Why Testing Matters?
STDs is an umbrella term used to refer to 25 infectious organisms transmitted mainly through sexual activity. STD prevention is a crucial aspect of an individual’s essential primary case strategy to ensure better reproductive health and overall wellbeing.
Although STDs incidences cost an additional burden of costs and complications for the state health department, they are all worth it because these are largely preventable diseases. Still, STDs remain an issue of concern for health care providers simply because most of the time, the disease stays undetected. The general public, health care professionals, and even policymakers have so employed a lackluster approach to intensify efforts to detect STDs early.
If left untreated, STDs can cause highly adverse and usually irreversible health outcomes along with pricey clinical complications because of the issues it can lead to. These include reproductive health issues like infertility, cancer, perinatal and fetal health issues, and HIV infection.
Given the stigma associated with STDs, people often find it difficult to talk about the issue with their partner or health care providers. They do not undergo proper testing for STDs or realize the repercussions of this ignorance. It must be noted that some STIs are just as common as flu.
Chlamydia can be easily cured with antibiotics and is the most prevalent STI in Hawaii. The 2nd most prevalent STI is gonorrhea, which is also treatable and, if not diagnosed at the right time, can cause irreversible damage. In Hawaii, the number of STDs proliferates from 611 gonorrhea cases in 2009 to over 1,400 cases in 2019.
Therefore, sexually active people should make sure they undergo STI screening every 3 to 6 months. The test is non-invasive as you only have to provide a urine sample or mouth swab. Given their asymptomatic nature, STD testing should be a mandatory part of your routine health care nevertheless. Don’t assume that you are fine and get tested at your nearest screening center.
STD Statistics in Hawaii
Hawaii has bucked national trends as far as the growth and prevalence of STDs and STIs are concerned. However, when we compare the state’s STD statistics from the past five or six years, it becomes apparent that most diseases have steadily grown in Hawaii. This indicates that many people are infected with STDs and are unaware of their condition. In this state, STDs like chlamydia, syphilis, and gonorrhea are currently at their highest rates compared to the past 30 years. Honolulu Star-Advertiser reported that Hawaii’s STD trends are in line with national and global STI rates.
Experts claim that online dating is the prime culprit behind the rapid increase in STD cases. As per the state health officials, in 2018, there were 7,732 chlamydia cases reported in Hawaii, with 544.3 cases/100,000 people. In 2008, this rate was 463 cases/100,000 people, and the overall number of chlamydia cases was 5,972.
Similarly, gonorrhea rates have doubled over the last ten years. In 2018, there were 1,496 cases diagnosed, with 105 cases per 100,000 people. In 2008, this rate was 611 for gonorrhea. Syphilis infections increased to 180 cases or 12.7/100,000 people in 2018, while a decade ago, this rate was 3 cases/100,000 people, and 38 cases were reported.
According to Gerald Hasty, the Hawaii State Department of Health Harm Reduction Services Branch’s program coordinator, all three STDs are either near or at their peak rates currently, compared to the rates recorded 30 years back. https://www.athomestdkit.com/s...
Digital dating, as per Hasty, is not the only contributor because several other factors play a role in their increase, such as new birth control methods and advancements in STD treatments.
An analysis of population-adjusted chlamydia infection statistics in Hawaii reveals that the state ranks at number 32, which isn’t too concerning. But the fact that this rate is twice as high as the rate in West Virginia that has the lowest rate of chlamydial infections. The current rate of infections in Hawaii is 479 cases/100,000, while in 2012, it was 455.5 and reached its peak in 2015 with 494 cases per 100,000.
Gonorrhea rates in Hawaii also keep fluctuating, but currently, the rates are low enough to keep the state at number 42 among the 50 US states. Hawaii is one of the 9 US states where the gonorrhea infection rate is less than 100/100,000 people.
Still, it is three times lower than gonorrhea rates in Mississippi, which as per the latest statistics, is the national leader in this context, but roughly three times higher than Vermont. Vermont has the lowest gonorrhea infection rates in the US. Between 2016 and 2017, Hawaii noticed a reduction in gonorrhea rates, but since 2012, there has been an over 60% increase in infection rates. In 2017 the gonorrhea infection rate was 95 cases/100,000 per people whereas, in 2012, this rate was 58.5 cases, and in 2016, it was 102 cases/100,000 people in Hawaii.
