According to the Centers for Disease Control and Prevention, there has been a continuing and troubling trend of persistently rising STD rates in the past five years. This is specifically noted in the most common STDs, namely syphilis, chlamydia, and gonorrhea. Since 2013, the CDC has observed a steady rise in the cases of these STDs, including all stages of syphilis.
The three reportable STDs can cause significant harm to those that get infected. Lifelong health issues, pain, and infertility are common complications that emerge from untreated STDs. In some cases, especially with syphilis, the health consequences are far more severe as it may lead to a permanent disability or death. With such an enormous increase in the number of cases, the number of adverse health outcomes also increases. Given Utah's under-resourced public health system, it is a great struggle to keep up with the rapidly rising number of STDs cases.
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STDs, inherently, are social diseases and linked intrinsically to social determinants of health. Certain groups of population in Utah, such as the poor, minorities, and men who have sex with men (MSM), bear a disproportionate burden of STD prevalence. These groups are generally less able to receive timely and appropriate care. These populations are also subject to risky lifestyles and behaviors that eventually prove more conducive to STD transmission than other people. That's why every sexually active individual need to get tested for STDs regularly, as you may never know if and from where you've contracted the disease.
Generally, STDs share similar transmission pathways, especially the three reportable STDs mentioned above, which are comorbid with other STDs and HIV. The increased threat of coinfection makes the risk even more severe and further adds to the struggles the public health department faces in high-burden communities.
The fact that STDs are preventable and treatable if diagnosed early makes it all the more important for you to get tested. Unfortunately, factors like stigma, poverty, discrimination, unemployment, lack of access to care, inadequate resources, and inequity have proven to be critical barriers in curbing STDs rates. Luckily, there has been a substantial improvement in care provision and access to testing and treatment facilities in Utah state. You can easily find an STD testing center or clinic nearby, which usually offers a free-testing facility.
Remember that all STDs may not be life-threatening, such as chlamydia or gonorrhea, but these can lead to serious health issues like ectopic pregnancy, infertility, and pelvic pain. Those infected with human papillomavirus are at an increased risk of developing genital, cervical, and oral cancers. To prevent your health from permanent deterioration, it is better to get tested for STDs annually.
In Utah, public health services are administered locally and offered directly through public health clinics or via contract-based relationships with providers. This includes community-based clinics like FQHCs, Title X Family Planning clinics, and Planned Parenthood clinics.
CDC funds the Utah State Health Department to channel resources for reducing STDs incidences using science-based prevention and control methods. Utah's STD prevention program focuses on devising high-impact, cost-effective, scalable, and sustainable STD control services. Utah State is part of a network of STD programs that gather additional information from across the state to identify and report STD trends quickly.
Every county and district in Utah has a dedicated STD control program. For instance, the Salt Lake County Health Department STD Clinic and Prevention Program is responsible for offering effective STD prevention education and low-cost testing and treatment via utilizing the latest technology. Similarly, Utah County and Davis County have their dedicated Sexually Transmitted Diseases Programs that focus on disease surveillance and preventing infection transmission while ensuring extensive availability of testing facilities.
According to the state health department, in Utah, all four STDs that the depart tracts, including HIV, syphilis, chlamydia, and gonorrhea, are on the rise. However, it is gonorrhea that is going viral across the state. For instance, in 2011, Salt Lake County reported 200 gonorrhea cases annually, which increased to 669 in 2013 and dramatically rose to 998 in 2014. In 2016, the county reportedly recorded 1,024 gonorrhea cases, which was 5 times higher than the levels reported in 2010-11.
According to the CDC, in 2013, Utah ranked 38th among the 50 states for syphilis rates, 44th in gonorrhea rates, and 48th in the number of chlamydia cases. In Salt Lake County, around 4,500 chlamydia cases are reported annually, making it the state's most commonly and frequently reported STD. However, the state's gonorrhea rates are rising faster and may overtake the state's and national average in the near future.
Other STDs are also rising steadily. In Davis County, there was a 17% increase in Chlamydia cases, a 122% increase in gonorrhea cases, and a 91% rise in cases of syphilis during 2016-2017. A similar trend was noticed in Weber and Morgan counties, where chlamydia rates were higher than anywhere else in the state, with around 318 cases/100,000 people reported in these counties in 2017 against 251 cases/100,000 people across the state. Utah County isn't too far behind, as, in 2018, there were more cases reported of chlamydia than influenza.
Statewide, the number of STDs cases has continued to rise since 2011. In 2015, there were over 1,000 chlamydia cases, which increased to 1,058 in 2016, 1,190 in 2017, and reached 1,257 in 2018. Furthermore, there were 139 gonorrhea cases reported in 2015, 167 cases in 2016, 200 cases in 2017, and 225 cases in 2018. Regarding syphilis, the state reported 13 cases in 2015, 21 cases in 2016, 21 cases in 2017, and 36 cases in 2018.
STDs, although prevail more in people having a history of incarceration and MSM, Utah's gonorrhea outbreak is increasing faster in the general public. A majority of the infections are reported among 15 to 34-year-old white males and females. That's surprising because, historically, STDs have been disproportionately prevalent in Hispanic and Black communities. It is a fact that Utah, historically, has had low STD rates in comparison to other states, but there has been a sudden upsurge in the recent past.
Around 60% of reported STD cases were diagnosed in people aged 15 and 24 years of age. In 2019, the overall chlamydia infection rate in Utah state was 345.4 cases/100,000 residents. There was a 37% decrease in teen births between 2013 and 2018, from 20 to 13 births/1,000 females aged 15 to 19, respectively.
In 2019, gonorrhea rates were higher among males aged 25-29, with 352.2 cases/100,000 people, and for the 30-34 age group, the number of cases was 297/100,000 people. Among women, the highest number of gonorrhea cases was reported in 20 to 24-year-olds with 227.4 cases/100,000 females. Interestingly, there were zero cases of congenital syphilis in Utah from 2011 to 2015.
As far as race and ethnic disparities are concerned, African-Americans are the most impacted population in Utah. In 2019, blacks reportedly accounted for 1,419 chlamydia cases, followed by Latinos/Hispanics with 624.4 cases, and 230.8 cases in whites, per 100,000 people. A similar trend was observed in the number of gonorrhea cases per 100,000 people, with blacks reporting 507 of total diagnoses, Latinos/Hispanics reporting 152.6 cases, and whites reporting 65.7 cases of gonorrhea. Primary and secondary syphilis rates in 2019 revealed that blacks reported 21 cases, Hispanics/Latinos were the second most affected group with 6.7 cases, and whites reported 3.7 cases per 100/000 people.
Utah state code supports an abstinence-based sexual education program. The program promotes celibacy as the best and most effective way to prevent disease and pregnancy. Teachers aren't allowed to encourage or promote premarital or extramarital sexual activity. The state has developed new sex education standards. Still, there haven't been many changes in the curriculum except that it offers information on the different contraception methods, such as birth control pills. The new standard will include lessons for students from kindergarten through second grade. Parents will be allowed to opt-in their kids for the middle and high-school sex education units. The curriculum will also include a discussion on pornography addiction.
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