CDC Data Shows Signs of Slowing STI Epidemic in the United States
The United States reported more than 2.4 million sexually transmitted infections (STIs) in 2023, though new data from the Centers for Disease Control and Prevention (CDC) suggest the epidemic may be slowing. While overall infection numbers remain high, declines in gonorrhea cases and a significant drop in primary and secondary syphilis cases indicate a potential shift in national trends.
Did You Know?
Primary and secondary syphilis cases, which are considered the most infectious stages of the disease, fell by 10% in 2023. This marks the first substantial decline for these specific stages in more than two decades.
Signs of a Shifting Epidemic
Recent federal data show varied progress across different STI categories. Gonorrhea cases declined by 7% in 2023 compared to the previous year, marking two consecutive years of decreases and bringing figures below 2019 pre-pandemic levels, according to the CDC. While overall syphilis cases saw a marginal 1% increase, this follows years of double-digit growth.
The data also reflect a potential slowing in the rise of congenital syphilis among newborns. While cases still increased by 3% over 2022, this is a notable shift from the 30% annual increases observed in prior years. Additionally, primary and secondary syphilis cases among gay and bisexual men dropped by 13%, the first such decline since the CDC began tracking these national trends in the mid-2000s.
Addressing Persistent Health Inequities
Despite these emerging trends, the STI epidemic continues to affect specific populations disproportionately. According to the CDC, American Indian/Alaska Native, Black/African American, and Hispanic/Latino communities, as well as gay and bisexual men, face higher burdens of infection. These disparities are driven by systemic factors including poverty, limited access to quality health care, a lack of health insurance, and social stigma.
Expert Insight:
Jonathan Mermin, M.D., M.P.H., Director of the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, characterizes these developments as a “glimmer of hope.” The challenge moving forward lies in maintaining this momentum through sustained investment and innovation, as the current progress remains fragile against the backdrop of long-standing health service barriers.
Future Directions in Prevention
To sustain these declines, public health officials emphasize the need for continued innovation. Recent advancements include the CDC’s clinical guidelines for the use of doxy PEP to prevent bacterial STIs and the authorization of at-home self-tests for syphilis, gonorrhea, and chlamydia by the Food and Drug Administration (FDA). The National Syphilis and Congenital Syphilis Syndemic Task Force is also leading a coordinated national response.
Future efforts to address the epidemic may focus on expanding the availability of testing and treatment. Potential steps include integrating STI services into emergency departments, increasing the reach of doxy PEP to eligible groups, and further investing in the public health workforce to ensure local communities have adequate capacity for care.
Frequently Asked Questions
Which STI saw a decline below pre-pandemic levels?
Gonorrhea cases dropped by 7% in 2023, falling below the levels recorded in 2019, according to CDC data.
Are congenital syphilis cases still rising?
Yes, but the rate of increase is slowing. There was a 3% increase in 2023 compared to 2022, which is significantly lower than the 30% annual increases seen in previous years.
What factors contribute to health inequities in STI rates?
Deeply entrenched factors, such as poverty, stigma, lack of health insurance, and limited access to quality health services, contribute to the disparities seen among certain racial and ethnic populations and gay and bisexual men.
What local resources in your community are currently available to improve access to STI testing and prevention?