According to the year 2018 data shared by the California Department of Public Health (CDPH), California continues to register high levels of sexually transmitted diseases (STDs) diagnoses. Within the past 30 years, the state has noted a steadily growing upward trend in the number of cases diagnosed year-after-year.
Since 2016, California has seen an unprecedented 45% rise in STDs and reported the CDPH, and in 2017 there were 300,000 cases of Chlamydia, Syphilis, and Gonorrhea. This increase in STDs has encouraged serious implications for Californians, especially pregnant women because the number of stillbirths has spiked across the state. So many STDs are diagnosed every year due to a lack of awareness about safe sex practices and ignorance towards STD testing/screening.
Testing for STD is the key to resolving a health crisis of such magnitude. If left undiagnosed and untreated, sexually transmitted diseases like gonorrhea, chlamydia, and primary & secondary syphilis can cause chronic, long-term health issued. Undetected STDs are the leading cause of cervical cancer and infertility.
In most Californian regions, STDs, particularly syphilis, continue to remain a major public health concern among both men and women. People with STDs may display mild symptoms, but most of the time, the diseases are asymptomatic.
Untreated syphilis leads to bigger health issues as it can affect the brain, heart, and other organs of the body, cause paralysis, neurological problems, and blindness. Not only this, it impacts the growth and wellbeing of the unborn baby if a pregnant lady contracts syphilis. It also increases the person's chances of contracting HIV/AIDS.
People under 30-years of age must undergo regular testing for STDs because they are the most common STDs carrier. Chlamydia rates are higher among females, whereas gonorrhea is more common among males. Males are the most impacted group with syphilis, particularly men who have sex with men (MSM).
According to the CDPH, the state has observed the largest increase in the number of congenital syphilis-related stillbirths (30 cases) since 1995. Though 30 isn't as high, it does indicate a larger issue at hand, which is rising STDs rates. It also suggests that people do not receive proper care, and pregnant females aren't getting prenatal care. That's why there have been a sudden rise in ectopic pregnancies, vision loss, and pelvic inflammatory disease over the years.
It is worth noting that STDs are preventable simply through getting tested and taking appropriate medication. Practicing safe sex is the key to better sexual health. Regular testing and treatment are the main prevention strategies. Therefore, even if there aren't any symptoms, you must get tested for STDs.
Decades of insufficient funding and lack of strategic coordination within the state's public health system has resulted in such high STDs rates in California. California needs to implement a carefully devised and fully funded action plan to deal with STDs' growth rates. Despite registering high STDs cases in annual surveys, the state still lacks a definite statewide plan.
California has recently started reinvesting in STDs prevention and treatment initiatives, but the current resources are inadequate in meeting the state's needs. The 2019-2020 State Budget signed by Gov. Gavin Newson includes limited investment in STDs prevention and treatment plans. It also didn't have funding to develop a well-coordinated statewide strategy for addressing STDs and HIV.
In California, the STD Prevention Center is responsible for developing and disseminating public awareness campaigns for the promotion of STD testing and treatment. The organization offers community partners, providers, and clinicians maximum support in this regard. Its resource library is developed by experts from the Essential Access Health, the Centers for Disease Control and Prevention (CDC), and the California STD Control Branch.
STD Prevention Center's main focus is on preventing syphilis, chlamydia, gonorrhea, and HIV. Essential Access Health works with the CDPH STD Control Branch, Title X Network, the Los Angeles County Division of HIV/STD Programs, and county health departments to support prompt delivery of quality care and preventing STDs from spreading.
California also offers free family planning and other associated services to low-income patients through the Family PACT and Medi-Cal program. Medi-Cal offers comprehensive coverage in sexual and reproductive health care to Californians who earn up to 138% of the federal poverty level. Family PACT also provides coverage for contraceptive care and STDs services to uninsured patients who earn around 200% of the federal poverty level and cannot access better health coverage because of confidentiality issues.
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According to the CDPH, in 2018, there was an alarming increase in the number of reported cases of syphilis, chlamydia, and gonorrhea. The most dramatic spike was noted in syphilis, which crossed the 10-year record in percentage with an incredible 265% rise since 2008 (25,344 cases). On the other hand, the number of reported gonorrhea cases recorded a 211% increase since 2008 (80,000 cases), and chlamydia cases registered a 56% increase with 230,000 cases.
A concerning aspect is that congenital syphilis cases have been rising steadily every year. The 2018 data suggests that the current rate of congenital syphilis cases is 14% higher than in 2017 and around 900% higher than 2012 statistics. This led to a sharp increase in the number of stillbirths and neonatal deaths in 2018.
California's Los Angeles County recorded the 4th highest rate of chlamydia in the state, 3rd for gonorrhea, and 7th for syphilis and had a total of 275,000 STDs cases in 2016. Since 2012, the state has had a whopping 900% increase in infants diagnosed with lethal diseases.
According to CDPH, all state regions are reporting high rates of STDs among people aged 15-24, gay, African-Americans, bisexuals, and MSM. Both males and females are equally affected by STDs in California. The main factors promoting an increase in STDs within this particular age group include substance abuse, disparities in access to health care, and incarceration, claims CDC.
However, California also has one of the highest rates of STDs for older adults in the country. In 2018, the STD rate for older adults was 134.1/100,000 people. As per a study from Indiana University, older adults (aged 60 or above) do not rely much on condoms, which exposes them to STDs. Athenhealth Network's research revealed that people aged 60 or above comprise the largest rise in in-office treatment for STDs. Herpes simplex, syphilis, gonorrhea, chlamydia, and trichomoniasis cases have increased by 23% among people over 60 between 2014 and 2017.
In recent years, Californian females have registered the highest number of cases of syphilis. Between 2008 and 2018, there was a 743% increase in syphilis diagnoses among women than 268% in men.
Congenital syphilis cases increased by 391% between 2008 and 2018. Less than two out of ten people in California are between the ages of 15-24. However, this particular age group reported the highest number of STD cases, with five out of ten chlamydia diagnoses, three out of ten gonorrhea cases belonging to people between ages 15-24 in California. Compared with the whites, the reported STDs rate was around five times higher among African-Americans in gonorrhea and chlamydia cases and three times higher for early syphilis.
California has implemented a proactive sexual education strategy and revised the sex-ed curriculum to make it more comprehensive and inclusive. The state passed a law AB-239 in 2016 that made it compulsory for schools to offers LGBTQ-inclusive sex education and include lessons on gender identity, healthy relationships, and HIV/STDs prevention. The law is also called the California Healthy Youth Act.
The bill was aimed to create awareness among K-12 students to ward off STDs and develop a healthy attitude towards gender, sexual orientation, and relationships. Apart from aiming to help the youth understand that sexuality is a part of their natural development, the bill also promises to support educators and provide them guidance and tools to accomplish this goal.
Although allowing parents to opt their kids out of sex ed, it prohibits them from opting their kids out of gender-related materials, such as gender identity, sexual orientations, and gender expression. It also bans discussion of any religious doctrine and discourages abstinence-centric sex-ed.
According to the state's most recent guidelines on sex education, schools are required to put this bill into practice and provide comprehensive sex ed to students of grades 7-12. HIV prevention education must start in middle school and continue until high school.
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