For the past five years, Americans have been breaking records left and right — a good thing when we’re talking about athletic feats or scientific breakthroughs, but not so great when we’re shattering records for catching sexually transmitted diseases (STDs). Chlamydia, gonorrhea, and syphilis are all on the upswing, with a combined 2.3 million cases in 2017 — and those are just the cases that were reported. Since most people with these infections don’t know they have them, the real number is thought to be much higher. The United States has the dubious honor of boasting the highest STD rates of all industrialized countries — though rates are also climbing in England and Western Europe.
The good news is that these three STDs are preventable and curable. Sexually active people can dramatically reduce their risk by using condoms and dental dams, or by being in mutually monogamous relationships in which partners test negative for these infections. And, because many STDs don’t show symptoms, it’s important for them to receive regular STD screening to ensure infections are caught and cured before they can do any damage.
But there’s also bad news. First, while the symptoms of these infections can be awful, they compel you to seek prompt treatment — making these awful symptoms a good thing, in a weird way. Unfortunately, most people with these infections don’t have symptoms, allowing the bacteria that cause them to spread silently from person to person. If not caught, chlamydia and gonorrhea can lead to chronic pain and fertility problems, and syphilis can lead to organ damage and even death. These infections can also increase HIV risk and be passed to a baby during childbirth.
More bad news: While chlamydia and syphilis are still easily treated with antibiotics, gonorrhea is becoming more difficult to cure. If we don’t develop new antibiotics — or, even better, a vaccine — soon, we could be returning to an era of untreatable gonorrhea, which wreaked havoc before the first antibiotics were developed in the ’30s.
The bad news doesn’t stop there. Systems that have been designed to keep STD rates in check have been “strained to a near-breaking point,” said Dr. Jonathan Mermin of the Centers for Disease Control and Prevention (CDC). Thanks to funding cuts from lawmakers who don’t prioritize public health, more obstacles are being thrown in the paths of people who need access to STD prevention, screening, and treatment. Since 2003, the CDC’s STD prevention budget has fallen by 40 percent. Statewide and local STD programs have also felt the pain of slashed budgets, with many of them forced to close their doors in response. These cuts occurred during the George W. Bush and Barack Obama years, but the Trump administration hopes to slash STD prevention funds by another 17 percent, which could ensure that we continue to break STD records for many years to come.
When STD clinics are forced to reduce their hours or shutter their operations entirely, fewer people will receive testing — even those who have access to primary care providers. Many patients are reluctant to bring up sexual health with their doctors, and many doctors are also shy about starting the conversation. Health centers that make private, confidential STD testing available to the public are essential in ensuring that as many sexually active people as possible have access to screening and treatment.
Politicians may feel they are saving money by cutting funds, but chlamydia, gonorrhea, and syphilis cost us more than $16 billion each year — an amount that dwarfs the $70 million needed to mount a response to this STD epidemic. Even those who value the bottom line over public health must recognize that taking money away from STD prevention is a short-sighted strategy that will cost us more money than it saves in the long run.
Michael Fraser, the executive director for the Association of State and Territorial Health Officials, compares our investment in STD prevention to investments in other forms of infrastructure. “You’ve got to maintain your bridges and your roads, and we see them on TV when they crumble,” he said. “You don’t always see a crumbling public health infrastructure … But part of the rise in STDs is the lack of funding at the state level to really invest in prevention work.”
When our lawmakers favor apathy over a can-do spirit, public health suffers. These problems are exacerbated by the dismal state of sex education in this country, where too many students aren’t learning the information they need to protect their health. When schools promote abstinence to the exclusion of other risk-reducing strategies, children grow into young adults who are no more likely to delay sex, but who might not fully understand the risks associated with sex — and how to mitigate those risks with prevention, testing, and treatment.
Planned Parenthood provided 4.4 million STD tests and 700,000 HIV tests in 2017, and is looking forward to continuing to connect people to this lifesaving health care. You can pick up condoms or be tested for STDs at any Planned Parenthood health center.
Click here to check out other installments of our monthly STD Awareness series!