Our increasingly celibate country is thrusting the United States into a “sex recession,” yet somehow sexually transmitted diseases have spiked to record highs.
For nearly half a decade, the combined cases of gonorrhea, chlamydia, and syphilis have escalated, reversing decades of decline. It seems we’ve saved syphilis from near-extinction.
How did we pull this off?
Some of the blame might fall on budget cuts, which led the Centers for Disease Control and Prevention to dial back its STD prevention programs. The opioid crisis certainly exacerbates the high-risk behaviors that spread STDs, and we now have a public health crisis.
The distribution isn’t equal across the country. Black Americans reported having chlamydia, gonorrhea, and syphilis orders of magnitude higher than their white, Asian, Hispanic, and multiracial counterparts. Even more remarkable was the disproportionate impact of this crisis on gay men. Whereas women comprise just 14% of syphilis patients, men who have sex with other men comprise anywhere between 53% and 70%. Gay men tested positive for chlamydia at nearly twice the rate of women. Most alarmingly, while gonorrhea rates for women and straight men nearly doubled since 2010, for men who have sex with men, it’s almost quadrupled.
Why? Perversely, some of the problem may be the strides made against HIV. PrEP is a medication intended to prevent HIV transmission, which seems to have led to a decrease in condom usage and, thus, an uptick in other STD transmission.
There’s another odd wrinkle in here: Syphillis appears to be a West Coast problem, while the others are mostly present in the South. If you want to avoid STDs, it seems you ought to live in a place where your dates take you hiking, as the lowest rates of all three diseases were found in scenic states like Colorado, Idaho, and Vermont.
