US health agency warns of worsening sexual health crisis

More funding is needed for sexual health services as well as innovative screening and prevention tools to combat an “alarming” rise in sexually transmitted infections in the United States, the country’s top public health agency has warned.

Dr Leandro Mena, director of the division of STD prevention at the Centers for Disease Control and Prevention, told the Financial Times that new data showing the number of syphilis cases rose by more than a quarter the year last highlighted the “crisis” that is unfolding in the sexual realm. America’s health.

Rising cases of syphilis and other bacterial STDs – such as gonorrhea and chlamydia – are fueled by a combination of underfunding of sexual health services, reduced condom use among certain groups and stigma surrounding sexual diseases and access to treatment, he said.

“We find these [statistics] quite alarming. For six or seven years in a row, STI rates have been rising in the United States, and last year’s 26% jump in syphilis cases was one of the largest year-over-year increases ever. we have ever seen,” he said.

The resurgence of STIs in the United States and elsewhere is worrying health officials, who warn that wards are already overstretched due to Covid-19 and monkeypox. Last year, the CDC estimated that one in five Americans had an STI at some point in 2018 and that the lifetime cost of treating new infections acquired in that year alone would be $16 billion. .

Mena said America’s sexual health prevention and treatment services have been underfunded for more than two decades, resulting in more than a 40% reduction in per capita purchasing power when inflation is taken into account. This has led to a decrease in testing and tracing services in many communities, he said.

“To deal with the crisis that we recognize we have in America’s sexual health, I think we really need innovation,” Mena said. “We need to improve access to affordable sexual health services free from stigma and discrimination. . . we need more tools to fight the national outbreak of bacterial STIs.

Preliminary data released last month by the CDC shows that 2.5 million bacterial STI infections were reported in 2021, a 4.4% increase from the previous year. The number of gonorrhea and chlamydia cases rose about 3% year-on-year, while reported cases of syphilis, a life-threatening disease when left untreated, rose much more rapidly.

Syphilis infection rates hit an all-time low in 2000-2001, according to CDC data, but have been rising steadily since then. Over a five-year period, reported cases of syphilis have increased by almost 70%, while the number of congenital cases – when a mother passes a syphilis infection to her baby during pregnancy – jumped by 184% since 2017.

“Congenital syphilis can have devastating consequences that affect perhaps the most vulnerable people in society, newborn babies. It is also 100% preventable, so in many ways it represents failures in our systems,” Mena said.

He said there has been a decline in condom use among certain groups, including young people and men who have sex with men, as the availability of antiretroviral treatment for HIV has expanded in recent years. last years. Drug addiction and the opioid epidemic are linked to increases in risky sexual behaviors, and stigma has played a role in preventing people from accessing testing services and treatment, Mena said.

He said people needed access to ‘stigmatism-free and affordable’ sexual health screening services to tackle rising infection rates. Developing and rolling out home testing kits and point-of-sale testing in pharmacies or places other than health clinics could also help, Mena added.

Dr. Leandro Mena: “We need to improve access to affordable sexual health services free from stigma and discrimination” © Brandon Clifton/CDC

He said the CDC was evaluating “exciting” research published in July that showed a single pill of a common antibiotic taken up to three days after sex could significantly reduce infection rates from bacterial STIs. .

“We are very encouraged by these initial data in an NIH-funded study for the use of doxycycline as post-exposure prophylaxis to prevent infection,” Mena said.

He said the agency wanted to review the full study data before advising doctors on the use of doxycycline among high-risk groups. This would examine the issue of antimicrobial resistance and whether prescribing the antibiotic in this way could cause other pathogens to develop resistance against doxycycline, Mena said.

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