After years of seeing sexually transmitted infection (STI) case numbers rise nationwide, new data shows that number appears to be on the mend.
That’s true for Central Florida, as well.
There were 2.4 million cases of STIs reported in 2023 in the U.S. according to the Centers for Disease Control and Prevention.
For public health experts, that’s still a high number, but that number has slowed down -- a trend not seen in decades. In the last 20 years, the number of STIs has increased by 90%, according to CDC research. But last year, cases for gonorrhea dropped by 7% falling to pre-COVID-19 levels.
Cases of primary and secondary syphilis stages (the most infectious stages of syphilis) fell by 10%. However, overall syphilis cases increased by 1%.
At Orlando Health, Dr. Christine Greves said she’s noticed a slight drop in patients with STIs like gonorrhea, syphilis, and chlamydia.
“Yes, we have seen that drop here,” she said. “But the numbers are still high.”
STI cases in Orange County hit a peak of about 17,000 cases in 2021, according to the Florida Department of Health. That’s up from around 8,000 cases a decade before. However, cases dipped by 4% in 2023.
Greves said that drops have come for a few reasons.
“I tell my patients that before having sexual relations with someone, it's important to get tested before and after, in order to make sure that you're not sharing that with someone and you're not getting it like that testing before the relationship begins,” she said. “Also, healthcare workers have been testing more, and when they are testing, not only do we test the patient tested but also treated.”
Additionally, testing has become more available with chlamydia and gonorrhea self-testing kits, which the FDA approved last year. A syphilis self-testing kit also became available earlier this year.
The real game changer has been something Dr. Greves refers to as the “new morning-after pill.”
“Doxycycline. It's an antibiotic, so they're taking the pill the morning after (an encounter) to help prevent infection from occurring,” she said.
The use of “Doxy” to treat STIs has been around for decades, but it’s gained traction in recent years, and also received CDC guidelines for treatment earlier this year, said Makella Coudray, an assistant professor of medicine at the University of Central Florida.
“Specific counties in areas like San Diego have successfully implemented this intervention and seen significant decreases in key populations,” Coudray said. “Though there has been a decrease, we're not at the targets that we're trying to hit just yet, but we are moving in the right direction. I would say that the rates that we do have are still too high.”
In particular, Coudray pointed out the health disparities STIs painted for populations in Black, Hispanic, gay, and bisexual men, transgender women, as well as Native Americans.
According to the CDC, the increase in cases found in these groups is due to obstacles in quality health services such as poverty, lack of health insurance, less access to healthcare, and stigma.
The slowing of STIs is promising, Coudray said, and more gains for 2024 are likely to show. But what isn’t certain is whether or not the momentum of those gains will hold in 2025 and beyond as cuts to public health funding are expected.
“Some of these increases also resulted in temporary though it may have been significant increases in public health funding to increase efforts in infectious disease interventions, and that was also very significant in the fight against STIs,” Coudray said. I'm hoping. I’m optimistic, but it truly does depend on what comes next.”
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