The rising number of sexually transmitted diseases (STDs) in Michigan only reflects a shocking upward trend noticeable throughout the United States. The combined cases of common, reportable STDs, chlamydia, gonorrhea, and syphilis, are touching their all-time highs, revealed a report from the Centers for Disease Control and Prevention (CDC).
Chlamydia has been on an upswing for the past few years. Between 2017 and 2018, a 3% increase was noted in nationwide cases of chlamydia, with 1.7 million cases reported nationally. That’s the highest number of cases CDC has reported to date. A similar trend was noted in gonorrhea, and primary and secondary syphilis cases, as the country is witnessing the highest number since 1991.
It is noted that the number of STDs cases is increasing in Michigan and across the USA. But, this also indicates better testing awareness among the masses. STDs testing should be a part of your annual medical check-up if you are sexually active, and testing should be conducted every three months if you have multiple sex partners. That’s because most STDs are asymptomatic and have no signs. The only time one realizes that something might be wrong is when an STI (sexually transmitted infection) has progressed into an STD, the more dangerous stage of the infection.
Untreated chlamydia can cause severe damage to the female reproductive system, gonorrhea and syphilis can cause adverse health outcomes such as infertility, stillbirth in infants, ectopic pregnancy, and increased risk of HIV.
In 2015, the CDC strengthened its chlamydia testing guidelines after identifying the potential dangers the infection entailed. This change of guidelines incentivized insurance providers/firms to encourage regular screening of females. The CDC has made it necessary for women of childbearing age, specifically those under 25, to undergo annual screenings for chlamydia. This is why Ottawa County’s chlamydia count among women increased from 754 cases in 2012 to 926 cases in 2018.
Testing for STDs is also necessary because infected individuals can pass on the virus to other, non-infected people, leading to an overall increase in the number of cases.
“Many infected people are unaware of their status, which allows them to unknowingly pass it to their partners. All sexually active individuals should speak to their health care provider about regular testing so they can get proper treatment and prevent the spread of disease,” said Dr. Joneigh Khaldun, Michigan Department of Health and Human Services’ chief medical executive and chief deputy for health.
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Michigan’s numbers are pretty unsettling when it comes to STDs. The state reported 51,256 chlamydia cases in 2018, which is an all-time high for the state, as per the 2018-2019 STD surveillance report from the Michigan Department of Health and Human Services (MDHHS). The average number of cases per 100,000 residents was 477 between 2008 and 2012, which in 2018 increased to 513 cases. Between 2008 and 2014, the recorded gonorrhea cases indicated a decline but post-2014, a 70% incline was noted when cases reached 16,922 in 2015. The average rate also increased from 120 cases between 2008 and 2012 to 169 cases per 100,000 residents in 2018.
A decline in primary and secondary syphilis cases was noted until 2013, but the disease showed a surge in 2018 with 654 cases overall, which is three times higher than the 216 cases reported in 2008. The average rate of cases per 100,000 population increased from 119 cases from 2008 to 2012 to over 169 in 2018.
It is worth noting that Michigan has experienced a rise in chlamydia cases, with 45,000 to 51,000 cases reported annually since 2008. In 2018, the state recorded a 1% rise as the number crossed 51,000. Gonorrhea cases recorded a 10% increase in 2018, whereas compared to 2008 statistics, the state reported a whopping 70% incline. Reported syphilis cases jumped by 36% in 2018 compared to the rate between 2008 and 2012.
In Michigan, chlamydia case rates by county vary considerably, as the MDHHS noted from 64 to 1,539 cases/100,000 residents. The highest disease burden was observed in Metro Detroit as 20% of all cases were diagnosed in Detroit and 46% in the Macomb‐Oakland‐Wayne Counties metro area. Gonorrhea cases are consistently highest in Detroit since the rate is 5.5 times higher than the rest of the state. Around one-third of all reported gonorrhea cases in 2018 were diagnosed among Detroit residents and 52% in the Macomb‐Oakland‐Wayne Counties metro area. In Michigan, gonorrhea cases reported a 73% hike between 2014 and 2018, and a 9.9% increase was noted between 2017 and 2018.
