Our nation’s deadly disregard for sexual health
Our failure to prioritize sexual health in the United States is making people sick, and for some of us it will be deadly.
The Centers for Disease Control and Prevention (CDC) released new data showing that STDs have reached record highs, after five straight years of increases. Most STDs can be treated, and many are curable, but if they go undetected, they can have life-changing and life-threatening consequences, including cancer, infertility, ectopic pregnancy, and increased risk for HIV. Thousands of Americans die every year as a result of STDs, even though every single one could be prevented.
Many fine people have devoted their careers to fixing this problem, including members of my organization, the National Coalition of STD Directors. But, as a nation, we are failing. More and more people are falling through the cracks, and those cracks are getting bigger.
Shockingly, as STD rates have skyrocketed, federal funding to support STD prevention has been effectively cut in half. In recent years, more than half of local STD programs have experienced budget cuts, resulting in clinic closures, reduced screening, and loss of important frontline workers. These cuts have left public health programs and clinics scrambling to continue providing a bare minimum of services. It’s no wonder we’re seeing outbreaks of STDs across the U.S.
As a nation, we have turned a blind eye to this growing threat. We don’t talk enough amongst ourselves or with our kids about STD prevention, let alone healthy sexuality. In most of the country, a majority of high schools and more than 80 percent of middle schools aren’t meeting CDC standards for sexual health education.
A key symptom of the STD crisis is the increasing number of cases of syphilis in babies. That’s right: Syphilis in babies. This tragic condition is a result of the infection going undetected in pregnant women. It’s a condition that was nearing eradication at the end of the last century, but that has since roared back with cases nearly tripling in five years. Between 2017 and 2018, the number deaths associated with the transmission of syphilis from mother to child increased 22 percent.
We can fix this problem with a modest increase in federal support for STD prevention, but for decades, Congress has failed to act. The National Coalition of STD Directors estimates that an additional $70 million — that’s one half of one percent of the total CDC budget — in funding for CDC’s STD prevention activities would be enough to jumpstart an effective response to this crisis. Among other things, it would allow state and local health departments to prop up STD prevention programs and public clinics that are critical to providing testing and treatment.
In May, the House of Representatives proposed a $10 million increase in funding for CDC’s Division of STD Prevention. Although this would not be enough to adequately address the epidemic, it would be a step in the right direction and could serve as a down payment. Unfortunately, this increase was not mirrored in the Senate proposal in September. As fiscal year 2020 appropriations continue to be negotiated, it is crucial that lawmakers understand that we cannot afford to short change sexual health and STD prevention any longer.
STD prevention must also be prioritized within the federal Ending the HIV Epidemic initiative launched by the Trump administration earlier this year. Success of this effort hinges on our ability to see the bigger picture: HIV elimination will not be possible without addressing the growing epidemic of other STDs and investing in the revitalization of STD prevention infrastructure across the United States.
STDs drive a substantial portion of new HIV transmission and STD prevention programs, including public clinics supported by STD prevention dollars, provides essential HIV prevention services. These include access to testing and treatment, as well as pre-exposure prophylaxis (PrEP) for HIV prevention, all of which are core elements of the president’s HIV elimination plan.
Whether at home, in school, or in the halls of Congress, we owe it to ourselves and to the next generation to take sexual health seriously. As part of that, we must make a real investment in STD prevention today. It will improve — and save — American lives tomorrow.
David C. Harvey is executive director for the National Coalition of STD Directors, a national public health membership organization representing health department STD directors, their support staff, and community-based partners across 50 states, seven large cities, and eight US territories.