A Glimmer of Hope amidst the Numbers

While sexually transmitted infections (STIs) continue to pose a important public health challenge in the United States, recent data offers a cautiously optimistic outlook. More than 2.4 million STI cases were reported in 2023, but the latest figures suggest a potential slowdown in the epidemic’s relentless climb.

Key findings from the Centers for Disease Control and Prevention (CDC) reveal encouraging trends in specific areas:

• Gonorrhea: Cases declined for the second consecutive year,dropping 7% from 2022 and falling below pre-COVID-19 pandemic levels observed in 2019.
• Syphilis:
  • Primary and secondary syphilis cases,representing the most infectious stages of the disease,experienced a 10% decrease. This marks the first substantial decline in over two decades.
  • Among gay and bisexual men, cases of primary and secondary syphilis fell by 13%, representing the first decrease since the CDC began tracking national trends within this population in the mid-2000s.
  • The rate of increase in newborn syphilis (congenital syphilis) cases appears to be slowing, with a 3% national increase over 2022, compared to the 30% annual increases seen in prior years.

I see a glimmer of hope amidst millions of STIs. After nearly two decades of STI increases, the tide is turning. We must make the most of this moment-let’s further this momentum with creative innovation and further investment in STI prevention.

Jonathan Mermin, M.D., M.P.H.,Director of CDC’s National Center for HIV,Viral Hepatitis,STD,and TB Prevention

Persistent Inequities Demand Focused Action

Despite the encouraging trends,the STI epidemic continues to disproportionately affect certain communities. American Indian/Alaska Native, Black/african American, and Hispanic/Latino populations, as well as gay and bisexual men, experience a higher burden of STIs.These disparities are rooted in deeply entrenched factors that limit access to quality healthcare, including poverty, lack of health insurance, and pervasive stigma.

Several federal initiatives are underway to address these disparities, but sustained action at the community level is essential for achieving meaningful progress.

innovations in Prevention and Response

The recent data coincides with significant advancements in STI prevention and response strategies. These include:

• CDC guidelines for doxycycline post-exposure prophylaxis (doxy PEP) to prevent bacterial STIs.
• FDA authorization of self-tests (or at-home tests) for syphilis, gonorrhea, and chlamydia.
• A nationally coordinated response to the U.S. syphilis epidemic spearheaded by the National Syphilis and Congenital Syphilis Syndemic Task force.

The Path forward: Prioritizing Prevention and Equity

Turning the tide on the STI epidemic requires a multi-faceted approach that prioritizes prevention, innovation, and equity. Key steps include:

• Prioritizing the STI epidemic at federal, state, and local levels.
• Developing new prevention, testing, and treatment solutions for diverse populations, including expanding the reach of doxy PEP and conducting further research to assess its potential benefits for other groups.
• Investing in robust public health systems and a well-trained workforce capable of delivering comprehensive STI services.
• Delivering STI testing and treatment in diverse outreach settings,such as emergency departments.
• Making STI services more accessible within local communities.