Written by Ingyu Bahng, Peer Reviewed by Nikhil Chakravarty, Edited by Courtney Coleman
Sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are showing a consistent rising trend within the US. Although generally contracted through sexual contact (blood, semen, vaginal fluids, etc.), STDs may also be contracted nonsexually—such as from mother to infant during childbirth or pregnancy (1). While basic symptoms can range in severity from severe genital discomfort to a mild fever, some infected individuals may remain
asymptomatic. In this article, we provide information about past STD trends and statistics that characterize today’s figures, as well as provide a comprehensive list of available preventative measures, treatments, and resources.
Statistics/Trends
STD incidence and prevalence trends in past years have shown general growth across all dimensions. Beforehand, it’s important to distinguish the definition of incidence and prevalence. Incidence is referring to the number of recorded new cases within a given period. Prevalence refers to the total number of cases within a given period. With this clarification, there was an estimated 67.6 million prevalent cases, with 26.2 million incident cases in 2018, meaning that nearly 20% of the US population had some form of STD (2). Furthermore, nearly half of incident cases were among those between the ages of 15 to 24 years old—which is also generally the case when we home in on common individual diseases as well, reaching as high as 66.5% for chlamydial infection specifically (2, 3). Thus, future STD prevention efforts should concentrate more on this age group.
Within the US, the three most incidental STDs were human papillomavirus (HPV), chlamydia,
and gonorrhea, infecting a total of 42.5 million, 2.4 million, and 209 thousand people, respectively, in 2018 alone (3). While the 15- to 24-year-old age groups for chlamydial and gonococcal infections represent over half of infections—66.5% and 50.9% respectively—
HPV shows a different pattern. Just 16.7% of new HPV infections occurred in the 15- to 24-year-old age group (3). Perhaps this implies that HPV is much more easily contracted in comparison to chlamydia and gonorrhea. There are also sex-related differences in disease occurrence, with females more likely to contract chlamydia and gonorrhea than males (Figure 1). Additionally, HPV showed a more even transmission rate (2, 3).
Since 2012, we have seen a generally rising increase in rates of chlamydia and gonorrhea infections within the US (4). It is interesting to see that, while chlamydia experienced a dip in infection rates during the recent COVID-19 pandemic, gonorrhea did not experience the same dip (4). The reason behind this difference warrants further research.
Preventative Measures/Treatment
While treatment for various STDs exists, the most efficient way to combat infection is through prevention. Various tools exist online and in stores to assist. Contraceptives like condoms and vaccination against certain STDs are highly effective tools in limiting infection and transmission (5). Behavioral adjustments, such as abstinence, reducing sexual partner count, and agreeing to mutual monogamy with partners can also reduce the risk of STD
contraction (5). Furthermore, several online resources based on prevention and informational courses dedicated to informing the public about basic knowledge of common STD symptoms and precautionary steps are available on the CDC website (6). Moving forward, resources such as these should be promoted among, and catered towards, the 15-
to-24-year age group due to the observed disproportionate and continually increasing rate of STD contraction (2, 4).
With the general rising trends in STD cases across the US, it is more important than ever to always take precautionary measures prior to engaging in sexual activity—especially among those 15-to-24 years of age. Public Health interventions should focus on helping people adjust to the changing landscape around STDs, including the reduction of stigma around their discussion, and address effective prevention methods through active prophylaxis and education about common symptoms and sexual decision-making skills.
References
1. “Sexually Transmitted diseases (STDs).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 21 Sep. 2021, https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/symptoms-causes/syc-20351240. Accessed 2 October 2022.
2. Kreisel, Kristen M, et al. “Sexually Transmitted Infections Among US Women and Men: Prevalence and Incidence Estimates, 2018.” Journal of the American Sexually Transmitted Diseases Association, vol. 48, issue 4, Apr 2021, pp. 208-214, doi: 10.1097/OLQ.0000000000001355. Accessed 5 October 2022.
3. Sieving, Renee E, et al. “Sexually Transmitted Diseases Among US Adolescents and Young Adults: Patterns, Clinical Considerations, and Prevention.” Science Direct, vol. 54, issue 2, June 2019, pp. 207-225, https://doi.org/10.1016/j.cnur.2019.02.002. Accessed 7 October 2022.
4. “Preliminary 2021 STD Surveillance Data.” Centers for Disease Control and Prevention, 1 Sep. 2022, https://www.cdc.gov/std/statistics/2021/default.htm. Accessed 10 October 2022.
5. “How You Can Prevent Sexually Transmitted Diseases.” Centers for Disease Control and Prevention, 23 March 2022, https://www.cdc.gov/std/prevention/default.htm. Accessed 11 October 2022.
6. “Training.” Centers for Disease Control and Prevention, 26 Feb. 2021,
https://www.cdc.gov/std/training/default.htm. Accessed 10 October 2022.
This post is not a substitute for professional advice. If you believe that you may be experiencing a medical emergency, please contact your primary care physician, or go to the nearest Emergency Room. Results from ongoing research is constantly evolving. This post contains information that was last updated on November 21, 2022.
Ingyu Bahng is currently an intended public health major undergraduate at UC Berkeley.
Nikhil Chakravarty is a second-year MPH student specializing in Epidemiology at UCLA Fielding and also received his BS in Microbiology and Immunology from UC Irvine.
Courtney Coleman is a master's degree candidate in biology at Harvard and Co-President of Students vs. Pandemics.