Washington, DC, April 11, 2023 — The National Association of County and City Health Officials (NACCHO) is concerned by the increasing rates of Sexually Transmitted Infections (STIs) reflected in the Centers for Disease Control and Prevention (CDC), Division of STD Prevention (DSTDP) report, Sexually Transmitted Disease (STD) Surveillance, 2021, released today. Preliminary data indicate a whopping 2.5 million U.S. cases of STDs, marking a continued increase during the second year of the COVID-19 pandemic. NACCHO represents the country’s nearly 3,000 U.S. local health departments.

“The prevalence of STIs in the United States is a major issue that is compromising the nation’s health,” said Lori T. Freeman, Chief Executive Officer of NACCHO. “CDC’s new report shows just how prominent STIs are in the United States. Moreover, the geographic clustering shown in the data highlights the importance of local health departments in using their data to ensure their messages are tailored to the populations and areas most affected locally.

“In recent years, the COVID-19 pandemic and 2022 mpox outbreak have monopolized program resources and threatened the health of those already disproportionately affected by STIs. However, we can pick up the pieces in our quest to reverse STI trends by moving forward with a new approach that employs holistic, coordinated care to address concurrent epidemics and health disparities.

“There is significant work that needs to be done to address and prevent further spread of these infections. Local health departments are the backbone of this work. As we see these infections rising, it’s crucial that we support local health departments and the work they are doing to slow the spread of STIs,” said Freeman.

NACCHO and local health departments are working hard to address STIs in a targeted way that aligns with the data. Some examples of work that is being done is a newly-funded pilot project to support local health department community engagement activities to create a community-driven syphilis reduction plan in nine jurisdictions. Additionally, NACCHO’s STD Registry is a centralized location to identify clinics devoted to examining and treating STIs, helping connect patients to providers and identifying geographic gaps in coverage.

CDC’s annual report included startling preliminary data:

• 1.6 million chlamydial infections were reported. This 4.1 percent increase from 2020 signals a return to pre-pandemic levels.
• More than 700,000 gonorrhea cases were reported, reflecting a 28 percent increase since 2017.
• Reported cases of syphilis (all stages) totaled more than 176,000 cases – a 74 percent increase since 2017.
• Congenital syphilis continued to surge, increasing 203 percent since 2017. In 2021, 38 jurisdictions, including 37 states and the District of Columbia, reported an increase in congenital syphilis cases.

Although STIs are common, the report also shows that some groups are more affected than others. Racial, ethnic, and sexual minority groups remain disproportionately impacted. African Americans accounted for nearly a third of chlamydia, gonorrhea, and primary and secondary syphilis (P&S) cases while only accounting for 12.1 percent of the US population. Meanwhile, gay, bisexual, and other men who have sex with men were severely impacted by gonorrhea and syphilis in 2021. Congenital syphilis rates increased for most racial and ethnic groups in 2021, but the highest rate was among infants born to American Indian and Alaska Native people.

Syphilis (all stages) has increased 447 percent in the last two decades. Cases of P&S syphilis—the most infectious stages of the disease—have increased a staggering 781 percent since 2001. Although the syphilis epidemic is impacting all states across the country, there are some geographic areas that are disproportionately affected. In 2021, five states (California, Texas, Arizona, Florida, and Louisiana) represented 58 percent of all reported cases of congenital syphilis. Furthermore, the broader syphilis epidemic was concentrated within states, as just 100 counties accounted for 60 percent of all reported cases in 2021.

About NACCHO

The National Association of County and City Health Officials (NACCHO) represents the nation’s nearly 3,000 local governmental health departments. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities. For more information about NACCHO, please visit www.naccho.org.