The drastic increase in sexually transmitted disease (STD) rates can be directly linked to the COVID-19 pandemic, experts say.
According to the CDC’s April 2022 review of sexually transmitted disease rates, 2.4 million cases of chlamydia, gonorrhea, and congenital syphilis were reported.
Since 2016, the CDC has seen an increase in:
- Gonorrhea: 677,729 cases; up 45% from 2016
- Syphilis: 133,945 cases; up 52% from 2016
- Congenital syphilis: 2,148 cases; up 235% from 2016
While chlamydia cases were technically down 1.2% from 2016, there were still 1.6 million cases. Ashley Briggs, M.D., an OB/GYN at Sanford Health in Sioux Falls, South Dakota, said chlamydia rates can be tough to comprehensively cite, “because chlamydia tends to be asymptomatic.”
“Unless they’re going in and being tested, those types of infections aren’t being found,” she said.
Rates rise as testing resources dwindle
And, testing for STDs has become more strained during the pandemic, said Johnathan Mermin, M.D., M.P.H., director of CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention.
“The COVID-19 pandemic put enormous pressure on an already strained public health infrastructure.
“There were moments in 2020 when it felt like the world was standing still, but STDs weren’t. The unrelenting momentum of the STD epidemic continued even as STD prevention services were disrupted,” he said.
Dr. Briggs said rates of gonorrhea, syphilis and chlamydia, the three most common STDs, were all on the rise within Sanford’s communities.
“In 2022, related to the Sanford footprint, chlamydia rose 14% compared to the five-year median rate. Syphilis rose 2,144% compared to that five-year median rate, and gonorrhea rose 62% compared to that five-year median rate. So, we’re seeing significant increases in these three STDs in South Dakota,” she explained.
Syphilis, the highest rising STD within Sanford’s communities, initially presents itself as a sore (or sores) called a chancre (chank-er). A chancre generally looks like someone touched the burning end of a cigarette to the skin.
Dr. Briggs said the disease is highly contagious at this stage.
“Brushing across the open wound can spread the syphilis to any part of the body that’s touched — not just the genitals.”
The sore doesn’t typically hurt. So, people can often see the sore and think they’re OK when it heals. But the disease remains in the body, and only a prescription medicine kills it.
If the chancre is inside of the vagina and the woman doesn’t know it’s there, her partner won’t know it’s there. Same thing with the mouth and anus, so it can also spread through oral or anal sex without the other person knowing.
In short, there’s not a spot on the human body where a chancre couldn’t grow.
Stages and treatment
In the first stage of a syphilis exposure, the only sign is the sore, which heals on its own and doesn’t hurt.
Left untreated, the disease progresses into the second stage, which includes a sore throat, low-grade fever and body aches — kind of like an unexplained virus. The telltale sign with the second stage is a rash on the person’s palm of the hand, sole of the foot or all over the trunk.
Syphilis progresses into the latent stage when there aren’t any symptoms, but it can still be passed to another person.
Finally, the tertiary stage can cause more serious health effects, including dementia, blindness, heart problems and damage to soft tissue like the stomach and lungs.
The only treatment for syphilis is penicillin. If the person is allergic to the drug, they’re typically admitted to the hospital and desensitized until they are able to receive it.
Danger to babies
Left untreated, STDs can cause long-term pelvic and abdominal pain, pregnancy complications or an inability to get pregnant. Congenital syphilis, passed on to babies from their parents, can cause:
- Rash on their palms or the soles of their feet
- Lesions in the mouth
- Swollen lymph nodes
- Failure to thrive
- Deformity in the tibia bone of their leg
- Intellectual challenges that get worse if not treated early
- Deformed mouth and nose
- Cataracts in the eyes
“Protecting moms protects babies. If you’re pregnant, you can get tested for syphilis at your first prenatal visit; additional tests throughout your pregnancy may also be recommended,” said Dr. Briggs.
How to protect yourself
Dr. Briggs said partners can prevent the spread of syphilis and other STDs with these simple steps, suggested by the CDC:
- Have an open and honest discussion with your health care provider about your risk.
- Ask your provider about getting tested.
- Discuss treatment options with your health care provider.
- Have a safer sex game plan like STD testing and condoms before you go out or swipe right.
“Some people don’t get tested because of the cost, or they’re worried about confidentiality, that it’s going to hurt or that they’ll be judged. At Sanford Health, we are nonjudgmental and culturally sensitive. Let’s talk about how you can be safer,” she said.
Sanford Health offers testing at all primary care clinic locations.
- Sexually transmitted infections: What you should know
- Maternal mortality: Working to keep moms safe
- How to find primary care at Sanford Health