New CDC Sexually Transmitted Infections (STI) Data Offers Hope Amid Challenges
This commentary is a repost from “Sex on Wednesdays” by Martha Kempner on Substack. Find her other articles on The Queen Zone here.
The CDC messaging around the agency’s newly released STI data for 2023 points to glimmers of hope and stresses cautious optimism. It’s hard to remain hopeful when congenital syphilis is still rampant, a new more serious strain of monkey pox has landed in California, and our infectious disease tracking and prevention system is about to be handed over to someone who’d like us to stop vaccinating for measles. Nonetheless, I agree that this news is not all bad.
According to the 2023 Sexually Transmitted Infections Surveillance report released last week, there were fewer STIs reported in the United States last year than the year before. Gonorrhea rates fell, chlamydia rates remained stable, and syphilis rates leveled off with only a 1% increase.
The report focuses on those three STIs because they’re reportable, meaning the CDC must be told about all diagnosed cases. In 2023 there were 2.4 million of them. That represents a 1.8% decrease from 2022. Much of this decline was the result of a 7% decrease in the number of gonorrhea cases. There was also a 10% drop in the number of early stage (known as primary and secondary) syphilis cases, though total syphilis cases (which include late stage and congenital cases) squeaked up by 1%. And while congenital syphilis rates went up, the 3% increase year-over-year pales in comparison to the 30% jumps we had been seeing.
As always, though, there are wide disparities in who gets STIs. Young people remain the age group hardest hit with 48.2% of reported cases occurring in those ages 15 to 24. Already marginalized communities are also hit harder by STIs. In 2023, MSM accounted for 57.5% of primary and secondary syphilis cases among men with known sex of sex partners. In addition, 32.4% of all cases of chlamydia, gonorrhea, and primary and secondary syphilis were among non-Hispanic Black or African American persons, even though they made up only 12.6% of the U.S. population. Like in previous years, cases of congenital syphilis were highest among American Indian or Alaska Native persons.
You May Want To Read: Teen STD Rates Are Surging: Is Your Child At Risk?
While it may be tempting to pass judgement and dust off those Comstock laws, it’s important to remember that getting an STI has more to do with sexual networks (who you’re having sex with and who they’re having sex with) than individual behavior. Sexual networks have more to do with societal factors like poverty, stigma, racism, and lack of access to health care than personal behavior. For example, gonorrhea will likely spread more widely within a sexual network made up of people who are uninsured or do not readily have access to health care because it’s less likely that they get screened and treated quickly.
It does seem like we’ve made progress in addressing the rise in STI cases. Experts credit increased testing (including the availability of at-home testing), and the introduction of doxy PEP (the use of doxycycline to prevent bacterial STIs) with helping to curb the epidemic. But we still have a long way to go at a time when the future of all public health efforts seems perilous, and programs to help with poverty, stigma, racism, and lack of access to health care seem destined for the dust heap.
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