Soaring numbers of sexually transmitted disease (STD) cases have prompted U.S. public health experts to call for more prevention and treatment.
This includes rising rates of syphilis and gonorrhea and HIV.
"It is imperative that we... work to rebuild, innovate, and expand [STD] prevention in the U.S.," Dr. Leandro Mena, director of the Division of STD Prevention at the U.S. Centers for Disease Control and Prevention, said in a speech Monday at a medical conference on sexually transmitted diseases, the Associated Press reported.
Solutions include home test kits for some STDs that will make it easier for people to learn they are infected and to take steps to prevent spreading it to others, said Mena.
But Dr. Mike Saag, an infectious disease expert at the University of Alabama at Birmingham, said a core part of efforts must be to increase condom use.
"It's pretty simple. More sexually transmitted infections occur when people are having more unprotected sex," Saag said.
The monkeypox outbreak has added another layer of concern, because the virus has been spreading largely between men who have sex with men.
Public health organizations and the National Coalition of STD Directors are calling for more federal funding, including $500 million for STD clinics.
Mena suggested reducing stigma, broadening screening and treatment, and supporting the development of at-home testing.
"I envision one day where getting tested [for STDs] can be as simple and as affordable as doing a home pregnancy test," Mena said.
While syphilis cases dropped sharply with the availability of antibiotics in the 1940s, rates of the infection last year reached their highest since 1991. The total number of cases reached its highest level since 1948.
At one point, infection rates had been so low the CDC planned to work to eliminate the disease, but the agency discarded those plans in 2013 as case numbers continued to grow, the AP reported.
Cases have been rising since 2002, primarily in gay and bisexual men. In 1998, there were only 7,000 new syphilis cases nationwide. By 2021, that number was 52,000, the AP reported.
The rate of cases was 16 per 100,000 people last year, with the highest rates in men who have sex with men and in Black and Hispanic Americans and Native Americans, the AP reported.
Women have typically had a lower rate than men, but it rose 50% last year.
Syphilis causes genital sores. The bacterial infection can lead to severe symptoms and death without treatment.
Congenital syphilis, which passes the infection between a pregnant woman and her baby, can lead to loss of sight, hearing and even death in a newborn. Last year, congenital syphilis cases reached 2,700, including 211 infants who were stillborn or died. That's a sharp increase from 300 cases annually a decade ago, the AP reported.
Infection rates for gonorrhea have also been increasing for years, while HIV cases were up 16% in 2021, the AP reported.
It is "out of control,” David Harvey, executive director of the National Coalition of STD Directors, told the AP.
Reasons for the increase range from inadequate funding for testing and prevention to delayed diagnosis during the pandemic. Condom use has also been declining, while drug and alcohol use may have reduced inhibitions. Increases may also be linked to a surge in sexual activity after COVID-19 lockdowns.
"People are feeling liberated," Saag told the AP.
The World Health Organization has more on sexually transmitted diseases.
SOURCE: Associated Press