As syphilis hits pre-AIDS rates among gay men—with numbers not seen since the early 1980s—and an antibiotic-resistant strain of ‘super-gonorrhea’ is emerging among a similar population in the UK, AHF is calling on the CDC to develop and roll out a new national STD prevention campaign.
As STD rates rise, CDC requests less overall prevention funding for its 2017 budget.
LOS ANGELES (April 26, 2016) As STD Awareness Month winds down, recent announcements from domestic and international health agencies reveal that rates of sexually transmitted diseases (STDs) have continued to rise annually, particularly among gay men, where syphilis is now hitting rates not seen since before the start of the HIV epidemic. In addition, the spread of drug-resistant strains of infections including gonorrhea and syphilis threatens the efficacy of medicines commonly used for treatment. With young people aged 15–24 and gay, bisexual, and other men who have sex with men (MSM) continuing to be at greatest risk for infection, AIDS Healthcare Foundation (AHF) has called on the Centers for Disease Control and Prevention (CDC) to develop and roll out a new national STD prevention campaign. While AHF acknowledges the efforts of the CDC’s “Get Yourself Tested Campaign,” its funding and scope has failed to match the severity of the growing STD epidemic.
“Among young people, women, and gay men, sexually transmitted diseases are spreading at alarmingly high rates,” said Dr. Michael Wohlfeiler, Chief of Medicine/US for AHF. “These infections can not only cause pain and discomfort in the short term but, if left untreated, can lead to more serious complications including internal organ damage and infertility. Regular STD screenings with a trusted medical provider must be a key component of maintaining one’s sexual health. It is more important now than ever for people to take the necessary steps to protect themselves and their partners from potentially harmful diseases.”
According to CDC estimates, there are 20 million new STD infections each year in the United States, costing the healthcare system nearly $16 billion in direct medical costs. The agency also reports there are more than 110 million total sexually transmitted infections in U.S. men and women. However, the CDC requested less overall funding for 2017 for HIV/AIDS, hepatitis, sexually transmitted infections (STIs) and tuberculosis (TB) than it did for 2016. For STIs, the CDC’s funding request has remained stagnant, while the HIV/AIDS Prevention and Research funding request is $10 million lower than the previous year. While the CDC did request more funding for 2017 than the agency actually received in 2016, enacted funding has consistently fallen short of requested funding.
“In many ways, we are a victim of our own success: in our fight against HIV, rates dropped over the past decade and fewer people are now advancing to AIDS-defining illnesses thanks to improvements in anti-retroviral therapies, which is great news. However, it appears that individual and organizational complacency has set in regarding condoms, which remain the best way to prevent most STDs,” said AHF President Michael Weinstein. “Given the CDC’s shift away from promoting condom usage and cuts in STD prevention funding, it is no real surprise that STDs are skyrocketing here, particularly among young people. We call on the CDC to step up and develop an innovative, aggressive national STD prevention campaign.”
Syphilis: Back from the brink of oblivion
In July 2000, Malcolm Gladwell wrote a piece for The New Yorker that explored the US government’s missed opportunity to eradicate syphilis, which at the time was at its lowest level in US history. Gladwell observed that, “…syphilis is very close to that critical point faced by many epidemics, when even the slightest push could tip them into oblivion.” He also noted, “…the Centers for Disease Control asked Congress, if, for an extra fifteen million dollars in C.D.C funding, it would like to wipe out syphilis from the United States by 2005. And Congress said no.”
Sadly, since that article was published, syphilis has rebounded and steadily increased almost every year, with gay and bisexual men accounting for the majority of new syphilis infections. Gail Bolan, director of the CDC’s Division of STD Prevention, recently declared on Capitol Hill, “We’re concerned about our high levels of syphilis … – really we’re back to the level of disease – burden of disease – in gay men that we were seeing before HIV in this country.”
“Super-gonorrhea” and the threat of drug-resistant bacterial strains
Physicians and public health officials in the UK have also expressed “huge concern” over emerging strains of antibiotic-resistant gonorrhea known as super-gonorrhea, as reported by the BBC last week. The sexually transmitted infection, which can lead to infertility and pelvic inflammatory disease in women, is feared to soon become untreatable. While gonorrhea is typically treated with a combination of the antibiotics azithromycin and ceftriaxone, new strains have proved resistant to azithromycin—and doctors believe that ceftriaxone is likely to become ineffective as well.
Although the outbreak in the UK that prompted a national alert last year originated with straight couples, antibiotic-resistant
strains have since surfaced among communities of gay men, where it may spread more quickly and increase the risk of HIV infection.
“With drug-resistant strains of STDs on the rise and sexually active young people being at particular risk for exposure, how many people will have to be infected before our elected officials and health agencies make confronting the STD epidemic a national priority?” added Whitney Engeran-Cordova, Senior Director of Public Health for AHF. “Creating a hashtag or talking about this issue for 30 days is simply not enough to address the magnitude of the problem at hand.”
AHF: CDC should prioritize condom use, place STDs at forefront of national public health agenda
Regarding the abandonment of the condom culture in the US: advocates from AHF note that in just a one month period between December 2013 and January 2014—and with little public review—the CDC changed its longstanding prevention wording regarding condom use from using the phrase “unprotected sex” to describe sex without a condom or some form of barrier protection to now using the phrase, “condomless sex,”—a move that may suggest to some that condomless sex is protected. A further indication of the erosion of the condom culture came in February of this year, when the CDC released a plan to prevent 185,000 new HIV infections—and failed to even mention condoms as a potential tool in that effort.
AHF advises sexually active individuals to reduce the risk of contracting and spreading STDs by engaging in safer sex practices such as regular condom use and participating in frequent STD screenings. Knowing your STD or HIV status is essential to your health and the health of your sexual partners.
AHF’s Wellness Centers provide free testing for sexually transmitted diseases, including chlamydia, gonorrhea, syphilis, and HIV. To find the nearest location for STD screening and treatment, visit http://www.freestdcheck.org.