U.S. States with the highest STD rates have one thing in common and that is a lack of appropriate sex education for adolescents.

Collected data between 2000 and 2018 illustrates ever-rising rates of STDs in the U.S and LetsGetChecked sexual health test sales, but the incidence rate of STDs in the U.S is only expected to rise according to Mayryam Mahmood, who is a practicing Infectious Disease Specialist and works with Mayo Clinic in Rochester, Minnesota.


Maryam says: "It’s expected to continue to increase. People don’t realize the importance of getting screened, providers don’t realize the importance of telling their patients to get screened. The majority of my concern is the lack of awareness around sexually transmitted diseases."

Recent studies illustrate that there is a connection between the quality of sex education in schools and the incidence rates of sexualy transmitted diseases in U.S states.

States including Alaska and Texas have seen a recent outbreaks of chlamydia in high schools wheras states like New Hampshire with high quality sex education in schools report the lowest rate of sexually transmitted diseases. The rate of unplanned pregnancies in New Hampshire sits at just under 16 births per 1,000 girls.


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Highest Rate Of STDs In The U.S.


According to the Centers for Disease Control and Prevention.

  • The District of Columbia has the highest rate of chlamydia, gonorrhea and syphilis in the US.

  • Not far behind D.C. on the list are Alaska, Louisiana and Mississippi.

  • Puerto Rico has the lowest rates of chlamydia in the U.S., Vermont has the lowest rates of gonorrhea.


The latest and largest scale report by the Centers for Disease Prevention (CDC) exemplifies a failure in the U.S public health sector to lower the prevalence of a number of sexually transmitted diseases (STDs).

Rates of STDs has continued to rise dramatically in the last two decades. In particular, the rates (#cases/100,000) of chlamydia in the U.S has more than doubled between 2000 and 2016.

LetsGetChecked can report that this number mirrors an increase in sexual health testing kit sales. The sale of sexual health testing kits were 3.5 times higher in January 2018 than in January 2017, showing an ever increasing need to take preventative health care more seriously.

The most recent report by the CDC has shown that increasing rates of STDs in the U.S shows no sign of slowing down. Chlamydia remains at an all time high, with gonorrhea and syphilis exceeding 2016 rates in 2017.


Abstinence-Only Education


When it comes to the connection between education in schools and subsequent STD rates, Maryam says: "I think it is highly accurate to say that the incidence rates of sexually transmitted diseases is partly related to sexual education in schools and sexual health awareness in general. Sex Ed. in the States may not be standardized, may rely on abstinence only teaching, or lack practical sexual health education. The CDC and public health departments play a key role in evaluating and treating sexually transmitted infections, for these services to remain effective, ongoing governmental support and funding is critical.”

While there may be more attempts out there to normalize sexually transmitted diseases, younger people are still at a higher risk of becoming infected in 2017.

Young people aged between 15 to 24 years account for 62% of chlamydia cases and 52% of gonorrhea cases.

In an era of dating apps such as Tinder, Grindr, Bumble and Scruff, sexual risk-taking behaviours are changing, however Maryam says that there are awareness programs in place that are trying to better the sexual health landscape in the States.

"There are digital media and social media campaigns out there to encourage people to have safer sex and promote sexual health awareness. For instance, Grindr users can now activate an icon on their profile which will indicate whether or not they have H.I.V or are taking precautionary methods against the condition...."

There are now emojis for people who are taking Truvada, men are declaring their status on their profiles and it is increasing awareness around it. There is a good population reach on these sites and we need to normalize it.

Regular STD testing is important for everyone who is sexually active, regardless of age, sexuality or relationship status. 80% of STIs display little to no symptoms, people cannot afford to be presumptive when it comes to their sexual health.

Schools that tell their teenagers that the only way to avoid STDs and unplanned pregnancies is to not have sex at all, unsurprisingly have higher numbers of STD cases and unplanned pregnancies. Schools that teach comprehensive sex education are more likely to have a lower birth-rate and STDs amongst their students.

