The STD epidemic has slowed dramatically in the U.S. but not in Georgia

STDs can cause lifelong complications if left untreated. They can lead to pregnancy complications and infertility, and they can increase the risk of some cancers.

The U.S. syphilis epidemic slowed dramatically last year, gonorrhea cases fell and chlamydia cases remained below prepandemic levels.

In Georgia, the numbers show different trend lines.

While the national rate of primary and secondary syphilis decreased 11% between 2022 and 2023, the rate remained the same in Georgia — 20 per 100,000 people. Primary syphilis refers to the early stage of infection with the bacteria that causes syphilis, while secondary syphilis applies to a later stage of the infection.

The rate of congenital syphilis — an infection passed to infants from their mothers — increased 26% in Georgia, from 80 to 100 cases in every 100,000 live births. Despite the increase, Georgia’s rate is lower than the national rate.

Georgia has the nation’s fifth-highest rate of chlamydia infections at 646 cases per 100,000. That rate is 30% higher than the national average rate of 492 cases per 100,000.

According to the CDC’s data, the rate of chlamydia infections in Georgia decreased for the first time since 2020 but still is above the national average. This is the second straight year of decline for the U.S. rate.

“I see a glimmer of hope amid millions of STIs,” Dr. Jonathan Mermin, director of the CDC’s National Center for HIV, Viral Hepatitis, STD and TB Prevention, said in a press release accompanying the federal data being released. “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.”

Last year in the U.S., cases of the most infectious stages of syphilis fell 10% from the year before — the first substantial decline in more than two decades. Gonorrhea cases nationwide also dropped 7%, marking a second straight year of decline and bringing the number below what it was in 2019.

But in Georgia, the rate of gonorrhea infections ballooned from 219 cases per 100,000 in 2020 to nearly 300 cases per 100,000 in 2021. Despite two years of modest improvement, the gonorrhea infection rate in Georgia last year remained high at 274.8 per 100,000.

Georgia, as well as the nation, has a long way to go to stop the STI epidemic.

“The South, and namely the Deep South, is still a hotbed for all of these sexually transmitted infections,” said Dr. Jonathan Colasanti, medical director at the Ponce de Leon Clinic, which is run by Grady Health System and provides HIV prevention as well as comprehensive care for people with HIV. “If we look at any of them, it’s this region that leads the way. I think that should really make us examine how we do things.”

Colasanti pointed to a lack of access to care as a major barrier to testing and treatment for these infections. He said more funding is needed for the prevention, testing and treatment of STDs. He also pointed to the importance of education so young people know tools are available to help prevent and treat infections.

“When half of all cases of STIs last year were in 15- to 24-year-olds, are we talking to our kids about how to prevent these? Are we talking to them about more than abstinence and condoms?”

Syphilis is a particular concern. It can cause serious health effects if not treated, including damage to the heart and brain, and it can be fatal.

In pregnant women, untreated syphilis results in infant death in up to 40% of cases. But with one penicillin shot given at least 30 days before delivery, a pregnant woman with syphilis and her baby can be cured of the infection.

It’s a message that Atlanta-area health facilities are trying to disseminate widely online, on billboards and by word-of-mouth.

Cases of syphilis in newborns also rose. The CDC noted nearly 4,000 babies in the United States, including 127 in Georgia, were born with syphilis in 2023.

Credit: AHF

Credit: AHF

Colasanti said the ripple effects from the pandemic can make it challenging to gauge whether STDs truly fell during the pandemic or if that was more a factor of fewer resources into STD screenings during the pandemic and some people holding off on seeking regular medical checks and testing.

But he sees some encouraging signs of a cooling down. In Georgia, like the U.S., STD rates were quickly rising before the pandemic, but since then the rate of spread has slowed.

“It can be easy to get lost in the numbers, and especially with nuances, because we are talking about three diseases with slightly different trajectories,” Colasanti said. “But I think in of broad strokes, clearly we are seeing some bending of the curve.”

Several experts, including Colasanti, say one contributor to the improvement in rates is the growing use of an antibiotic as a “morning-after pill” to prevent a new infection. Studies have shown that taking doxycycline within 72 hours of unprotected sex cuts the risk of developing syphilis, gonorrhea and chlamydia.

Another factor may have been an increase in the number of health workers testing people for infections, doing contact tracing and connecting people to treatment. Congress gave $1.2 billion to expand the workforce over five years, including $600 million to states, cities and territories that get STD prevention funding from the CDC.

There are reasons to think the next presidential administration could get behind STD prevention. In 2019, then-President Donald Trump announced a campaign to “eliminate” the U.S. HIV epidemic by 2030. Federal health officials later clarified that the actual goal was a huge reduction in new infections — fewer than 3,000 a year.

There were nearly 32,000 new HIV infections nationwide and 2,500 in Georgia in 2022, the CDC estimates. But a boost in public health funding for HIV could also help bring down other sexually transmitted infections, experts said.

The Associated Press contributed to this article