The CDC recently released data on numbers of infections of the three most prevalent STDs: Chlamydia, Gonorrhea and Syphilis. The data indicated approximately 2.3 million individuals contracted a sexually transmitted disease in 2018. The CDC notes that the rates have been on the upswing since 2013 when a total of 1.7 million cases were reported.
Chlamydia remains the most prevalent of the three STDs with 1.7 million cases diagnosed in 2017; gonorrhea followed with 555,608 cases and primary and secondary syphilis were diagnosed in 31,644 patients.
These three diseases are curable with antibiotics, but as the CDC report noted, most cases go undiagnosed and untreated and lack of treatment can lead to complications including infertility, ectopic pregnancy, premature and stillborn infants and an increased risk of contracting HIV.
There have been several studies examining factors which contribute to STD increases and economic factors including poverty, stigma, discrimination and drug use have been cited. To reduce the number of infections, we must have the two-pronged approach of prevention and cure.
Since it has been learned that most sexually transmitted infections are transmitted by people who do not know they are infected, education on the need for safe sex and regular testing for these diseases is needed. Patients need to be educated on the need to request testing and we, as providers, must be cognizant of the need to increase screening for sexually transmitted diseases as part of our routine care for patients.
As I mentioned in a previous blog, the threat of untreatable gonorrhea persists in the US and CDC recommendation for treatment remains azithromycin and ceftriaxone. At present in the US, 4% of organisms are resistant to azithromycin but none have been reported resistant to ceftriaxone. There is concern that azithromycin resistant genes in some gonorrhea could crossover and lead to ceftriaxone resistance.