Updated on May 3, 2023.
The number of some sexually transmitted diseases (STDs) in America hit an all-time high in 2021 during the COVID-19 pandemic, according to the Centers for Disease Control and Prevention (CDC). Data released in the CDC’s Sexually Transmitted Disease Surveillance Report in April 2023 showed that more than 2.5 million cases of chlamydia, gonorrhea, and syphilis were reported in 2021. Among the notable trends:
- Gonorrhea diagnoses rose to 710,151 cases, a 28 percent jump from 2017.
- Primary and secondary syphilis diagnoses climbed to 53,767 cases. The total number of syphilis cases across all stages (which also includes the latent and tertiary stages) was 176,713, an increase of 74 percent since 2017.
- Congenital syphilis, which is passed to a fetus during pregnancy, grew to 2,855 cases, representing a 203 percent leap over five years. There were also 220 congenital syphilis-related stillbirths and infant deaths, a 464 percent increase over 20 years.
- Chlamydia diagnoses rose to 1,644,416 cases, a slight increase from 2020, indicating the beginning of a return to pre-pandemic levels. Chlamydia infections are generally asymptomatic and are often only discovered through screenings, which dropped sharply in 2020.
The CDC also highlighted concerning trends among racial and ethnic minority groups, who are disproportionately affected by STDs, along with men who have sex with men. Gay and bisexual men, for example, accounted for nearly one-third of gonorrhea cases in 2021. The agency noted that social, economic, and cultural conditions contribute to health inequities, which affects many people’s ability to remain free of infection.
Digging into the details
“STDs have always been a major problem and concern,” says OBGYN Allyn Alexander, MD, of Richmond Women’s Specialists in Richmond, Virginia. Dr. Alexander says some of the other common STDs—such as herpes, human papillomavirus (HPV), and trichomoniasis—are not routinely reported to the CDC, so it’s possible these rates could have risen along with those of gonorrhea and syphilis. The CDC warns that HPV is so common that almost everyone who is sexually active will get the virus at some point. Nine out of ten infections resolve on their own, but when they linger, they may cause cancer. Based on CDC data from 2015 to 2019, about 37,000 cancers are caused by HPV each year.
The CDC warns that many STD cases go undiagnosed and untreated, leading to other health issues, such as increased HIV risk and infertility. Some STDs also can result in a higher risk of pregnancy complications, including ectopic pregnancy, miscarriage, premature birth, and stillbirth in infants.
Education is key
Education is the number one way to lower the nationwide STD infection rate, according to Alexander. At-risk populations, such as young people and people who engage in risky behaviors such as having unprotected sex, need to “understand the realities,” she says, because misconceptions abound.
For example, the HPV vaccine is a simple, effective way to protect against a virus that not only contributes to cervical cancer, but can increase the risk of certain mouth and throat cancers. Unfortunately, some of Alexander’s patients believe the vaccine can protect against all forms of STDs—which is not the case. “The HPV vaccine does wonderful things for cervical cancer prevention, but it’s not broad coverage for all STDs,” she says.
Oral sex, too, is not as safe as some people may think. “Some patients feel they’re not sexually active, but they’re active with oral sex and they end up with genital herpes,” Alexander says. “I think the important thing is to continue having open dialogue and enforcing things we know to be true: that STDs are very prevalent and easily transmissible.”
Tried and true prevention methods
Beyond learning about STD risks, you can take precautions to stay healthy. Abstinence remains the best way to avoid getting or giving an STD, but safe practices can also offer protection. These include:
- Using condoms and other barrier methods like dental dams consistently and correctly
- Avoiding risky sexual behaviors
- Keeping an open dialogue with partners about sexual behaviors
- Getting vaccinated for HPV
Make sure to speak with a healthcare provider about STD testing, as well. Unless you’re completely abstinent, it’s important to get tested regularly. The CDC’s recommendations for STD testing are:
- Everyone between the ages of 13 and 64 should be tested for HIV at least once.
- Sexually active women under 25 should be tested each year for gonorrhea and chlamydia.
- Sexually active women over 25 should continue to test for gonorrhea and chlamydia if they have risk factors, like multiple sex partners.
- Pregnant people should get tested for a variety of STDs beginning in the early months of pregnancy, including hepatitis B and C, HIV, and syphilis.
- Men who have sex with men should test annually for syphilis, chlamydia, gonorrhea, and HIV, and if they have multiple partners, they should test every three to six months.
