CDC Releases Annual STD Surveillance Report

In the battle against HIV/AIDS, many people often forget or dismiss other sexually transmitted infections like chlamydia, gonorrhea and syphilis, which go undiagnosed and can increase the likelihood of contracting HIV. Toward the end of December 2014, the Centers for Disease Control and Prevention released their 2013 data of STDs in the United States. The data are based on state and local STD case reports from a variety of private and public sources. They indicate that the majority of these cases are not being reported in STD clinics, but rather in private physician offices or health organizations.

Many cases of chlamydia, gonorrhea, and syphilis continue to go undiagnosed and unreported, and data on several additional STDs, such as human papillomavirus, herpes simplex virus, and trichomoniasis, are not routinely reported to CDC. As a result, the annual surveillance report captures only a fraction of the true burden of STDs in America. However, it provides important insights into the scope, distribution, and trends in STD diagnoses in the country.

STDs are a significant health challenge facing the United States. CDC estimates that nearly 20 million new sexually transmitted infections occur every year in this country, half among young people ages 15-24, accounting for almost $16 billion in health care costs. Each of these infections is a potential threat to an individual's immediate and long-term health and well-being. In addition to increasing a person's risk for acquiring and transmitting HIV infection, STDs can lead to severe reproductive health complications, such as infertility and ectopic pregnancy.

There is good news for infections of chlamydia and gonorrhea, as reported cases went down. In 2013, there were 1,401,906 reported cases of chlamydia, a decrease of 1.5 percent since 2012. Gonorrhea also decreased, with 333,004 reported cases in 2013, a 0.6 percent decrease from the year before.

But syphilis, both primary, secondary and congenital, went up. In 2013, there were 17,375, a 10 percent increase since 2012. Worse still, this national rate increase was only found among men, particularly gay and bisexual men.

Some Groups Bear a Disproportionate Burden

While anyone can become infected with an STD, certain groups, including young people and gay and bisexual men, are at greatest risk. Gonorrhea and chlamydia primarily affect young people.

While surveillance data show signs of potential progress in reducing chlamydia and gonorrhea among young people aged 15-24, both the numbers and rates of reported cases of these two diseases continue to be highest in this group compared to other age groups.

Both young men and young women are heavily affected by STDs, but young women face the most serious long-term health consequences. It is estimated that undiagnosed STDs cause 24,000 women to become infertile each year.

The other group facing the burden of STDs are men who have sex with men (MSM). There has been a troubling rise in syphilis infections among gay, bisexual, and other MSM. Trend data show that MSM account for three quarters (75 percent) of all primary and secondary syphilis cases.

Primary and secondary syphilis are the most infectious stages of the disease, and if not adequately treated, can lead to long-term infection, which can cause visual impairment and stroke. Syphilis infection can also place a person at increased risk for acquiring or transmitting HIV infection. In fact, available surveillance data indicate that an average of half of MSM with syphilis are also infected with HIV.

Disparities result from a range of factors, including individual risk behaviors (such as higher numbers of lifetime sex partners), as well as environmental, social and cultural factors (such as higher prevalence of STDs or difficulty accessing health care) contribute to disparities in the sexual health of MSM.

For example, MSM with lower economic status may have trouble accessing and affording quality healthcare, making it difficult to receive STD testing and other prevention services. Additionally, complex issues like homophobia and stigma can also make it difficult for gay and bisexual men to find culturally-sensitive and appropriate care and treatment.

One thing is certain: STD screening is critical. If you are sexually active, be sure to talk to your healthcare provider about STD testing and which tests may be right for you.

If you are a sexually active woman younger than 25, or have risk factors such as multiple sex partners, you should request annual chlamydia and gonorrhea tests. If you're pregnant, you should request syphilis, HIV, chlamydia and hepatitis B tests early in your pregnancy. If you have new or multiple sex partners, you should also request gonorrhea testing early in pregnancy.

Sexually active MSM should request tests for syphilis, chlamydia, gonorrhea and HIV at least once a year. More frequent STD testing is recommended for men at high risk.