Maryam says: "There is a stigma around sexually transmitted infections that your risk is based on lifestyle choices or high risk sexual behaviors. It’s important to note that the rates of STDs are increasing in all age groups and in all areas of the US, however the highest rate of STDs are among younger people aged 15-24."

A lack of knowledge regarding sexually transmitted diseases can translate into adulthood, and the proof is in the numbers, illustrating that more people are purchasing at home sexual health test kits after symptoms present themselves.

Unfortunately, this often seems to be a reactionary practice as opposed to regular screening which would be condusive to better overall health and wellness.


The report further shows that:


  • Chlamydia remains the most widely reported sexually transmitted disease in the U.S.

  • Gonorrhea rates rose by 75% between 2009 and 2016, and by 19% between 2016 and 2017.

  • Gonorrhea rates in those aged over 65 has increased by 73%.

  • Syphilis cases have increased from 31,618 US cases in 2000 to 88,053 in 2016 and 101,567 in 2017.

  • 80% of male syphilis cases were reported by MSM (men who have sex with men).


LetsGetChecked consumer data mirrors that of the CDC, concluding that:


  • Chlamydia is the most common notifiable condition reported by men and women

  • There are almost twice as many cases of chlamydia in women than in men

  • Syphilis is the STD most prevalent among bisexual and gay men.


So, are more people getting screened? The LetsGetChcked data would indicate that more people are using at home testing to test their sexual health.


Feeling like this information is a lot to take in?

U.S Medical Director Dr. Robert Mordkin breaks it down for you:



Miseducation And Confusion


Founder of The STD Project, Jenelle Marie offers us an example of the confusion that young people face when it comes to sexual health. Marie sat down with a 19 year old woman from South Carolina who contracted Herpes (HSV1) through genital contact even though she still identified as a virgin. “No one ever told me you could contract an STD by having oral sex,” she said. “I thought I was being responsible, because I was saving myself for marriage. I come from a very religious background and that’s what I was taught. Good girls don’t practice safe sex, they don’t have sex until marriage.”

When asked if she believed more thorough sex education in school would have influenced her behaviour, she answered firmly: “Yes, definitely. No one told us to use some kind of barrier with oral sex; they didn’t want us to have sex at all. Why would they tell us how to do it safely?”

According to Health Research Funding, only 13 out of 50 states require information provided in a sex education class to be medically accurate and contain verifiable facts.

So, why continue to teach abstinence?

Critics of this right-wing funded programme say that abstinence-only education isn’t about prevention or education. It’s an anti-sex campaign masquerading as a health campaign.

Maryam says:

"Things that might hinder someone’s access to screening their sexual health include access to healthcare, poor socioeconomic conditions and needing to face your local doctor, especially if you live in a smaller town."


The Importance Of Sexual Health Knowledge


Regardless of political viewpoint, where there is a lack of information on sexual health more people are likely to contract sexually transmitted diseases. More STD screening is needed in these abstinence-only ‘hot-spots’.

Comprehensive sex education has been proven to:

  • Increase the age that teens have sex
  • Help prevent STDs
  • Help prevent unplanned pregnancies

Maryam says:

"People are more comfortable with talking to providers especially in urban centres, I feel like people think it is less appropriate in rural towns. Social media is making it easier for people to get tested, and I think a lot more people would buy a test if they didn’t have to go to the GP, who could know your mom or pop."

Comprehensive information regarding sexual health should be mandatory and easily accessible for everyone. A good place to start is where children are first introduced to these important topics, at school.

There are a few more elements that come into play when it comes to awareness around sexual health screening.

Public discourse continuously blames three pillars for the rise in STD rates in the U.S.


Politics


The Mexico City Policy, also known as the global gag rule instigated by Donald Trump is said to be igniting rising rates of STDs. The legislation terminates U.S federal funding for non-governmental organizations that provide abortion counselling or referrals. Ultimately, the policy restricts funding STD testing, HIV testing and treatment, contraception, sexual health campaigns and workshops.


