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  • Over 2.5 million STIs were reported in the United States in 2021, marking a 7% increase in cases between 2017 and 2021.
  • Cases of syphilis have increased by nearly 74% during that time.
  • Between 2017 to 2021, cases of gonorrhea have increased by about 28%, cases of syphilis have increased by nearly 74 %, and cases of congenital syphilis have increased by over 203%.

Sexually transmitted infections (STIs) like syphilis, chlamydia, and gonorrhea continued to rise in 2021, a new report from U.S. Centers for Diseases Control and Prevention (CDC).

Over 2.5 million STIs were reported in the United States in 2021, marking a 7% increase in cases between 2017 and 2021.

Cases of increases in syphilis saw the biggest spike, growing by 32% between 2020 and 2021.

The CDC says the COVID-19 pandemic, which drove many people to forego or delay prevention services like testing, contributed to the spread of STIs.

Even before the pandemic hit, however, STIs were on the rise — a trend that has disproportionately impacted ethnic minority groups, gay and bisexual men, and people younger than age 25.

“Rates of STIs continue to increase in the U.S. with alarming numbers over the past few years. Changes in sexual behavior with a decrease in condom use, decrease in prevention and testing efforts are likely the major contributors to the increase in STIs in the U.S.,” says Dr. Maria Alcaide, an infectious disease specialist with UHealth, University of Miami Health System and a professor of Medicine with the University of Miami Miller School of Medicine.

Between 2017 and 2021, cases of gonorrhea have increased by about 28%, cases of syphilis have increased by nearly 74%, and cases of congenital syphilis have increased by over 203%.

The report showed that cases of chlamydia dropped by 4%, but the researchers suspect the decline is due to reduced prevention and public health efforts during the pandemic and not an actual decrease in infections.

“The COVID-19 pandemic may have contributed to the rising rates of STIs as people may have had less access to education, testing, and treatment,” Dr. Alcaide says.

But STIs were swiftly rising even before the pandemic hit.

Data suggests barriers to care, discrimination, and the stigma attached to STIs have all contributed to the rise in STIs.

Reduced condom use, a decrease in prevention and screening efforts, and opioid use, which is known to go hand-in-hand with STIs, are believed to have played a role, too.

Between 2020 and 2021 alone, syphilis rose by 32%.

“While most of new syphilis cases occur among men who have sex with men, we are also seeing an increasing number of cases among women, which reflects the increase in congenital syphilis,” Alcaide said.

Dr. Irene Stafford, a maternal-fetal medicine physician and an associate professor of OB/GYN with McGovern Medical School at UTHealth Houston, says syphilis is often a silent infection that presents with no symptoms.

“The rash and lesions of early syphilis can be asymptomatic and after they clear, an infected individual is unaware they are still infected,” she says.

People who are infected can then unknowingly spread it to others through skin-to-skin contact or mucosal contact with an infected person.

“Transmission is easier than with other STIs that are transmitted through sexual intercourse,” says Alcaide.

Many STIs can be asymptomatic in certain individuals, however, left untreated, can lead to complications like chronic pelvic pain, pelvic inflammatory disease, infertility, pregnancy complications, an increased risk of contracting infections like HIV, and infant death.

Syphilis, for example, is more common in reproductive-aged people, including pregnant women, according to Dr. Stafford.

Untreated, the infection can be passed to the fetus and lead to health complications, like speed and liver problems and nerve issues, due to congenital syphilis.

To prevent the spread of STIs, all sexually-active people should get regularly tested once a year.

“If there is a new sexual partner, unprotected sex, recent STIs, or a partner with STIs testing should be done more frequently,” says Alcaide.

STI screenings and open conversations should be a part of all routine health care visits, according to Stafford, not just when people have behavioral risk factors.

“This discussion should include an open dialogue about practices and behaviors that might increase your risks of STI,” Stafford said.

To combat the spread of STIs, she thinks more non-traditional settings, like emergency rooms, should be screening patients for STIs.

Consistent condom use, early diagnosis, treatments, and vaccinations can all help stop the spread of STIs.

“Access to quality health care and innovative ways to reach our patients, increase health literacy and promote STI screening are desperately needed to reduce STI and the morbidity and mortality of congenital syphilis — an infection that is 100% preventable,” says Stafford.

Sexually transmitted infections (STIs) like syphilis, chlamydia, and gonorrhea rose by 7% 2021. Syphilis saw the biggest surge, growing by 32% between 2020 and 2021.

The pandemic, which led to reduced public health efforts and testing, likely contributed to the surge in cases, however, STI numbers have been growing for years. Health experts say there are many contributing factors behind the trend, such as limited access to care, reduced condom use, stigma, and heavier opioid use.