Planned Parenthood recently announced it would not accept federal dollars to pay for STD testing and treatment instead of complying with the federal rule that prevents Title X funded programs from offering information about abortion.
The federal government said there was a recorded number of new STI infections in the U.S, marking it the fourth straight year of rising infections for diseases thought to be controlled. Both gonorrhea and syphilis have made a return, which means the country is sliding backward.
Johnathan Mermin works with the CDC to prevent STDs, and he said the systems that work to identify, treat and prevent sexually transmitted diseases are at a breaking point.
With Planned Parenthood refuses the federal dollars, it means further strains on the systems.
Planned Parenthood offers birth control services to low-income individuals, and also provides mammograms, Pap smears and other preventative care services. The organization is going to rely on its financial reserves and look for new funding to make up for the loss, but specialists are worried that there will be even more of an erosion to public health efforts to deal with the rising number of STD cases.
National Coalition of STD Directors Executive Director David C. Harvey said STDs are at their highest, and both Planned Parenthood and Title X offer important safety net services for people who have or could have an STD.
Planned Parenthood, which is turning down the $60 million in funding instead of complying with the federal rule regarding funding and abortion information, said it did so over patients’ rights to alternatives and information. The organization said the rule was a gag order, calling it a physical separation between clinics that get Title X funding and clinics that do abortions.
Planned Parenthood is going to court to challenge the rule with states like Rhode Island, Connecticut, Vermont and Massachusetts signing on.
Maine Family Planning, which is a separate nonprofit which gets Title X dollars from the state, is also challenging the rule and is holding fundraisers and uses its reserves to keep its 18 centers afloat. Every one of them provides abortion services.
Maine Family Planning Senior Vice President of Program Services Evelyn Kieltyka said the clinics do receive money for STD screening through the CDC program, but it’s only earmarked for high-risk individuals. She said the organization is working tirelessly to find funding to continue offering the screening to those individuals since there are no Title X funds available.
STD specialists are trying to find out why STD rates are rising even though the number of HIV cases are dropping. A 2018 CDC analysis looked at three key STDs found that chlamydia cases increased 22 percent, whereas syphilis cases rose by 72 percent and gonorrhea rose 67 percent.
Kieltyka said nobody has a clue as to why the rates are increasing, which has been happening even before the Trump administration imposed the new rule.
Harvey said the changes in sexual behaviors – such as the use of dating apps – has brought strangers together. He said a lack of funding is another issue. Plus, people have gotten complacent about using condoms with the AIDS scare no longer forefront in their minds.
Harvey said the healthcare industry hasn’t done a great job in getting the message across about the continued use of condoms for protection against STDs and unwanted pregnancies. He said both adults and young people need to be informed about the latest contraceptive technologies and prevention tools available to them while also stressing the need for condom use.
It’s an area, Harvey said, where health professionals must do better.
With Planned Parenthood disengaging from Title X, some states such as Massachusetts and Vermont, are looking to close the gap in funding. Patients in Massachusetts will not see any service disruptions, as the governor and state legislature agreed to $8 million in state funding to programs losing the federal funds.
The Department of Health informed the federal government of its withdrawal from the Title X program completely and would continue to fight the good fight using state funds.
Like other states, Massachusetts has seen a rise in STDs with more than 1,000 cases of syphilis and more than 7,300 cases of gonorrhea. There has also been a 23 percent increase in the number of chlamydia cases.
According to the government, one in 20 sexually active females will be diagnosed with chlamydia in the U.S. And, even though the disease can be cured, it often goes undetected because it is asymptomatic. Chlamydia that has not been timely treated can lead to ectopic pregnancies and pelvic inflammatory disease.
In 2000, syphilis was thought to be close to being eradicated, but there has been a resurgence in the disease throughout the country. The diseases will cause lesions and rashes that will spread to the nervous system and brain. It can also cause dementia, blindness and paralysis.
Gonorrhea, widely known as the clap, will cause burning and pain in men, and even though women don’t experience symptoms, it can leave them with long-term health issues such as stomach pain, infertility and pelvic inflammatory disease.
Harvey said there was some good news on the STD treatment front. He said the Trump administration was going to release an initial federal action plan on STDs and has launched a plan to get rid of HIV altogether. While the number of cases of HIV isn’t spiking as much as other STDs, there are over 30,000 new cases every year.
Harvey said there two ways in which to reduce the infection rates of all STDs – continued public health funding and awareness.
Written by Mark Riegel, MD
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