More than 2.5 million cases of sexually transmitted infections were reported in 2021, jumping by 7% in one year, according to new data from the US Centers for Disease Control and Prevention.
"The US STI epidemic shows no signs of slowing," said Dr. Leandro Mena, director of the CDC's Division of STD Prevention.
Chlamydia accounted for more than half of the reported cases, with rates increasing about 4% in 2021. Cases of gonorrhea rose nearly 5%.
Cases of syphilis surged 32% in one year, including an alarming rise in infections passed from pregnant mothers to babies developing in the womb. In 2021, congenital syphilis caused 220 stillbirths and infant deaths.
"The most important thing to remember is that congenital syphilis is 100% preventable," Mena said. "In many ways, it is the result of our failure to prevent syphilis among women of reproductive age and their partners."
Lacking prenatal care and adequate maternal treatment are among the most common missed opportunities for preventing congenital syphilis, he said.
But a recent report found that it's become harder for women to access reproductive health care services - such as routine screenings and birth control - in recent years. Women seeking reproductive health care were more likely to report challenges to access - and more of them - in 2021 than they were in 2017.
A combination of factors has contributed to the overall rise in STI cases, and the pandemic exacerbated many of them, Mena said.
"The lack of access to health care, including testing and treatment for STI, can make it difficult for people to receive the care they need," Mena said. "Decreased funding for public health and an eroding infrastructure in public health really have limited access to testing driven services."
Persistent stigma associated with STIs and lingering effects of pandemic-related disruptions challenge the scope of screening services. The number of reported STIs is likely a vast underrepresentation of a "staggering" number of actual cases, he says.
STIs affect every population, but the 2021 data from the CDC shows that case rates are disproportionately high among gay and bisexual men, younger people, and Black and American Indian people.
"To make progress towards ending this STI epidemic, we must really meet people where they are by developing tailored and localized interventions to have the greatest impact," Mena said. "We want to make sure that we're addressing the social and economic conditions that make it more difficult for some of these populations to stay healthy."
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