STD Testing in Texas

Texas STD Data

STD data & statistics in Texas

CDC reports that the state ranks 23 on the list of U.S. states having the highest number of STD cases. Texas state's number of uninsured people is the highest in the country. As per the Kinder Houston Survey 2020, around one-quarter of Harris County families are uninsured. Many of the Texas cities are included in the national list of cities reporting the highest number of STD cases in recent years.

Austin ranks at number 56 with over 1000 cases, Killeen ranks number 8 with 1600 cases per 100,000 people. Waco was ranked 33rd, Lubbock 38th, San Antonio 74th, and Dallas was featured on number 60. The highest number of STD diagnoses were made in Harris County and Dallas Country, stated the Texas Department of State Health Services.

As per the CDC, the state reported the highest number of Chlamydia cases. The number of cases was higher among women with 752 cases per 100/000 people, which is 2.6 times higher than men (288 cases). The Texas STD Surveillance Report 2018 reveals that around half of the top 25 U.S. cities having the highest STD rates were reported in Southern Texas.

In 2018, the state registered 12,900 new cases of Syphilis, which was 10.6% higher than in 2017. The number of primary/secondary Syphilis cases was 2,528 per 100,000 population, 15% higher than in 2017. The number of overall Chlamydia cases in Texas during 2018 was 145,874, and around 46,958 cases of Gonorrhea were recorded.

In many Texas counties, the number of STD cases is on the rise and reveals the year 2016 study from the University of Wisconsin's Population Health Institute. The study utilized data from 2013 and concluded that Dallas, Bexar, El Paso, Travis, and Midland counties were getting worse in Chlamydia cases. In 2013, Bexar Country had around 11,826 new cases, which was the highest in Texas that year, and almost all major counties reported around 600 cases per 100,000 residents. Some even reported over 1000 cases per 100,000 persons.

Testing for HIV is Vital

Although there has been considerable advancement in testing and treatment services across Texas, the rate of HIV transmission and new cases is increasing every year. To reduce new HIV transmissions and improve the quality of life for people living with HIV, regular testing, viral suppression, and retention in HIV care is imperative.

Reportedly, 16% of Texans live with the disease but haven't been diagnosed as yet, which is a concerning issue. CDC reports that around one in seven people infected with HIV in the US is unaware of their condition. Furthermore, not all Texans benefit equally from the advancements made to HIV prevention and medical care.

It is a fact that the Texas populace is impacted disproportionately by HIV primarily due to its extreme diversity. Hence, the only way out is early diagnosis, which is possible through testing and screening. Testing is important to identify those living with HIV at the right stage. If diagnosed early, HIV can be treated with Pre-exposure prophylaxis (PrEP) and non-occupational post-exposure prophylaxis (nPEP). These medicines can effectively prevent HIV transmission among people at increased risk.

Research suggests that those living with HIV are least likely to transmit HIV if they receive effective and timely treatment. It happens because the amount of virus reduces in the body after treatment.

In Texas, low-cost HIV testing and medical care facilities are widely available. The Texas HIV Medication Program has collaborated with the Ryan White Program to increase the accessibility of people living with HIV to proper medical care and treatment.

HIV Rates in Texas

According to CDC, Texas is among those states that have been severely impacted by HIV. In 2018, the state recorded the second-highest number of new HIV diagnoses with 4520 cases/100,000. Texas also has the fourth-largest number of people living with HIV (around 327.9 per 100,000 persons). The overall number of HIV-positive individuals in Texas steadily increased to over 94,000 in 2018 from 68,000 in 2010.

An analysis of the recent statistics shared by CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention reveals that African-American females comprised almost 51% of Texas's newly reported diagnoses.

Around 37% of African-Americans, 34% of Latinx or Hispanic, and 53% of above 45-years-old adults living with HIV in Texas resided in urban localities, and over 61% acquired HIV via male-male sexual contact. Harris, Dallas, Tarrant, Bexar, and Travis counties had the highest HIV burden.

Texas is listed among the states where the rate of people without health insurance (17.7%) is relatively higher because it hasn't yet expanded Medicaid. Lack of expansion to the state-federal healthcare program for low-income individuals is a significant barrier for HIV prevention and care services and a major driver of prevailing health disparities among people with HIV.

Age, Gender, and Ethnic Breakdown

In not just Texas but overall in the U.S., claims CDC, sexually transmitted diseases disproportionately impact ethnic and racial minorities. The rate of STD cases is significantly high among the Black community than Whites.

