Common sexually transmitted diseases such as syphilis and gonorrhea have exploded in recent years, in part because of reduced funding for public health clinics, federal officials reported Tuesday.
And more than 1.4 million cases of chlamydia were reported last year — the highest number of cases of any disease ever reported to the Centers for Disease Control and Prevention.
Just under 20,000 cases of syphilis were reported in 2014, the highest rate since 1994 and a 15 percent increase over 2013, the CDC said. The CDC found 458 cases of syphilis in newborn babies — a startling 27.5 percent increase over 2013.
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And more than 350,000 cases of gonorrhea were reported, up 5 percent from 2013.
"Certainly, this is the first time since 2006 that all three of our notifiable sexually transmitted diseases have increased," said the CDC's Dr. Gail Bolan. "Some of the increases are quite alarming."
Most of the increases have been seen in young adults, who get infected soon after they first begin having sex.
The CDC estimates that half of the 20 million new sexually transmitted infections that occur every year are among people aged 15-24.
"Young people are the most vulnerable," Bolan said. While antibiotics can treat the infections, they often do not cause symptoms until damage has been done.
"Women can lose their reproductive health for a lifetime from infection of chlamydia or gonorrhea," Bolan said.
What's going on to cause the increase? There are several factors, the CDC says. Budget cuts are a big factor.
"Most recently, there have been significant erosions of state and local STD control programs," Bolan said. "Most people don't recognize that the direct clinical care of individuals with sexually transmitted diseases is supported by state and local funds and federal funds."
Just one example: In October, the Illinois Department of Health stopped paying for STD tests at 100 jails and local health departments across the state
"In one year 7 percent of local health departments said they closed their STD clinics," Bolan said. And 43 percent said they had to cut back on the hours they could stay open. About a third had to raise fees and co-pays, something that's been shown to keep some people away.
Another big factor is a change in behavior among gay and bisexual men.
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"The increase in syphilis among gay men is concerning because we have been seeing this increase for almost a decade," Bolan said. "It seems to correlate with the advent of HIV treatment."
Bolan's quick to say that HIV treatment is not responsible for the change. But the cocktails of powerful HIV drugs that are now available have made the infection a chronic disease that can be managed, instead of a death sentence. HIV patients know they can stay healthy if they take the drugs, and that they are less likely to infect someone else.
"People are excited about it," Bolan said. And some may have stopped using condoms so consistently, because they are no longer afraid of a deadly infection.
"But, unfortunately, HIV treatment has no impact on prevention of (other) STDs," she added. "Unless you are using condoms consistently and correctly, you are putting yourself at risk for STDs."
And uninfected people can also take HIV drugs to protect themselves from infection. That might make people think they're even safer from HIV. A study just published Monday supports this. Researchers across the country found that people at high risk of HIV who took the drugs in a practice called pre-exposure prophylaxis or PrEP almost never caught HIV, but they did catch syphilis and gonorrhea.
"There is some data suggesting that there is less condom use in some populations now," Bolan said.
As for chlamydia, Bolan thinks it's mostly a matter of better reporting that's driving the record numbers of reported cases.
"Chlamydia has been a very common sexually transmitted infection for years," she said.
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