The city of Detroit accounted for 32% of all primary and secondary syphilis cases. 71% of the cases were diagnosed in the Macomb‐Oakland‐Wayne Counties metro area. A one-quarter drop is noted in syphilis cases after the state reported a syphilis outbreak in 2013. The cases rose again by 28% in 2016 and 36% in 2018.
In Michigan, the highest increase in STDs during 2018 and 2019 was noted among adolescents, men who have sex with men, and the African-American community. This corresponds with the national trends where people aged 15-24 were the most impacted age group regarding STDs.
Reportedly, black males have the highest primary and secondary syphilis cases compared with any other racial or ethnic group in Michigan, with 47.0 cases/100,000 residents in 2018, which is around 8.9 times higher than white males. Moreover, around 89% of syphilis cases in Michigan were diagnosed among males. Most of these cases were reported among men who have sex with men.
In Michigan, females accounted for 67% of all chlamydia cases in 2018, mainly due to increased screening rates during routine visits as per CDC’s guidelines. Black females recorded a 5.7 times higher rate of chlamydia than any other race. Overall black population accounted for 49% of all chlamydial infections in Michigan. Compared to white males, black males reported a 3.8 times higher number of diagnoses. 68% of chlamydia infections were diagnosed in people under 25 years.
Regarding gonorrhea, the black race accounted for 66% of all diagnoses in the state, which is at least a 13.6 times higher rate than whites. Black males are disproportionately impacted by gonorrhea as they were 18.2 times more likely to be diagnosed with gonorrhea than white males. As witnessed in chlamydia, around 51% of all diagnoses were made among people below 25 years of age. Five-year average rates for chlamydia, gonorrhea and syphilis revealed that people between 30-44 years were the most affected age group in Michigan.
Moreover, congenital syphilis is also rising, and currently, its rates are at an all-time high in Michigan, with 14 cases identified in 2018. In contrast, 63 babies were born with congenital syphilis in the past five years. It is required by law in Michigan that all females should get tested for syphilis at their first prenatal visit, and the MDHHS works with clinicians to assure pregnant females are tested and treated timely and infected infants are also promptly treated.
To make sure that STD screening/treatment is accessible to high-risk communities, the MDHHS has established STD specialty care centers. The purpose of establishing them is to expand service options in select areas. Moreover, the MDHHS strives to build community awareness, offer technical assistance to medical providers, and introduce initiatives that target priority populace such as adolescents and women of childbearing age.
Community-based Approaches to Reducing STDs (CARS) is an important initiative established and funded by the Division of STD Prevention of CDC in 2011. The program was introduced to support the planning/implementation/evaluation of innovative projects to reduce STDs. The three main goals the program aims to achieve include- Reducing STD disparities; Promoting awareness about sexual health, Advancing community wellness. Through CARS, the state focuses on addressing STD disparities among bisexual, gay, and adolescent men as well as gender-nonconforming youth and the transgender community.
One of the two key initiatives under CARS includes Health Access Initiative, a free training program for health centers and clinics to improve access to sexual health care for LGBTQ+ youth. The other program is Advocacy Collective. An advisory board serves as consultants to educate the LGBTQ+ community via workshops, digital media, and presentations to create awareness about safe sexual health practices.
Sexually Transmitted Disease Control Program is offered by the Central Michigan District Health Department, under which testing for Chlamydia, Gonorrhea, Hepatitis C, Syphilis, and HIV is offered. Partner services include Family Planning and Health Promotion Programs. The testing is offered free of charge or at the lowest possible costs. High-risk populations, pregnant females, and women of childbearing age are given priority. Testing facilities are offered to everyone without religion, race, creed, origin, sex, marital status, sexual orientation, or ethnic biases.
Most people experience feelings of hesitation when going to get tested for STD, despite knowing they might have contracted one. EasySTD was created to change that.
Visit your nearest lab or clinic, order your home testing kit online, and follow the given instructions from an STD testing provider.
After ordering your STD test, visit the testing center to get tested or take a self sample including urine, cotton swab, or finger prick with the home testing kit and mail it back.
Receive the lab-certified results of your STD test from your test provider via mail or phone within 2 to 3 days. If the test comes positive, consult your doctor immediately.