According to the Texas Department of State Health Services, around 36.7% of all primary and secondary Syphilis cases reported in 2014 were diagnosed among the African-American populace. African-American females had the highest number of Chlamydia cases with 1,250 per 100,000 people, almost double the number for Hispanic females and around three and a half times more than the number of cases reported in White women.

The rate of Gonorrhea cases was also higher in the Black community, with 411 cases per 100,000 people, which is around five times higher than the number of cases in Hispanics (85). It was almost seven times higher than for whites, which was 61 cases per 100,000 people.

Between 2006 and 2010, the average annual incidence of all stages of Syphilis in Texas was comparatively lower in South than the rest of the state with 19.8 and 25.9 per 100,000 persons respectively.

However, Hispanics in this part of the state reported a higher incidence of Syphilis (21.9), while in the rest of the state this number was comparatively less (18.7). In South Texas, the average annual incidence of Chlamydia was also higher than the rest of Texas, with 429 cases per 100,000 people between 2006 and 2010.

In this context, Hispanics reported a higher rate of incidence than non-Hispanic whites and African-Americans. On the other hand, the incidence of Gonorrhea during the same period was the highest in Southern Texas with 90.3/100,000 people, which is nearly 2.4 times higher than non-Hispanic whites (37).

HIV-Specific Data

As per the Texas HIV Surveillance Report 2018, in 2015, about 4,476 adolescents were diagnosed with HIV, and most of the new cases were reported among men who have sex with men (MSM). By 2018, the rate of new diagnoses among MSM in Texas reached 70%, which was 62% in 2010. In 2018, 4 out of 5 people with new HIV diagnoses were males. 3 out of 4 cases were either African-Americans or Hispanics, and 3 out of 5 were reported among people below 35-years.

Around half of the newly reported diagnoses were among African-American MSM and Hispanics. In fact, MSM and Black Texans recorded most disproportionately high diagnosis rates. Almost 1 out of 12 MSM in Texas had HIV in 2018.

In the last ten years, the cause of death in 62% of the deceased in Texas' transgender community living with HIV was HIV/AIDS. In 2018, over half of the total HIV diagnoses were among people below 30 years of age. The number of new diagnoses among African-American Texans fell by 6% between 2009 and 2018, and the number for Hispanics increased by 19%.

This increment among Hispanics can be attributed to an increase in Hispanic MSM. However, regardless of the reduction among the Black community, the diagnosis rate was still 2.8 times higher in this group, followed by Hispanics.

The rate of diagnosis for Black females was reportedly five times higher than Hispanic females. It is worth noting that Texans' age profile diagnosed with HIV in 2018 varies considerably by gender. Males lean more towards younger ages, and most new diagnoses were reported among young MSM of color. On the other hand, female diagnoses were more tilted towards the older age.

About 1 in 3 infected females in 2018 were 45 or older. In 2018, 28% of all new diagnoses in Texas were 24 or younger, out of which 24% were males and 16% females. 37% of diagnoses were reported between 25-to-34-year-olds, with 39% males and 27% females. Approx. 19% of the total cases were among people aged 35-44, where 18% were males and 24% females. 21% of the new diagnoses were 45 or older, where 19% were males and 33% females.

Teen Pregnancies and STDs - A Growing Cause of Concern for Texas

Every year, around 35,000 teenagers and young females get pregnant before turning 20 in Texas. In the rest of the U.S., the rates of teen pregnancies are declining with every passing year. However, as per a study published in Obstetrics & Gynecology journal, the rate of decline is considerably slower in Texas state.

Dallas and San Antonio had 50 and 40 percent higher teen pregnancy rates than the national average. As per the Texas Campaign to Prevent Teen Pregnancy's CEO, Gwen Daverth, teens in the state start indulging in sexual activity early. Research suggests that over half of high school students have had sexual intercourse. This reveals Texas is in dire need of revising its sex education policy.

In Texas, it is hard for teens to access reproductive health care. In the state, if a 16 or 17-years-old mom wants a birth control prescription, she will require her parents' permission. This law is prevalent only in Texas and Utah. Those who are already a parent will be the legal medical guardian of their baby but cannot make their own medical decisions without grandparents' permission. Perhaps, this is the reason Texas is reporting the highest number of repeat teen pregnancies in the U.S.

However, several studies have concluded that contraception is fundamental to reduce the rate of teen pregnancies. The National Campaign to Prevent Teen Pregnancy revealed that teen pregnancies cost Texas over $1 billion every year. These costs are incurred due to lost wages and excessive reliance on social services by this age group.

