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Local health departments struggle to treat and prevent the spread of STDs amid ongoing budget cuts.
Budget cuts and funding shortages make it increasingly difficult for local health departments to prevent and treat rising numbers of sexually transmitted diseases, health officials said this week.
“They need more support,” Lori Tremmel Freeman, chief executive officer of the National Association of City and County Health Officials (NACCHO), said in a statement. “Stagnant or decreasing resources are not enough, and local health departments and their partners need more resources to address these rapidly rising STD rates.”
The number of sexually transmitted diseases hit record levels nationwide in 2017, with more than 2.4 million reported cases of chlamydia, syphilis and gonorrhea, according to an analysis of the most recent STD surveillance report from the Centers for Disease Control and Prevention.
“In 2016, record highs were made for reported cases of STDs, but when data from 2017 became available, those record highs were replaced,” says the analysis, compiled by Health Testing Centers, an STD-testing company. “In just a year, the 2 million cases of chlamydia, gonorrhea and syphilis increased drastically, and certain states and counties saw bigger changes than others.”
Connecticut and New Hampshire, for example, both saw a 27 percent increase in chlamydia cases from 2016 to 2017, while West Virginia saw a 14 percent decrease, according to the data.
The increase marked the fourth consecutive year of rising rates of infection, a reverse after years of steady progress. Possible reasons include the increasing use of long-term contraceptives, including intrauterine devices, which prevent pregnancies but do not stop the spread of disease. Some infections, most notably gonorrhea, have become resistant to common antibiotics, making it difficult to treat or cure new cases.
“Not that long ago, gonorrhea rates were at historic lows, syphilis was close to elimination, and we were able to point to advances in STD prevention, such as better chlamydia diagnostic tests and more screening, contributing to increases in detection and treatment of chlamydial infections,” Gail Bolan, director of the CDC’s division of STD prevention, wrote last year. “That progress has since unraveled.”
Nationwide, health officials reported more than 1.7 million cases of chlamydia (an increase of 6.9 percent), 555,608 cases of gonorrhea (an 18.6 percent increase) and 30,644 cases of primary and secondary syphilis (an uptick of 10.5 percent).
Half of all cases occurred in people between the ages of 15 to 24. Those infections “can lead to long-term health consequences, such as infertility; they can facilitate HIV transmission; and they have stigmatized entire subgroups of Americans,” Bolan said. “To complicate the matter, STD public health programs are increasingly facing challenges and barriers in achieving their mission.”
Funding challenges were chief among those. More than 80 percent of local health departments “reported stagnant or decreased funding levels over the past year,” according to a NACCHO member survey in October 2017. “Of those that experienced recent budget cuts, 43 percent reported reductions in staffing levels and one-third reported reducing or eliminating services in response.” Those funding shortages were most likely to affect STD programs, including surveillance, vaccinations and HIV testing.
The problem continues in communities across the country. Cases of syphilis in Missouri have more than quadrupled since 2012, and officials in San Francisco this week urged residents to get tested amid spiking rates of both chlamydia and syphilis.
Federal, state and local officials should work together to reduce STDs by “promoting sexual, reproductive, maternal and infant health,” Golan said. “The resurgence of syphilis, and particularly congenital syphilis, is not an arbitrary event, but rather a symptom of a deteriorating public health infrastructure and lack of access to care.”
Kate Elizabeth Queram is a Staff Correspondent for Route Fifty and is based in Washington, D.C.