California STD Rates Continue to Rise, with Blacks and Latinos Often Hardest Hit

Rates of bacterial sexually transmitted diseases have increased in California for the third year straight, according to a recent report from the California Department of Public Health.

Over a quarter million cases of chlamydia, gonorrhea and syphilis were reported in the state in in 2016, a 40 percent increase compared to five years ago, including 198,503 cases of chlamydia, 64,677 of gonorrhea, and 11,222 of early (before symptoms occur) syphilis.

“Budgets for STD prevention campaigns, as well as STD clinics that can test and treat if needed, have been slashed throughout the state in the last few years, so it’s no surprise that rates are increasing,” said Jeffrey Klausner, professor of Medicine and Public Health at UCLA and a former director of STD Prevention and Control Services at the San Francisco Department of Public Health.

“Most STDs have no symptoms so people who are sexually active need to know that they have to be tested at least once a year for the diseases, find out the test results and go for treatment if any of the tests are positive,” Klausner said.

Particularly concerning to health officials are 207 cases of congenital syphilis reported last year in newborn babies. If not caught early, syphilis during pregnancy can result in congenital syphilis leading to stillbirth or permanent, lifelong disabilities.

Syphilis can also cause permanent loss of vision, hearing and other neurologic problems in adults. Left untreated, STDs can increase the risk of HIV infection and lead to lifelong reproductive health problems in both men and women.

Statewide, the highest rates of STDs were found among young people, African-Americans, and gay, bisexual and other men who have sex with men. But in Los Angeles the rates were highest both among African Americans and Latinos:

  • Many of the chlamydia cases in Los Angeles occur among young women and men under 25 and are mostly likely to be detected in people who are African American and Latino.
  • Nearly 75 percent of female gonorrhea cases are among 15 to 29-year-olds and over 80 percent of male gonorrhea cases are among 20 to 44-year-olds, with African-Americans most affected by the disease.
  • Of the 7 percent of syphilis cases diagnosed among women, the sharpest increases over the last year have been among African-American and Latinas.

Public health experts say a range of factors keep STD rates rising including the increasing use of dating apps among young adults, explained Jeffrey Reynoso, executive director of the Latino Coalition for a Healthy California, based in Sacramento. That increases the opportunities for sexual encounters and STDs, Reynoso said.

In a statement to the California Health Report, the California Department of Public Health (CDPH) said “High rates of STDs have always been related to a complex web of social issues. Poverty, stigma, and discomfort talking openly about sexual health play an important role for many vulnerable populations [and] closures of many public STD clinics around the state within the past 10 years disproportionately affected low income and minority clients.”

CDPH says it will be collaborating with the California Department of Education and community groups to implement the California Healthy Youth Act, which became law in January 2016. The act mandates comprehensive STD/HIV prevention education in schools including at least once in middle school and once in high school.

A survey by researchers at UCLA, including Klausner, shows why that information is so critical to reduce the rates of STDs. Close to eight hundred female students responded to the survey last Spring (23 percent were Hispanic or Latino, 4 percent were African American.) Many of the responders did not know that STDs do not have symptoms—the key reason why regular testing is so critical—nor how the testing is done.

In response to the county’s recent STD report, the Los Angeles County Department of Public Health said it will be will be working closely with physicians and clinics to increase access to testing, reduce barriers to screening and treatment, and support provider training where needed.

The department also plans to beef up condom distribution through the LA Condom Program which distributes condoms at about 600 sites.  And the health department will invite young adults to design social media campaigns on STD awareness, testing and treatment and will form a youth council to help advise the department on effective strategies.

“Increasing awareness among all populations is key [and] outreach efforts are especially important with vulnerable populations,” said Fred Wyand, communications director for the American Sexual Health Association (AHSA), based in Research Triangle Park, North Carolina.

Earlier this year the AHSA launched a campaign called Yes Means Test aimed at educating young adults that saying yes to sex also means they should get tested for STDs. “We’re trying to normalize testing so young people don’t feel ashamed to seek out [it out],” said Wyand. “We’re working with popular bloggers in the black and Hispanic communities to elevate this issue among the young people who need screening most.”

Public health experts see a tough road ahead to reduce STD rates in California, both among the general population and minorities. “There isn’t one factor we can tie the problem to so a lot of work is needed,” said Reynoso.

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