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STD rates are surging. Here's why


Sexually transmitted infections, or STIs, are surging in the United States. The Centers for Disease Control and Prevention is reporting 2.5 million new cases of syphilis, chlamydia and gonorrhea last year. That's based on preliminary data. Syphilis infections alone shot up 26%, bringing total cases to levels that have not been seen since the 1950s. Here to explain is David Harvey, executive director of the National Coalition of STD Directors. Thanks for being here.

DAVID HARVEY: Thank you for having me.

KELLY: So what's going on? Why are we seeing this data - these numbers shooting up compared to previous years, previous decades?

HARVEY: These are shocking numbers. These numbers are on the rise for several reasons. One is there really is a lack of awareness in America about the scope of this problem. We're not testing enough. Patients aren't asking to be tested, and doctors aren't doing enough testing and doing sexual health histories as part of primary care. And we have intersecting problems of substance abuse. And intersecting with STIs is also increased rate of HIV infections last year and a continuing problem with hepatitis.

KELLY: All right. Let me tease out a couple of things you said. First, what's different? Because a lot of those things you just said - I'm not sure why they wouldn't have been true - I don't know? - in the '80s, '90s and so on.

HARVEY: Right. Well, COVID has really complicated things. We have increasing social disparities in the country. We have new generations coming of age that are assessing their risks for things like sexually transmitted infections in different ways. We have falling condom use. The bigger problem was the sheer size and scope of the disruption to the health care delivery system. The whole STI public health workforce was redeployed to COVID.

KELLY: Right. So there's that. There's the fact you said testing isn't happening at the rate that it should be. Does that mean these numbers - as shockingly high as they are - could actually be an underreporting?

HARVEY: Yes. We think this is an underreporting. COVID laid bare that our public health system is not where it needs to be in the U.S., but we still have a lot of work to do to improve our ability to collect data.

KELLY: Yeah. Well, this brings me to the what is to be done question because we don't want to see rates going up and up and up. What measures would you recommend?

HARVEY: You know, CDC has been very articulate about the fact that they can't mandate the collection of data from jurisdictions - from states. And that is true. They can't. So we need a policy change there. But there's a range of other things that we really need to be doing. First and foremost, President Biden, this administration, Secretary Becerra - they need to be really increasing monies for STI prevention in the United States. And we need to create the first-ever federal funding stream for STI clinics. The biggest gaps we have are with increasing testing rates and providing expert health care that isn't stigmatized.

KELLY: Are there ever days where it feels like your message is a hard sell when people have - we're being told there's so much we need to worry about, not being - not taking risks, so much we need to be testing ourselves for. Is it hard to get people to worry about syphilis and gonorrhea when we're worried about COVID and monkeypox and so much else?

HARVEY: Thank you for asking that question. Yeah, it is a pretty overwhelming situation. Particularly when you look at this new STI data, it just seems to get worse and worse. I am an eternal optimist. I am looking forward to and hope one day that I'm going to get a meeting in the Oval Office and be able to talk and brief President Biden about this - about what he can do to tackle this issue. And until then, I'm just going to continue to plug away at this.

KELLY: David Harvey, executive director of the National Coalition of STD Directors and eternal optimist. Thanks for stopping by our studios.

HARVEY: Thank you for having me.

(SOUNDBITE OF MAHALIA SONG, "LETTER TO UR EX") Transcript provided by NPR, Copyright NPR.

Mary Louise Kelly is a co-host of All Things Considered, NPR's award-winning afternoon newsmagazine.
Ayen Bior
Ayen Deng Bior is a producer at NPR's flagship evening news program, All Things Considered. She helps shape the sound of the daily shows by contributing story ideas, writing scripts and cutting tape. Her work at NPR has taken her to Warsaw, Poland, where she heard from refugees displaced by the war in Ukraine. She has spoken to people in Saint-Louis, Senegal, who are grappling with rising seas. Before NPR, Bior wore many hats at the Voice of America's English to Africa service where she worked in radio, television and digital. Bior began her career reporting on the revolution in Sudan, the developing state of affairs in South Sudan and the experiences of women behind the headlines in both countries. In her spare time, Bior loves to kayak, read and bird watch.
Christopher Intagliata is an editor at All Things Considered, where he writes news and edits interviews with politicians, musicians, restaurant owners, scientists and many of the other voices heard on the air.
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