Syphilis rates increased 26% in 2021, for a second year in a row, and the “Big Three” STIs (sexually transmitted infections) racked up a record 2.5 million reported cases among Americans. That was at a time when we were supposed to be “socially distancing” and quarantining. COVID-19 was one of several infections that had banner years in 2020 and 2021.
Of course, most STIs are not fatal, except for syphilis if left untreated. Getting and having an STI carries a truckload of shame and stigma, which fuels new infections because the infected patient is less likely to tell a sexual partner of their condition. Another factor in the not-as-bad column: STIs are treatable and curable—except for herpes.
One for the not-so-hot column, though: infection with one STI makes you more susceptible to others, including HIV, which is also potentially fatal if left unmedicated.
According to the Centers for Disease Control, these are the 2021 statistics: • Chlamydia: 1,628,397 cases – up 3% • Gonorrhea: 696,764 cases – up 2.8% • Syphilis: 171,074 cases – a 26% increase, for the highest number of cases in 75 years • Overall (chlamydia, gonorrhea, syphilis): 2.5 million cases
What is not reflected in these numbers: the Mpox (monkeypox) epidemic, which has exploded in the past two years. HVCS has a dedicated Mpox wellness coaching team ready to answer questions and help clients connect to vaccines.
You may be asking, why are STI rates rising? Condom usage is dropping, spurred by the greater use of PrEP to prevent HIV. More and more of our clients report that they use barrier protection less often since they’re taking PrEP pills. While safer from HIV, those who go condom-less risk exposing themselves to STIs.
Scientists also posit that the ongoing opioid and meth epidemics are leading to more HIV and Hepatitis C infections among people who share needles, and the spread of other STIs as user trade drugs for sex that is often unprotected.
Leandro Mena, the director of the CDC’s Division of STD Prevention, was quoted by POLITICO: “Over two decades of level funding, when you account for inflation and population changes, have effectively decreased the buying power of public health dollars and resulted in the reduction of STI services at the local level. That reduction in screening, treatment and partner services likely contributed to these STI increases.”
April is National STI Awareness Month. We’re using this opportunity to call attention to our free STI testing services, available to anyone who doesn’t know their STI status. The best way to reverse the rise of STI rates is to increase knowledge of infection rates—knowledge really is power! To set up your appointment, visit our Testing Request page.
An anonymous HVCS employee’s remembrance in observance of STI Awareness Month
During my junior year of college, I worked off campus at a big-box retail store with a closeted guy named Orin*. We occasionally but infrequently hooked up, usually at his apartment. One night my roommate was away, and I invited Orin back to my dorm room for a hook-up. I usually had a stash of condoms, but I was out that night—so we both shrugged and threw caution to the wind. As we had had sex before, I thought, “I didn’t catch anything last time, and he looks healthy.” Never mind that “last time” was a few months ago, and it was almost pitch-black in my room.
Within a few days, urinating felt like a shower of needles. It was a sharp, tingly pain that made me dread the next bathroom break. I powered on through classes and work, determined to ignore the slivers of agony and refusing to admit that I’d made a mistake. I also avoided Orin, though I wanted to demand, “What did you do to me? Aren’t you feeling this pain too?”
Feeling Worse
I traveled to Virginia to spend Thanksgiving with my family. The burning in my urethra started to linger long after urinating, and I struggled to stay in “celebratory holiday mode” as the weekend dragged on. We had lunch at a fish n chips restaurant that was touted as a favorite among locals for its fresh catches. Within hours, I hovered over the toilet bowl, returning the meal, and a lot of other stuff, to the sea. I spent the rest of the holiday in my brother’s bed, shivering, in growing groin agony, popping Tylenol to lower my fever in between trips to the bathroom to puke. My sister-in-law endured the same symptoms, camped out in a spare bedroom. Mom’s verdict: food poisoning. For me, it was all coming out the top—and nothing, absolutely nothing, was coming out the bottom.
By Sunday when I returned to campus, my fever had abated but what I strongly suspected to be a sexually transmitted infection continued with a fury. I imagined my bladder swollen and red, angered by some tiny spirochete armed with a sword of ice. My intestines felt hard to the touch, and I had no interest in food of any kind. (Younger me also was blind to basic over-the-counter constipation remedies, for some reason.) My birthday falls soon after Thanksgiving, and I turned down all invitations to celebrate it at the local nightclub.