Economics


Following the U.S syphilis epidemic in the 1990s. The CDC claimed that they would work to eradicate the disease, and in the early 2000s, the rate of syphilis had fallen to 24% before doubling back to a prevalence rate of 48% by 2016. The CDC has been the most renowned collector of U.S health data since 1942 with the intention of breaking down medical barriers.

Last February, CDC Director Brenda Fitzgerald, reported “complex financial interests that have imposed a broad recusal limiting her ability to complete all her duties.” The Trump administration or underlying misinterpreted funding scandals are said to be the cause of the slow down in better quality public health funding at this time, a definite draw back to the attempted eradication of sexually transmitted diseases in the U.S.


Societal Sexual Health Choices


New methods of birth control may have caused a waning desire to use condoms between partners however, thus causing a further spread and rise of sexually transmitted diseases amongst those who have not been tested. There are also those who believe that being in an monogamous relationship acts as a get out of jail free card for infectious diseases.

In a study carried out by LetsGetChecked, it was found that 65% of college students had never visited a sexual health clinic. The majority of this demographic claim that they felt too embarrassed, or that they didn’t require screening. The arrival of dating apps have unquestionably added to the prevalance of sexually transmitted diseases.

Amongst MSM (Men Who Have Sex With Men), numerous reports have shown that using PrEP (pills that can prevent HIV), may be inadvertently leading to a rise in other sexually transmitted diseases as the gay community feels comforted by the HIV prevention and forgo using further protection, illustrating a rise in new syphilis and gonorrhea cases, especially amongst the MSM.

In research study cases, we read a lot about the term "risk sexual behaviours", but do we know what is definied as "risky"?

Maryam says that demographics who fall into the category of partaking in "high risk sexual behaviour" include:


  • Men Who Have Sex With Men (MSM)
  • People who have 2-3 sexual partners in one month
  • People who have unportected sex
  • People who attend Chem sex parties (group sex parties which involve alcohol and/or drugs.)

Worried You Might Have Contracted An STD?


Regardless of what state you live in, if you think you might have been exposed to an STD, the most important thing is to get checked.

If you do have a sexually transmitted infection, getting checked early and accessing treatment is important for your health and to make sure you don’t pass the infection on to someone else.

With many STDs such as chlamydia causing long-term complications like infertility if left untreated, getting checked if you think you may have been exposed is essential.

According to the data collected by the CDC you are at a higher risk of contracting a sexually transmitted disease if you are a female between the age of 15 and 24. Of the 15-24 year old demographic, one in four females have had a sexually transmitted disease, most commonly chlamydia or HPV.

Regardless of your age, you are at higher risk of contracting an STD, quite simply, if you are having sex. If you are not using protection, you are putting yourself in a high risk situation, regardless of the duration or type of sex you are having.

You need to get tested if you are experiencing symptoms associated with particular STDs, if you are entering into a new sexual relationship or if you have received a notification from a previous sexual partner that they are infected.
The only real way to lower your risk is through awareness. Do you think you have contracted an STD? At LetsGetChecked, you can purchases tests that covers the most common sexually transmitted diseases, including:

Chlamydia

Chlamydia is an infection caused by the bacterium Chlamydia trachomatis. Chlamydia can be contracted through sexual contact and at birth. Chlamydia is generally asymptomatic and is most common in women, between the ages of 15 and 24 years old. Chlamydia is congenital, meaning it can be passed from mother to child.

Gonorrhea

Gonorrhea is a bacterial infection caused by the bacterium Neisseria gonorrhoeae. Gonorrhea is transmitted through sexual contact, it can also be passed on through child-birth infecting the eyes of newborn babies. Gonorrhea commonly causes a yellowish discharge in men, it is generally asymptomatic in women.

Trichomoniasis

Trichomoniasis is caused by infection with the protozoan parasite Trichomonas vaginalis and is transmitted through sexual contact. Trichomoniasis is often responsible for a green or frothy discharge in men and women.