The rate of primary/secondary syphilis infection rate in Hawaii is high enough to keep the state in the top 25 US states, but it is still far behind Nevada, the national leader in this regard. Hawaii recorded over 6 cases/100,000 in 2017 but compared to 2012 when the state had reported 1.7 cases/100,000, this is alarming. The number of primary/secondary syphilis infections reached its peak in 2016 with 7.8 cases/100,000. This means, over 288% rise in primary/secondary syphilis infection is noticed in Hawaii between 2012 and 2017.
The city of Honolulu accounted for the highest number of cases in the state in all common STDs. Out of four, at least three cases were reported in Honolulu. At the same time, it accounted for nine out of ten cases of gonorrhea, and three-quarters of syphilis cases in Hawaii occurred in Honolulu.
Age, Gender, Ethnic Profile
In 2018, the number of reported chlamydia cases among NHOPI (Native Hawaiian and other Pacific Islander) was 700.8 cases/100,000 population. The overall rate of chlamydia infections among NHOPI was 3.3 times higher than the rate among Whites and at least 5.3 times more among Asians.
The rate of gonorrhea cases among NHOPI was 181.4 cases/100,000. It was 2.6 times higher in Whites. The disparity was evident in NHOPI females, who reportedly had 2.6 times higher gonorrhea cases than White females. NHOPI males had 2.5 times higher rates of gonorrhea infections than White males. This disparity was higher in the Midwest region compared to the South, West, and Northeast.
The primary/secondary syphilis cases among NHOPI during 2018 were 2.7 times higher than the rate of Whites with 16 cases and 6 cases per 100,000 people, respectively. The disparity was higher in NHOPI males as they reported 2.8 times more cases than White males, and NHOPI females had 1.9 times more cases than White females.
Government Initiatives
Most federally qualified health centers in Hawaii are Title X sites, which receive federal grant funding for confidentially testing and treating STIs. However, these clinics have limited operational hours, and they quickly reach their full capacity. Another issue is that they cannot offer this service for free. In the state of Hawaii, the out-of-pocket costs for a screening or diagnostic test vary a lot, and it doesn’t also include treatment costs, which could be several hundred dollars. So, the point to be noted here is that the government of Hawaii has to work towards making STDs testing and treatment more accessible and affordable for people.
CDC offers funding to the state health department to reduce STDs rates through scientifically proven prevention and control measures. The focus is on providing scalable, high-impact, sustainable, and cost-effective services.
Honolulu Health Center offers a range of STDs testing and treatment services, including the three common STDs and other STIs such as bacterial vaginosis, genital warts, HIV, trichomoniasis, and herpes.
Planned Parenthood is also quite active in the state. it offers STIs testing/treatment at all of its branches across Hawaii. However, since 2020, it is not providing free testing services because the organization recently decided to opt-out of receiving federal funding.
There’s a specialized STI/HIV Clinic associated with the Department of Health’s Diamond Head Health Center. It also handles up to 5,000 patient visits annually. But the problem with Hawaii is that overall state approaches have been lackluster, and the outdated sex education curricula further aggravate it. Although students can get awareness about STIs, they will not understand how the infection could be spread and transmitted to their partners. The curriculum mostly focuses on the extreme representation of STDs and uses scare tactics to desensitize students. While an ideal sex-ed curriculum should cover pregnancy prevention and STI prevention simultaneously and offer a realistic representation of STIs.
References
- Athomestdkit.com. 2019. Hawaii STD Statistics & Rates - Find Testing Near Me | AtHomeSTDKit.com. [online] Available at: https://www.athomestdkit.com/s...
- Avendano, E., 2019. Sexually Transmitted Infections On The Rise In Hawaii. [online] Honolulu Civil Beat. Available at: https://www.civilbeat.org/2019...
- Cdc.gov. 2020. Native Hawaiians and Other Pacific Islanders | Health Disparities | NCHHSTP | CDC. [online] Available at: https://www.cdc.gov/nchhstp/he...
- Consillio, K., 2019. STDs in Hawaii are at an all-time high as more take part in online hookups. [online] Honolulu Star-Advertiser. Available at: https://www.staradvertiser.com...
- Hhdw.org. 2021. Sexually Transmitted Diseases | Hawaii Health Data Warehouse. [online] Available at: http://hhdw.org/health-reports...
- Kitv.com. 2019. Number of STDs spikes in Hawaii. [online] Available at: https://www.kitv.com/story/402...
- Plannedparenthood.org. 2021. STD Testing in Honolulu, HI - Herpes, Chlamydia, Gonorrhea Tests. [online] Available at: https://www.plannedparenthood....
- Preidt, R., 2011. 19 Million New STD Infections Reported Annually, CDC Says. [online] MedicineNet. Available at: https://www.medicinenet.com/sc...