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STDs--What to Know, What to Do.
April is “STD Awareness Month,” which is the ideal time to review the state of STDs in the U.S. and consider approaches to address the STD epidemic in our country. Surveillance data through 2017 recently released by CDC indicate sustained increases nationally in the primary STD (non-HIV) infections.
What to Know
  1. STD Surveillance 2013 – 2017 Highlights:
  • Total STD Cases – increased 31%; 2.3 million cases in 2017, up from 1.8 million in 2013.
  • Chlamydia – increased 22%; 1.7 million cases reported in 2017.
    • Highest among adolescent and young adults, and among women.
    • Southern region of the U.S. had the highest rates, but increases occurred in all four regions of the U.S.
    • Prevalence among Blacks was 5.6 times the prevalence among Whites.
    • Chlamydia is also common among men who have sex with men (MSM). (
  • Gonorrhea – increased 67%; over ½ million cases reported in 2017.
    • Highest rates among males, with increases in females as well.
    • Southern region of the U.S. had the highest rates, but increases observed in all four regions.
    • The rate among Blacks was 8.3 times the rate among Whites.
    • Increases in drug (cephalosporin) resistant gonorrhea. (
  • Syphilis – increased 76%; over 30,000 cases reported in 2017.
    • Highest among MSM, with increases in both men who have sex with women and in females.
    • West region had the highest rates of primary & secondary (P&S) syphilis in the U.S., with increases also in the South and Midwest, and no change in the Northeast.
    • P&S syphilis rates were highest among Blacks (4.5 times the rate among Whites).
    • Congenital Syphilis increased 154%; 918 reported cases (including 64 syphilitic stillbirths and 13 infant deaths).
    • Increases in all four regions of the U.S., with the highest increase in the West, followed by the South. (
2. Disparities:
3. Primary Concerns if untreated:
  • Infertility, and complications with pregnancy;
  • Long-term abdominal pain for females;
  • Syphilis in pregnant women can lead to congenital syphilis, which can lead to birth defects and stillbirth;
  • Transmission of STDs to unborn and to babies during delivery;
  • Transmission to sexual partners;
  • HPV is leading cause of cervical cancer in women;
  • Increased risk of HIV transmission and acquisition;
  • Stigmatization of populations highly impacted (regardless of treatment status).
What to Do
Prevention Messages & Options:
  • Test! Test! Test!
    • Most people with an STD are not aware they have an infection;
    • Promote screening as part of a broader sexual health messaging;
    • Get tested when no signs or symptoms;
    • Encourage testing with sexual partners, at the start of a new sexual relationship;
    • Repeat testing per recommendations (
  • Promote open communication with sex partners and healthcare providers.
    • Encourage expanded extragenital screening (throat & rectum), when applicable
  • Offer sexual prevention options:
    • Consistent & correct use of condoms
    • Be with one partner who has no other risks, is also monogamous and both be tested during that relationship
    • Reduce number of sexual partners
    • Abstinence – no exchange of genital/rectal fluids
  • Incorporate STD prevention messaging with other services (e.g. HIV Testing; Viral Hepatitis; PrEP; Family Planning).
  • Discuss STD prevention in the context of sexual health.
  • HPV vaccination can prevent some HPV strains (recommended for males & females 13-26 years of age)
  • Hepatitis B vaccination
  • STD screening & treatment also help to prevent sexual transmission of HIV.
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