HIV

HIV stands for Human Immunodeficiency Virus. HIV is a blood-borne virus that can be passed on through unprotected anal and vaginal sex, sharing HIV contaminated syringes, and mother to child transmission during birth and breastfeeding. HIV attacks immune cells and can develop into AIDs in the later stages.

Syphilis

Syphilis is a chronic bacterial infection by the bacterium Treponema Pallidum. Syphilis is transmitted through sexual contact. If left undiagnosed and untreated, syphilis can eventually cause damage to the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. In extreme cases, it can cause gradual blindness, mental illness, and even death.

Gardnerella

Gardnerella vaginalis causes Bacterial Vaginosis (BV), Gardnerella develops as a result of an overgrowth of anaerobic bacteria in the vagina. Gardnerella is one of the leading causes of unusual vaginal discharge and odor.

Mycoplasma

Mycoplasma genitalium is a bacterium found in the urinary tract, it is transmitted through sexual contact. It may cause abnormal discharge, pain during sex and abdominal discomfort. In men, it can cause a burning pain in the genitals.

Ureaplasma

Ureaplasma urealytica is a bacterium that infects the urogenital tract. It can cause premature birth or spontaneous abortion. Ureaplasma has been found in up to 70% of sexually active adults. The infection can be transmitted sexually.

Herpes Simplex I & II

Herpes is a sexually transmitted infection caused by the herpes simplex virus (HSV). After the initial infection, HSV remains dormant in certain nerve cells of the affected area of the body for life. The dormant virus may reactivate and cause recurrences.


The Proof Is In The Sales


LetsGetChecked can reveal that between January and July of this year, the number of sexual health testing kits sold has increased 5 fold (or 600%). The highest number of sexual health kits were sold in June, compounding numerous studies that suggest that rates of sexually transmitted diseases rise in Summer months.

A study carried out by Denver Metro Health Clinic surmises: “Seasonal variation in human behaviour has a major effect on disease incidence. For example, in temperate climates living indoors predisposes to respiratory infections during the winter, while outdoor activities in summer promote the spread of various enteric diseases from a common source.”

Increased opportunities to socialize may promote the increased likelihood of contracting a sexually transmitted disease, along with more free time when universities break for the Summer and people tend to take their leave from work when the weather is better.

LetsGetChecked can report that sales for sexual health testing kits were 3.5 times higher in January 2018 than in January 2017, showing an ever increasing need to take preventative measures when it comes to sexual health.


What Can Be Done To Combat The Rising Prevalence Of STDs?


Education and preventative healthcare are the answers for combating the rising prevalence of STDs in the U.S and further afield.

The most affected demographic demonstrate an increasing need for better quality sex education in schools.

If condoms haven’t been used, it’s also essential to know what symptoms to monitor when you become sexually active to prevent the further spread or development of sexually transmitted diseases.

The most common symptoms associated with sexually transmitted diseases in men and women include:

  • Painful urination
  • Pain during sexual intercourse
  • Rash on the genitals and/or anus
  • Itching or irritation on the genitals and/or anus
  • Unusual lumps or bumps around the genitals and/or anus
  • Change in color of the male or female discharge
  • Abnormal discharge in terms of smell, consistency or volume
  • Strong vaginal odor
  • Painful erections

Findings from the latest 2018 report which is yet to be published by the CDC will shine a light on whether the epidemic continues. In the meantime, LetsGetChecked can report that the sale of sexual health tests only continue to rise.

Maryam says:

"The highest rate of sexually transmitted diseases are in the industrialized world. Screening and education is unfortunately reflected across class and personal economic, the type of sex you have and how it is transmitted. If people are going to have sex, they need to protect themselves."


The only way to know if you have a sexually transmitted disease is to get tested. LetsGetChecked offer an efficient, convenient and confidential service that offers you support at every step of the way.


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Read: At Home STD Testing: What You Need To Know Before You Pick A Test


Written by Hannah Kingston | Medically Approved By Dr. Maryam Mahmood