Why Are Sexually Transmitted Infections on the Uptick and What Can We Do?
Laura Power, MPH ’15
Clinical Assistant Professor of Epidemiology and Internal Medicine; Associate Program Director for the Preventive Medicine Residency
Over the last few years, the rates of infection for diseases like chlamydia, gonorrhea, and syphilis are staggering. Why do you think we're seeing this significant rise in sexually transmitted infections (STIs)?
I see two major themes in how the health sciences community is thinking about this huge surge in cases of chlamydia, gonorrhea, and syphilis.
First, we are in a different era now—socially speaking—with the relationship of sex and disease. It starts with the fears around HIV, and how careful people were with safe sex practices when an HIV diagnosis would have been seen as a death sentence. A lot of people in their 40s and 50s knew friends, relatives, and even celebrities who died from AIDS. Today, most people do well with HIV. Younger people tend to have a lower level of fear or concern about HIV and how it affects the decisions they make about their sexual activity.
Many in public health argue that the state of STIs reflects the support and infrastructure we have for public health.
Second, many in public health argue that the state of STIs reflects the support and infrastructure we have for public health. How much funding are public health outreach programs receiving? What support is government providing to public health services? Is it enough? If this surge in STIs is related at all to those factors, then we're not receiving the support we need.
Is that the whole picture?
In addition to people's attitudes about the severity of STIs and how that affects their sexual behavior, I think we need to remind people that anyone can get an STI. There are social disparities in who gets STIs, but that again takes us back to funding and where we need to be providing more medical support and more community outreach around these diseases.
How can we get better at preventing and treating STIs?
Communicating about the risks is important. I don't think a lot of people are aware of the numbers—well over 2 million cases of chlamydia, gonorrhea, and syphilis in the US in 2017, according to the CDC. And we have new developments in the diseases, for example strains of antibiotic resistant gonorrhea. Expedited partner therapy—where a provider can prescribe treatment for a patient's partner without seeing that person—is a very effective strategy for mitigating the spread of more common infections, like gonorrhea and chlamydia.
Where can I get tested for STIs?
Testing for STIs can be obtained by visiting a primary care provider, your local health department, or through organizations like Planned Parenthood. The Washtenaw County Health Department, for example, provides STI testing, treatment, and counseling. Their website contains more information and also lists other locations for STI testing.
About the Author
Laura Power, MPH, MD, is Clinical Assistant Professor of Epidemiology in the School of Public Health
and Clinical Assistant Professor of Internal Medicine in the Infectious Diseases Division
at the School of Medicine. She is Associate Program Director for the Preventive Medicine Residency at the University of Michigan School of Public Health and an assistant editor for
the American Journal of Preventive Medicine. She completed an internal medicine residency
at Wayne State University in Detroit, followed by an infectious diseases fellowship
at Beth Israel Deaconess Medical Center in Boston. She later completed a Preventive
Medicine Residency at the University of Michigan School of Public Health. Prior to
joining the University of Michigan, Dr. Power practiced at Henry Ford Health System
as an infectious diseases physician, where she also served as Medical Director for
Infection Prevention. Her research interests include vaccine-preventable diseases,
communicable diseases epidemiology, infection prevention, and public health.