Later that week during my evening shift, I finally felt something happening in my nether regions. Warm liquid blossomed in my underwear, and I dashed to the restroom. It turned out to be a small amount, but it was red: I had bled and it had soaked through onto my jeans. Completely humiliated, I tied an apron around me, backwards, and fought with my boss to leave early. When he objected strongly, I told him the truth: I had a blood stain on my pants—“Don’t make me show you.” He let me leave.
Seeking Medical Care At Last
Finally, I was ready to go to the Student Health office. The regular doctor, whom I’d been to a few times over the years, was out, and a substitute provider was filling in. Now gripped with double the embarrassment of having to admit my mistake to a stranger, I told my story. “Well, sounds like an STD,” she said. “I’ll have to do a culture to be sure.” Obtaining a culture (back then)** involved many men’s worst nightmare: a swab up the urethra for a scraping. I endured this humiliation, zipped up, and went back to my dorm to wait for the test results.
The sub doctor called the next morning, and in essence she said: “You tested negative. Whatever you’re feeling is probably from the food poisoning and should go away soon.” End of call. I soldiered on through the week, steeled against the pain and discomfort. My bowels felt impacted—wasn’t food poisoning supposed to clear everything out?
On Monday morning, I got a call from the usual campus doctor. “I reviewed notes on the cases that came in while I was out, and yours stood out. Can you come over right now?” When I sat on the exam table, she said, “I think my sub was wrong. I think you do have an STD. I don’t know what she did wrong with the culture, but all your symptoms point to an STD. The burning when you pee, the constipation. You have a case of anal gonorrhea. Here’s a prescription for azithromycin.”
Within a day of taking the antibiotic, the burning sensation faded. The constipation took longer to resolve, but it did go away eventually. A friend with a keen eye spotted the medicine bottle on my dresser and asked about it, and I finally confessed: I had unprotected sex. He let loose a torrent of disappointment, admonishment, and concern. “You know better than that. Of all people, you? For a one night stand?” I explained that it wasn’t a one-nighter per se, which didn’t help my case. “I hope it’s a never again,” he said. “Did the doctor order an HIV test? No? Well, you need to get one ASAP.”
Confrontation
A few nights later, I wound up closing the store with Orin, and I finally worked up the nerve to say, “You gave me gonorrhea.” He wrinkled his nose and said, “It wasn’t from me. I feel fine.” Which makes perfect sense when you learn that many men with STDs are asymptomatic. I pushed back, stating that he had been my only sexual partner in the past month. He kept denying it. “Get tested,” I advised.
After two weeks of suffering, mixed with a case of food poisoning, a wrong medical diagnosis, an excruciating outing to my boss, and a missed birthday, I resolved to use condoms for every sexual encounter. I took an entire class on AIDS issues to understand better the science behind transmission and risk. That class led me to volunteering for HVCS. After I graduated, that volunteer work turned into a paid job.
All the literature and articles say, “it only takes one condomless encounter,” and while mine wasn’t technically “just one” with the same guy, the risk was certainly there. The HIV test came back negative, and from that point on, for at least a decade, I sero-sortied: only sleeping with men who were HIV-negative. There wasn’t, and still isn’t, a realistic way to sero-sort STD status, since it’s so hard to know if, and when, you have an STD.
Lessons Learned
Looking back now, I wish I could say I “slipped up” on safer sex for burning passion, or drunken abandon, or some other (ultimately meaningless) excuse, but the truth was, changing the plan in favor of safer, non-penetrative acts was simply inconvenient. I didn’t have a great reason, other than laziness. The sheer stupidity of that (I’m allowed to call my actions stupid, aren’t I?) gave me insight into how others cope with the specter of HIV and other STDs. There are so many possible reasons for forgoing a condom: it’s very difficult for disease prevention programs, like those at HVCS, to give clients a road map to navigate all of those scenarios. With STIs (the more modern term for STDs) on the rise, empowering clients to be self-advocates for their sexual health is likely the best defense. Arm up with the facts—and take this post as a cautionary tale I hope you never have to experience for yourself.