STD Prevention Measures

To offer treatment, care, and prevention services, Texas has implemented several key measures. The Department of State Health Services HIV/STD program is initiated under national guidelines related to the care and treatment of STD. These guidelines are developed by nationally recognized groups, including CDC, Office of AIDS Research Council, U.S. Department of Health and Human Services, AIDS Education and Training Center, and National Institute of Health.

STI Care Options During COVID-19 is another significant step towards addressing the issue. It is developed by the Denver Prevention Training Center to deliver STI (sexually transmitted infection) services while people are staying at home or in shelters due to the pandemic. It is launched specifically to help people access to care as social distancing and lockdown have made it challenging for them to seek care and treatment.

Moreover, the government is responsible for distributing informative materials produced annually by collaborating representatives of the federal government, local communities, states, community-based organizations, hospitals, service organizations, and schools. The Program Materials Review Panel (PMRP) of the DSHS reviews all the new publications, educational materials, and videos that will be used in its HIV/STD prevention activities.

The CDC is funding the National Infertility Prevention Project. It is a multi-state project that was launched around 20 years back and is still active in Texas. Through this program, the government aims to implement effective STD prevention strategies, with a special focus on reducing Chlamydia prevalence and Chlamydia-related health complications among females. Through this project, screening for Gonorrhea was made essential for sexually active people, including male partners.

The Texas Infertility Prevention Project (TIPP) is initiated in partnership with DSHS. It focuses on identifying, screening, and treating men and women who are at the highest risk of getting infected with Chlamydia and Gonorrhea. Under this program, infected or at-risk people are offered counseling regarding treatment options and safe sex practices. STD clinics, family planning centers, correctional facilities, maternity clinics, etc., are some of TIPP screening sites spread across the state.

HIV Prevention Initiatives by the Government and CDC

Texas lags in HIV control measures compared to other Southern states. The state has launched several initiatives and the federal government to reduce the number of cases across Texas. One such initiative is Ending the HIV Epidemic: A Plan for America (EHE). The US Department of Health and Human Services launched EHE to eliminate HIV via action-oriented approaches. It comprises several strategies to follow, the most important of which is routine testing and early diagnosis. Immediate linkage to care is another integral part of this program.

It is a fact that HIV testing is the only gateway for prevention as well as treatment of the disease. However, in Texas, the rate of undiagnosed individuals is relatively higher (18.9%) compared to the national average (14.2%), and so is the rate of new diagnoses (15.7 for Texas and 11.4 nationwide per 100,000 people). The Ryan White Program offers federal funding to facilitate early testing among low-income people with HIV to address this issue.

Under this program, support is provided to over half of the HIV-positive individuals in the US. Around 63% of people that the Ryan White program supports have income below the poverty line. The EHE's success relies on the Ryan White program and demands sustained funding from the federal government.

CDC is funding the Texas State Health Department and local health department to implement scalable and cost-effective HIV prevention programs and policies. The funding is geared towards increasing access to care within Texas's most severely affected regions and communities. Through CDC's funding, evidence-based disease monitoring, staff development, routine program evaluation, and staff development are supported.

Moreover, the CDC offers support to 15 community-based organizations, two local education agencies, and one capacity-building assistance provider in the state. CDC aims to initiate HIV prevention strategies and activities, developed educational programs to encourage delayed sexual initiation, and devise youth-friendly health services.

Sex Education in Texas

Texas lags behind other states regarding offering effective sexual education to adolescents and teenagers. Learning about birth control methods beyond abstinence is required in high school, but health education becomes optional at this stage of academia. Furthermore, Texas doesn't require public schools to address LGBTQ issues while providing sex education. This approach frustrates the transgender people and bisexual community, which make up about 2% of the state's population.

Texas's elementary and middle schools are currently required to offer health education to students from Kindergarten to Eighth Grade. However, when in high school, students don't need to take these classes to meet the state's graduation requirements. Also, Texas hasn't mandated that schools teach sex education, and those that do must promote abstinence as the ideal means of birth control among unmarried young adults. Also, parents have the right to opt their kids out of any lesson of their choice.

To eliminate the prevailing loopholes in the health and sex education curriculum taught at schools in Texas, the Texas State Board of Education is in the process of developing new and more inclusive standards for sex education. If approved, it will become the first-ever revision to the statewide sex and health education policy since 1997. Reportedly, from 2022 onwards, seventh and eighth-grade students across Texas will be offered education about different forms of birth control beyond abstinence.