Idaho is seeing an alarming increase in the rates of sexually transmitted diseases (STDs) such as chlamydia, gonorrhea, syphilis and HIV. Knowing this is important because these infections can lead to long-term health consequences if they are not treated, including infertility. They can also make it easier to spread HIV infections. Understanding the risks will help protect you and your sexual partner.
Not so long ago, the rates of these diseases were at historic lows and they were considered nearly eliminated. That is what makes this next statement so alarming: According to the Centers for Disease Control and Prevention (CDC), “it is estimated that there are 20 million new STDs in the U.S. each year, and half of these are among young people ages 15-24. Across the nation, at any given time, there are more than 110 million total (new and existing) infections.”
Basically, that means overall rates of STDs are increasing, especially for people younger than 30. In 2016, Idaho received 6,706 reports of STD infections among Idaho residents, or nearly 4 infections for every 1,000 Idahoans. Chlamydia and gonorrhea affect Idahoans ages 15-29 to a greater degree than other age groups. More than three-quarters of chlamydia infections and almost two-thirds of gonorrhea infections are reported among 15-29-year-olds in Idaho. Early syphilis infections and HIV infections, however, affect Idahoans from a wider age range.
Chlamydia and gonorrhea
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Chlamydia trachomatis infection is the most frequently reported STD in Idaho and the United States. The 2016 incidence rate of 350 infections in every 100,000 people is the highest annual incidence rate in Idaho since tracking of the disease began. Thankfully, Idaho’s rate is still lower than the national incidence rate of 479 per 100,000 people. Chlamydia infections continue to be reported most frequently in Idahoans between the ages of 15 and 24.
After years of decreasing rates of gonorrhea in Idaho, the incidence rate of infection with Neisseria gonorrhoeae, the bacteria that causes gonorrhea, rose to alarming levels in 2015 and 2016. The 2016 incidence rate of 36 infections in every 100,000 Idahoans is the highest reported infection rate in 30 years. In 1987, gonorrhea infections were reported in 68 out of every 100,000 Idahoans. This increase in Idaho has been geographically widespread and is similar to increases seen in other western states.
Like chlamydia, gonorrhea infections are reported most frequently among younger people in Idaho. While two-thirds of gonorrhea infections are among people aged 15-29 years, more than 50 percent of all infections occur among Idahoans 20-29 years of age.
The consequences for not getting treatment can be severe. Untreated chlamydia and gonorrhea infection can cause pelvic inflammatory disease, which can scar parts of the female reproductive system and increase the risk of infertility and ectopic pregnancy. In men, inflammation caused by infection can cause infertility and chronic pain. Untreated infections can lead to joint pain and occasionally liver inflammation and meningitis (swelling of the lining of the brain).
Syphilis and HIV
The incidence rate of early syphilis reported during 2015 and 2016 was about 5 infections in every 100,000 people annually, significantly less than either chlamydia or gonorrhea. (Early syphilis is when the infection has been happening for less than 12 months.) However, recent reports of early syphilis in Idaho are higher today than they have been in 20 years. The increases over the last two years can be attributed to an ongoing outbreak of syphilis in Southwest Idaho and steady incremental increases in the number of early syphilis infections reported among Idahoans in other areas of the state.
Nearly 1 out of every 10 early syphilis infections in Idaho during 2016 occurred among men (86 percent). Compared with chlamydia and gonorrhea, infections with early syphilis were reported among Idahoans between the ages of 20-34. More than half of all infections were among those aged 20-34 years of age, with one-third of infections among Idahoans 25-34 years of age.
Idaho’s most recent syphilis outbreak began in 2014 and was only recently declared ended. The outbreak, which heavily affected residents of Ada and Canyon counties, contributed to the very large increase in the number of infections reported during 2015 and 2016. Syphilis infection, if left untreated, can result in meningitis, deafness, blindness, paralysis and dementia.
New human immunodeficiency virus (HIV) infection reports in Idaho have averaged about 40 per year in the last decade. Reports of infection with HIV, like syphilis, are among a wider range of age groups than chlamydia and gonorrhea and are nearly equally distributed between Idahoans aged 20-54 years. HIV infection can result in devastation of the immune system and lead to severe illness and death from a different infection that sets in because the immune system isn’t working properly.
Do you know your status? Get tested.
There are unique factors that place young adults at risk for STDs, not only those mentioned above but others such as human papillomavirus (HPV), genital herpes, hepatitis and trichomoniasis. Insufficient screening, concerns about confidentiality, biology, lack of access to healthcare, and multiple sexual partners increase the risk of STDs for those in their late teens and 20s. Because some infections might not have obvious symptoms, it’s possible to be transmitting the infection to others without knowing it.
So please get tested if you are sexually active and have multiple partners. Nearly all STDs can be cured or, as in the case of HIV, managed with medications.
National, state, and local health agencies are working to stem the rise in sexually transmitted diseases through public outreach, healthcare providers, and others. The Department of Health and Welfare, Division of Public Health, and CDC provide funding for clinical services and prevention initiatives throughout Idaho. Condoms and income-adjusted testing are available at most local public health district offices and federally qualified health centers. There are other community-based organizations, such as ALPHA (Allies Linked for the Prevention of HIV and AIDS) that also offer testing. Information about how and where you can get tested can be found at The Naked Truth website at http://www.nakedtruth.idaho.gov
STDs can have a range of symptoms depending on the infection, by common symptoms include painful urination, discharge, the presence of genital/anal/oral sores, bumps, or blisters, abdominal pain in women and testicular pain in men, pain during sex, excessive genital or anal itch, and rash.
Prevention efforts are important and can include:
• Vaccination for hepatitis B and HPV
• Reducing your number of sex partners
• Being mutually monogamous
• Always using condoms
Now that you have the facts, take control and protect yourself and your sexual partners.
Elke Shaw-Tulloch, master of health sciences, is the state health officer and Division of Public Health administrator with the Idaho Department of Health and Welfare. Find out more about Department of Health and Welfare services at www.healthandwelfare.idaho.gov.
How often should you get tested?
It’s vital for your personal short- and long-term health to be tested for STDs if you are sexually active, even if you don’t have symptoms and are monogamous and/or careful in your sexual relations.
• All adults younger than 65 years should be tested for HIV at least once.
• People who engage in unsafe sex or share injection drug equipment should be tested annually.
• Women under 25 and should have annual chlamydia and gonorrhea testing. Women 25 and older who have new sex partners, multiple sex partners, or a partner with an STD should also be tested.
• Sexually active gay, bisexual and other men who have sex with men should have chlamydia, gonorrhea, syphilis and HIV tests annually; more frequent testing may be beneficial.
STD testing has never been simpler. We now have a variety of rapid tests that give results while you are in the clinic or doctor’s office, and easy options for collecting specimens. Your healthcare provider may discuss such tests with you, but it’s also important to ask if he or she does not.