After briefly dropping in the early months of the Covid-19 pandemic in 2020, rates of sexually transmitted infections (STIs) then resurged beyond 2019 levels to finish the year at a record high, according to new data from the Centers for Disease Control and Prevention (CDC).
Researchers with the CDC said its report, 2020 Sexually Transmitted Disease Surveillance, shows how Covid-19 disrupted in-person healthcare and diverted scarce public health resources away from STIs, which had been on the rise for years.
Ultimately, diverting resources to Covid-19 caused young people, racial minorities, and gay and bisexual men to suffer disproportionately from new infections, it said.
The new data provides “the clearest picture yet of [the impact of] Covid-19 on STIs”, said Dr. Jonathan Mermin, director of the CDC’s National Center for HIV, viral hepatitis, STD, and tuberculosis prevention. “Honestly, there’s just much to be done.”
People who had previously limited casual sex during the pandemic have continued pre-pandemic behaviors, only this time with STI testing efforts being dampened because of the pandemic.
The CDC’s new report covers 2020, the first year of the pandemic and a time defined by lockdowns, social distancing, and fear. The new report covers rates of gonorrhea, chlamydia, and syphilis.
Early in 2020, it appeared social distancing might reduce rates of STIs. However, by the end of the year, few infections had surged past levels seen in 2019. In just one example, rates of gonorrhea had jumped 10% by year’s end, said Mermin.
Those increased rates were driven by a lack of in-person appointments, delayed health screenings, lapses in health insurance for people who lost jobs, and “crumbling public health infrastructure” that diverted contact tracers and testing supplies to Covid-19.
In 2020, reported cases of gonorrhea increased by 10%, and primary and secondary syphilis (two stages of the disease, with different symptoms) by 7% compared with 2019. Especially worrying was the rate of congenital syphilis or syphilis passed from mother to newborn, which increased 15% from 2019 and is up 235% compared with 2016.
Rates of chlamydia declined 13% in 2020, but researchers said the decline was not something to celebrate. Rather, chlamydia is typically asymptomatic and detected in in-person screenings such as pap smears. Because people put off these visits in 2020, cases probably went undiagnosed.
What’s more, groups that suffered disproportionately from new infections, such as racial and ethnic minorities, are among the same groups who were disproportionately affected by Covid-19. STIs also especially affected the young and poor.
“Some racial and ethnic minority groups continue to experience higher rates of STDs,” and half of the new infections are among 15- to 24-year-olds, said Dr. Leandro Mena, director of CDC’s Division of STD prevention.
For decades, the US has spent more on healthcare than any other country, yet has worse health outcomes than many other developed nations. Such high rates of STIs among people with fewer resources are a reflection of “the nation’s failure to provide sufficient healthcare for everyone who needs it”, said Mena.
Although the 2020 data is grim, researchers said there were bright spots. For example, testing capacity and contact-tracing staffing have stabilized since 2020, and are reaching pre-pandemic levels – though that may be because many health departments have given up or significantly scaled back contact-tracing for Covid-19 following the Omicron surge.
The federal government also released the first national five-year plan to combat STIs and has invested $200m to build public health capacity. The hope, said researchers, was to avoid disrupting services for diseases such as STIs should another emergency occur.