Data collected during the COVID-19 pandemic suggests reported cases of sexually transmitted diseases have declined, but experts at UC San Diego's AntiViral Research Center say rates could soon be on the rise.
"While stay-at-home orders and social distancing mandated by the COVID-19 pandemic have decreased sexual encounters in which STDs may spread, they have also reduced the availability and use of sexual health services,'' said Dr. Susan Little, an infectious disease specialist at UCSD Health.
STDs, also known as sexually transmitted infections or STIs, are viral or bacterial infections, not necessarily chronic diseases. According to the Centers for Disease Control and Prevention, there are around 20 million new cases of STIs in the United States annually. In an attempt to combat resurgent STI rates, the Good to Go clinic through UCSD School of Medicine will launch the Facts Over Fear campaign -- a series of weekly, community-based virtual events to educate the public on the landscape of STIs and HIV in San Diego, and why sexual health matters more than ever before -- for STD Awareness Month starting Thursday.
Nationally, in April 2020, reported cases of chlamydia, gonorrhea and early syphilis decreased by 47%, 33% and 30% respectively from the year prior. While decreases in rates of reported infections are usually a positive development, there is major concern from medical experts that sexually transmitted infections are now going largely undetected due to decreased testing. The lack of testing and diagnoses could spell out another public health crisis.
"Due to barriers created by the pandemic and a severe stigma around STI and HIV testing, less people are getting tested and treated for these illnesses. Now that San Diego is in the red tier, it is critical that community members take stock of their sexual health,'' said Dr. Gabriel Wagner, an infectious disease specialist at UCSD Health.
As stay-at-home orders decreased in early June 2020, in some instances, positive cases of diseases returned to or even exceeded 2019 levels.
"Over the last decade, we've seen consistent increases in STIs in the United States, in California and in San Diego,'' Wagner told City News Service. "It's likely such a sudden drop is related to lack of testing. I believe we will see a large spike in infections as things continue to open up.''
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San Diego's highest-risk populations for HIV are: Latino, Black, Gen Z and persons assigned male at birth having sex with other persons assigned male at birth. Wagner said a significant factor in these communities experiencing higher STI rates are systemic barriers such as cost and access to health care. Behavioral choices, social stigma and lack of a robust sex education all play contributing roles.
Although the number of newly diagnosed HIV cases has dropped, the number of people living with HIV continues to increase. At the end of 2018, 13,876 people were living with diagnosed HIV in San Diego County, while an estimated 1,364 people were living with undiagnosed HIV infection.
While there is no cure for HIV, antiretroviral therapy can suppress the virus, making it undetectable. National HIV/AIDS strategy 2020 has a viral suppression goal of 80% and San Diego is at 74% overall with the percentage fluctuating per demographic, sexual orientation and identity. The county's lowest viral suppression rates are among the Black and transgender communities.
"What I'd like to see is for us to start normalizing talking about sexual health,'' Wagner said. "And talk about it more directly and honestly.''
More information on the Facts Over Fear campaign and a schedule of events can be found here.