.
In 2017, Warren County had the sixth-highest case count and 12th highest rate for chlamydia, gonorrhea and syphilis in Kentucky.
Jefferson and Fayette counties had the highest counts, with 8,595 and 3,654, respectively, in 2017. Kenton, Hardin and Daviess counties has the next highest case counts. Warren County had a total of 805 cases.
Nationally, chlamydia, gonorrhea and syphilis infections reached a record high with nearly 2.3 million total cases, according to CDC.
“STD rates continue to climb,” said Mathew Prior, the communications director at the National Coalition of STD Directors. “There are a number of reasons that they are increasing.”
Prior partially attributes the increase in STDs to federal funding cuts for STD prevention. The budget cuts translated to clinics closing their doors and fewer STD prevention programs, which reduced critical care to uninsured or underinsured populations.
“I think that’s especially true in rural areas,” Prior said. “There’s just not as many places that people can get care. We have to educate people adequately and empower people to make healthy decisions.”
That’s especially true for young people. The CDC estimates that youths ages 15-24 constitute about one quarter of the sexually active population, but account for half of the 20 million new sexually transmitted infections that occur in the U.S. each year.
A 2016 survey published in the Journal of Adolescent Health found that only about 12 percent of people age 15-25 had been tested in the past year. The authors in the study suggested that young people might not understand patient-doctor confidentiality, and would benefit from this type of education.
In addition to knowledge deficits, the insufficient screening apparently stems from social stigma.
“People are uncomfortable talking about sex,” Prior said, referencing both patients and health care providers.
Shadowen agreed that there isn’t enough testing in the region. Frequent testing used to be a common practice in hospitals, especially for syphilis.
“We were in medicine, up to about 20 years ago, testing everyone who came into the hospital for syphilis because it was so prevalent,” Shadowen said.
After the prevalence decreased, the practice stopped.
“We don’t screen anyone who comes into the hospital for anything now,” Shadowen said, “which is part of the problem of identifying our risk populations and treating them.
“Unless we’re going to legislate that everyone gets HIV and STD testing when they come into the hospital, then we’re not going to identify those.”
Though easily treatable infections, undiagnosed and untreated cases of the three STDs can have serious consequences.
The CDC estimates that sexually transmitted infections cause 24,000 women to become infertile each year, as well as lead to pelvic inflammatory disease in women. Untreated gonorrhea can cause urethra scarring and inflammation of the prostate gland in men, and untreated syphilis can cause blindness, paralysis and issues for bones and internal organs for both men and women, according to the American Sexual Health Association.
