Gonorrhea cases increased by 10 percent in 2020, while syphilis infections increased by 7 percent. Congenital syphilis, which almost disappeared in the United States at the turn of the century, increased by 15 percent by 2020, contributing to at least 149 stillbirths and infant deaths that year.
And while a new report shows that chlamydia cases will decline by 13 percent by 2020, senior health officials believe this reflects a reduction in often asymptomatic disease screening rather than a real reduction in the number of infections.
CDC officials told reporters on Tuesday in a call that their as-yet-unpublished preliminary data from 2021 indicate that the situation has worsened, with higher rates of syphilis and congenital syphilis than in 2020.
“STDs have been on the rise for quite some time, but Covid-19 has boosted the factors that contribute to it in many ways,” Leandro Mena, CDC’s director of STD prevention, told POLITICO in a separate telephone interview. “We have had reduced public health funding for more than ten years, which has led to a reduction in STDs screening, prevention, education and other health services. “We have also been dealing with an increase in substance use related to less safe sexual practices.”
Although most STDs are preventable and curable if patients are diagnosed and given medication in a timely manner, people who are not treated can see severe and potentially fatal consequences. Increased risk during the Covid-19 pandemicWhen many clinics stopped having personal testing and millions lost their health insurance.
Based on 2020 data, the CDC report says the agency is currently seeking to increase “adverse outcomes” such as pelvic inflammatory disease and infertility.
Despite the deterioration of STDs, several independent sexual health organizations and the Department of State that are part of the Federal Title X program in Family Planning are receiving far less funding this year than they did during the Trump administration.
President Joe Biden moved last year to lift restrictions on the Trump administration on the program. Road cleaning Planned for hundreds of parenting clinics, several state health departments and groups to leave in protest of the abortion ban. Still, because Congress kept funding for the program at about $ 286 million in its recent spending bill, HHS says it has had to shift resources to meet the country’s most pressing needs, causing some providers to shrink deep. In countries with a high rate of STDs.
“The significant gap between available resources and communities has grown directly into difficult decisions, with consequences that reflect our highly qualified Title X community,” said Jessica Swaford Marcella, HHS Deputy Assistant for Population Affairs.
In California, for example, the group Essential Access Health has been receiving $ 21 million annually in funding for Title X for the past three years. In late March, he learned that next year’s funding would be $ 13.2 million – the largest reduction the group has experienced since joining the federal program in the 1970s.
In Wisconsin, the State Department of Health saw its Title X funding cut from $ 3.8 million to $ 3 million a year. And in Oklahoma, the group Community Health Connection received $ 300,000 under the Trump administration, but The Biden administration did not receive funding.
“We’re really left behind while we’re down,” said Laura Bellis, chief executive of the Take Control Initiative, which works with Community Health Connection and other Oklahoma groups on sexual health. “We have epidemic rates of STIs and they are getting worse. And now there will be many more people who will not be able to take care of themselves. There will also be fewer appointments, especially for young people who are unable to attend school. ”
While the Oklahoma State Department of Health has received Title X funding to match Community Health Connection cuts, Belis and other advocates argue that because of the sensitive nature of STD services, it is better to fund different options for a marginalized population. It may not be comfortable to come to a state provider.
“Where should the undocumented go?” He asked. “We have a large immigrant population who have a lot of fears about things like the public tax rule – where immigrants are fined for government medical care. And Tulsa County officials are cooperating a lot [Immigration and Customs Enforcement]”Many of these people are distrustful of government structures in general.”
Julie Rabinowitz, president and CEO of California’s Title X grant recipient Essential Access Health, says funding cuts are forcing her to remove about 400 out of 150 clinics in their network and cut budgets elsewhere. Their STD services will get one of the biggest blows.
“We can no longer have STD-specific staff with technical expertise and training,” he said. “We had an application for $ 22 million because we wanted to have more working hours, improve our quality of care, offer comprehensive services, and provide more contraceptives. So we were shocked and scared that our funding was so drastically reduced to $ 13 million.
Mena, a senior official in the Biden administration who focuses on STDs, argued that while Title X is important, it is only one tool in the fight against gonorrhea, syphilis, chlamydia and other infections. He argued that primary health care providers should also include the prevention and treatment of STDs in their routine care, and said doing so would help reduce stigma and help people see it as a normal part of health. Who may be uncomfortable visiting a Title X clinic or public health department. Mena added that drug treatment facilities should also offer STD services and that the private sector should develop more effective STD tests, treatments and vaccines.
So resources are a priority [for Title X] “It will be critical to tackle the STI epidemic,” Mena told POLITICO. “But there is no silver bullet.”
Title X providers have long argued that their sexual health services help people who are afraid that an STD test in their doctor’s office will appear in their insurance statement – including young people who are still on parental insurance and people in abusive relationships.
The CDC report also painted a bleak picture of sexual health for teens and young adults, finding that by 2020, 53 percent of all STDs reported were in people aged 15 to 24 years. From 46 percent in 2018.
More recent data indicate that the teenager rate could be even worse. A A study published by the American Academy of Pediatrics On Monday, it was found that 20 percent of sexually active high school students had passed the STD test last year. The rate for boys was 13 percent.
Rabinowitz says budget cuts in California will disproportionately affect young people who often come to them for confidential and non-confidential services.
“I’m very concerned about the area north of San Francisco, the Central Valley and the Inner Empire – all of which have the highest STDs and teen pregnancy rates in the state,” she said.
Despite rising STDs, congressional support for Title X funding fell by almost 10 percent after the program’s funding peak in 2010 was $ 317 million.
Although Biden recently proposed a significant budget increase for 2023, which increased it from $ 286 million to $ 400 million, the budget did not recommend other CDC programs to combat STDs – proponents of the move called it “irritating” and “deeply frustrating.”
“The CDC will not be able to use full weight in prioritizing the growing STD epidemic in the budgeting process when their data paints a bleak picture,” said David Harvey, chief executive of the National Coalition of STD Directors. “This budget misses the mark at this particular stage when we see our indicators explode and a large part of our workforce is redistributed to manage Covid-19.”
Amid a lack of funding, providers are trying to raise dollars and get resources for people in areas where clinics might close their doors.
In Oklahoma, for example, the Belize Group and others were looking at ways to make emergency contraceptive pills like Plan B available to patients before they became pregnant, researching partnerships with online pharmacies, and setting up wellness vending machines that carry condoms and STIs. Tests.
Nevertheless, they say it is not a substitute for experienced staff providing comprehensive personal service.
“We never expected to be in a worse place for preventive care than we were at the beginning of the pandemic,” he said. “We have dealt with many state bans on abortion, but what we did not expect was the federal government, which is destroying access to contraception and treating STDs largely through negligence.”
STDs are on the rise. There is no funding to fight them.
