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VCU infectious disease expert weighs in on four-year increase in STD cases nationally


A 10 percent increase in new cases of chlamydia, gonorrhea and syphilis in 2017 marks a four-year trend of rising sexually transmitted diseases.

The Centers for Disease Control and Prevention said 2.29 million new cases of these three diseases were diagnosed in 2017.

Michael Stevens, M.D.
Michael Stevens, M.D.

Federal officials blame a lack of awareness about the impacts of infection and changing sexual practices. Preventative therapeutics such as pre-exposure prophylaxis, or PrEP, a daily medication used to reduce the risk of HIV transmission, has caused some to stop using condoms. If left untreated, all three infections can result in infertility, pregnancy complications or can increase the risk of HIV transmission.

Particularly troubling to health officials is a 67 percent jump in gonorrhea cases since 2013. The bacterial infection has become resistant to all antibiotics except ceftriaxone.

In an interview with VCU News, Michael Stevens, M.D., associate chair in the Division of Infectious Diseases in the VCU School of Medicine, addressed the trend.



What do you think are the reasons for the increases in STD cases?

There has likely been an increase in unsafe sexual behavior in recent years. This may be due to a perception that sex is less risky since things like HIV are now highly treatable. Additionally, the advent of dating apps, such as Tinder, has potentially contributed by making access to sex easier and more anonymous. Most importantly, decreased investment in public health infrastructure has compromised our ability to identify, treat and ultimately prevent STDs. Without additional public health infrastructure investment, these rates can be expected to rise. 

Are you seeing an increase in the number of STD cases you treat in your clinical practice? How has the trend manifested at VCU Medical Center?

Anecdotally we are seeing increased rates of STDs, including syphilis. Often patients with syphilis are co-infected with other infections, such as HIV, and disease can be quite advanced when patients present. 

According to Virginia Department of Health, the rates of early syphilis, gonorrhea and chlamydia were much higher in 2016, the most recent year of data, compared to 2007. Across the board, rates in Richmond are much higher than those for Virginia as a whole.

What can people do to protect themselves from STDs?

People should become knowledgeable about STD risks and how they can protect themselves. Vaccinations are important and some vaccine-preventable STDs include hepatitis B and HPV. Practicing safe sex via the correct use of latex condoms is key and these should be used consistently for oral, vaginal and anal sex. Knowing one's STD status is also important and people who are at risk should seek out testing, including for HIV. For select people, using pre-exposure prophylaxis, PrEP, to prevent HIV can dramatically reduce the risk for HIV infection.