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Are syphilis, gonorrhea, and chlamydia still sexual threats? - (5/8/2018)

By Dr. Ron Gasbarro

The pharmacist was reading an article about how AIDS – acquired immune deficiency disorder, an infectious disease caused by the human immunodeficiency virus (HIV) – immediately eclipsed other sexually transmitted diseases (STDs) such as gonorrhea, syphilis, and even chlamydia. Why? These three bacterial STDs, even though they could become fatal, were curable with antibiotics. Conversely, HIV, caused by a virus which antibiotics could not kill became a death sentence when it first appeared in the 1980s. The public was terrified and often ostracized those with this new disease. By the early 1990s, antiretroviral drugs were available. The result was that AIDS morphed into a manageable, albeit chronic, disease much like diabetes, cancer, and certain cardiovascular conditions.    

So, is humanity all set with regard to STDs when medications can control even AIDS? Nope. More than two million cases of chlamydia, gonorrhea, and syphilis were reported in the United States in 2016, the highest number ever, according to the Centers for Disease Control and Prevention (CDC). Approximately 75% of these new diagnoses were chlamydia, 20% were gonorrhea, and 5% were cases of primary and secondary syphilis – the most infectious stages of the disease. If these STDs remain undiagnosed and untreated, they can have serious health consequences, including infertility, life-threatening ectopic pregnancy, stillbirth in infants, and increased risk for HIV transmission.

While young women continue to bear the greatest burden of chlamydia, surges in syphilis and gonorrhea are increasingly affecting new populations. Syphilis rates soared by almost 18% overall from 2015 to 2016. The majority of these cases occurred among men – especially gay, bisexual, and other men who have sex with men (MSM). However, there was a 36% increase in rates of syphilis among women and a 28% increase in syphilis among newborns (congenital syphilis) during this period. The CDC reported more than 600 cases of congenital syphilis in 2016, which has resulted in more than 40 deaths and severe health complications among newborns. The disease is preventable through routine screening and timely treatment for syphilis before the mother gives birth.

Contraceptives may protect against an unplanned pregnancy, but only condoms can help prevent one from contracting an STD. According to a recent report from the CDC’s National Center for Health Statistics, American women are increasingly choosing long-acting contraceptives such as intrauterine devices (IUDs), and fewer are using condoms. While options like the IUD are suitable for women in monogamous relationships in which both partners have been tested for STDs, women with multiple sexual partners should use condoms to prevent developing a sexually transmitted infection.

However, statistics show that men are wearing condoms less and continuing to have unprotected sex more. The reason is 2-fold. First, condom companies have been promoting their products to prevent pregnancy. But guess what? Women are opting for long-term contraception, such as the IUD, or the “depo shot” which lasts for 3 months. So, without the fear of pregnancy, the condom is tossed out the window. Yet, among people who have multiple partners, the risk of contracting an STD is greatly increased if the condom is not used.  

The pharmacist had an idea. He took a bunch of condoms and filled a fish bowl with them, and included a sign that read “Free. Take one.” In his own small way, he was doing his part to stop the STD epidemic. 

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com. Read more at www.rx-press.com


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