The annual Sexually Transmitted Disease Surveillance Report released in late September found that a total of 1,598,354 cases of chlamydia were reported in 2016, a 4.7 percent increase over 2015. Gonorrhea cases increased by 18.5 percent to 468,514, and syphilis increased 17.6 percent to 27,814 cases.
In Connecticut, 14,028 cases of chlamydia were reported, 759 more than in 2015, a 5.7 percent rise. There were 2,745 cases of gonorrhea, 653 more than in 2015, a 31 percent increase, according to the state Department of Public Health (DPH). The number of syphilis cases reported was 111, up 12 percent from the previous year.
“We need to start focusing our education efforts among younger populations so they can be aware of the risk factors,” says Martiza Bond, Bridgeport’s director of Health & Social Services. The city plans to hire a part-time epidemiologist to identify age groups that are experiencing an increase in STDs so they can be better targeted.
Connecticut has one of the lowest rates of STDs in the country, ranking 42nd of the 50 states for the number of chlamydia cases per 100,000, and 41st for gonorrhea and syphilis cases. But in the state’s largest cities, the rates are relatively high.
Hartford, Bridgeport and New Haven had the highest rates of STDs. Hartford had 1,689 cases of chlamydia and 415 cases of gonorrhea. Bridgeport had 1,254 and 314, respectively. New Haven had 1,125 and 260.
Chlamydia is almost twice as common among women as among men, and most common among adolescent and young adult women. Gonorrhea, which was once more common among women, is now much more common among men, mostly among men having sex with men. Syphilis is about eight times more common among men than women, and is mostly found in men having sex with men.
Experts caution that some of the increase seen in 2016 can be attributed to better screening and diagnostic testing that has been rolled out in the past year or so.
“Beginning in July 2016, we started conducting oral and rectal swabs for chlamydia and gonorrhea, whereas prior to this, we only tested urine in men,” says Joshua Rozovsky of the Hartford Gay & Lesbian Health Collective. “We now swab 100 percent of patients who walk in the door,” he says. In the past, testing of urine samples and swabs of the genitals in women may have missed infections.
Connecticut Department of Public Health’s (DPH) laboratory, which serves STD clinics, school-based health centers, colleges and some community health centers, also moved to oral and rectal swabbing last November.
Experts point to a rise in casual and unsafe sex and a lack of knowledge among young people about unprotected sex as reasons for the increase in STDs.
“It’s partly because of the increase in the use of apps for hookups,” Rozovsky says. “And because most people do not see oral sex as sex, it’s seen as a casual low-risk type of activity.” Adding to the problem is message fatigue among the gay community. “It’s a group that’s been hearing the same message for a long time,” says Dr. Lynn Sosa, TB/STD control programs coordinator at DPH.
At the Hartford Gay & Lesbian Health Collective, they are seeing STDs not only in gay men, but also in heterosexual men and women. “We’re treating men, women, people in their 90s, all age ranges,” Rozovsky says. “Nobody is immune and STDs have become essentially endemic with the sexually-active populations,” he says.
In women, untreated chlamydia and gonorrhea can cause pelvic inflammatory disease and infertility. Syphilis, which was nearly wiped out in the 1990s, has been on the rise since 2001 and is beginning to show up in women across the country. In Connecticut, it is still mainly seen in the male gay community.
“We are really at a little bit of a crossroads with syphilis,” Sosa says. “The real concern is if we start seeing syphilis among women, then we’re going to start seeing more babies with syphilis,” she says. In the United States in 2016, 628 babies were born with syphilis, compared with 334 in 2012. There were no cases of syphilis in infants in Connecticut last year, the health department reports. Babies born with syphilis can suffer physical and mental developmental disabilities. These complications can be prevented if women are tested and treated early in their pregnancy.
The CDC is calling for state and local programs to do more to reduce the incidence of STDs. But health departments are challenged with getting an effective message out. “We need to do more research on how we can engage this group better,” Sosa says.
“It’s important to continue informing and advising the public of the potential infections that could be acquired from unprotected sex and the effective and appropriate forms of contraception that can prevent infection, like male and female condoms or dental dams,” says Brian Weeks, an epidemiologist at the New Haven Health Department.
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