HVCS’ Andy Reid, Shakira Williams and Pat Ocasio talk with Prof. Sarah Espinosa, who teaches psychology at NYU, about the links between PTSD and sexual assault. This is part of our podcast series on sexual health. Learn more about our Women’s Services Program and our free STI (sexually transmitted infection) testing program.
In this episode of the PHA (Peer Health Alliance) Podcast, the team discusses all you need to know about getting tested for HIV, Hep C and other Sexually Transmitted Infections.
Got questions about the latest ways to reduce your risk for HIV, STDs and hepatitis C? So do lots of our followers. Members of our Education & Prevention Department went live on Facebook to answer them. In this video, we covered PrEP, PEP, how risky certain sexual behaviors are (or not), and how to reach our programs for more services!
Need free testing services? Contact us at (845) 704-7624 — you can call OR text! ? You can also email us to set up an appointment.
HVCS is launching a new infectious disease prevention program this December specifically for women of color. Our new Women’s Services Program will help prevent new HIV, STD, and hepatitis C infections among minority women in Dutchess, Orange, Rockland and Westchester counties. The program aligns with New York State’s “End the Epidemic” plan to increase the number of women who know their HIV/STD/HCV status and increase the number of women linked to medical care.
The Women’s Services Program will use a trauma-informed approach to outreach and prevention, since many women at high risk for these infections live with traumatic pasts or present-day circumstances, including abuse, homelessness, poverty, and immigrant status.
Our initial contract will run for five years, and we aim to serve at least 300 women each year. We look forward to sharing more news about this exciting and important new program in the future.
April is STD Awareness Month, an annual observance to raise awareness about the impact of sexually transmitted diseases (STDs) on the health of Americans and the importance of individuals discussing sexual health with their healthcare providers and, if sexually active, their partners.
STDs are a major public health issue:
* CDC estimates that there are approximately 19 million new cases of STDs each year in the United States, almost half of them among young people ages 15 to 24.
* STDs have an economic impact: direct medical costs associated with STDs in the United States are estimated at $15.9 billion annually.
Vaccines offer protection against two common sexually transmitted viral infections: hepatitis B and Human Papillomavirus (HPV). CDC recommends their use for people at risk.
* While serious health threats from STDs cross racial and ethnic lines, disparities persist at too high a level.
* Higher rates of the most commonly reported STDs persist among African-Americans and Hispanics when compared to whites.
* Most STDs have been associated with increased risk of HIV transmission.
Many STDs do not have any symptoms, so many of those who are infected don’t know it. The only way to know for sure is to get tested.
The Importance of Testing
To reduce the impact of STDs, it is important to increase knowledge about sexually transmitted infections and make STD testing a part of routine medical care. Because many STDs have no symptoms, those at risk need to get tested and find out if they are infected.
Chlamydia is one of the most common STDs, especially among young women. CDC recommends that all sexually active women younger than age 26 get tested for Chlamydia once a year. Women who are older than 26-years-old should be tested if they have a new or multiple sex partners.
Getting tested and treated for Chlamydia can reduce new cases of pelvic inflammatory disease (PID) by over 50 percent, according to a study in a managed care setting. Women with PID can experience pregnancy complications, infertility, chronic pain, and irreversible damage to their reproductive organs. Reducing the impact of PID among women also requires men to be tested and treated for Chlamydia to reduce new cases. Recent studies have shown that many young women who have been diagnosed with Chlamydia may become re-infected by male partners who have not been diagnosed or treated.
CDC’s Sexually Transmitted Diseases Treatment Guidelines recommends that sex partners of infected patients be treated to prevent re-infection of the patient and transmission of the infection to others and those with Chlamydia be re-tested for the infection approximately three months after treatment. CDC also recommends that sexually active men who have sex with men (MSM) be tested for chlamydia, as well as syphilis, gonorrhea, and HIV at least annually.
Health care providers should take a sexual health history of their patients and follow up with appropriate counseling, vaccination, testing, and if needed, treatment for STDs. Increased prevention efforts, including screening, are critical to reducing the serious health consequences of STDs.
What You Can Do
* Talk with your doctor or health care provider about STDs and ask about recommended vaccinations and testing.
* Get tested. Visit www.findSTDtest.org External Web Site Policy to find STD testing locations near you.
* Talk openly and honestly with your partner about STDs.
Learn more about STDs, STD Awareness Month, and where you can find the nearest STD testing site in your area: