Let’s talk about sex. On the heels of yet another congressional effort to defund Planned Parenthood and roll back access to health care comes news that last year set national and state records for sexually transmitted disease.
There’s a dispiriting feel to the data released this week by California’s Department of Public Health and the federal Centers for Disease Control and Prevention. Gonorrhea rates are up just as drug-resistant strains threaten to render the disease untreatable in the near future. Syphilis, close to eradication as recently as the 1990s, has increased, particularly among bisexual men, gay men and women.
California had the nation’s third-worst rates of infectious primary and secondary syphilis, after only Louisiana and Georgia. And a third of the babies born nationally with congenital syphilis were here.
In an especially heartbreaking trend, congenital syphilis – a completely preventable but lethal infection passed from pregnant mothers to babies – surged 28 percent from the year before to more than 600 cases, resulting in deaths and severe complications among newborns. In all, more than 2 million Americans were diagnosed last year with a sexually transmitted disease – including chlamydia, the most common.
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And while the hardest hit states were mostly in the Deep South, where stigmas around sex education and sexual health in general are strongest, some of the biggest statistical surprises were in tolerant, health-conscious California.
That’s where conversation really is needed, because there’s no excuse for this state’s numbers. California was responsible for more than 250,000 STD cases last year, up 40 percent from 2012.
Garden-variety chlamydia is treatable and mostly infects women under 30. But California also had the nation’s third-worst rates of infectious primary and secondary syphilis, after only Louisiana and Georgia. And a third of those babies born with congenital syphilis – 207 – were here.
In Stanislaus County, chlamydia rates actually fell fractionally from 2015 to 2016 from 474 cases per 100,000 population to 441, but that still was still 11 percent higher than in 2012. San Joaquin was much worse off, at 514 cases per 100,000. The incidence of gonorrhea nearly tripled from 2012 to 2016, while the incidence of syphilis doubled to 15 cases.
Dr. Heidi Bauer, sexually transmitted disease control branch chief in the California Department of Public Health, said the numbers reflect better screening and parallel epidemics.
In affluent California, there’s what might be termed an epidemic of safety. Gay and bisexual men now have state-of-the-art protocols to ward off HIV infection. Young women can afford long-term birth control under the Affordable Care Act. The result is a new amnesia about the value of condoms, just as one-night stands are finding each other at the swipe of a cellphone app.
In impoverished California, meanwhile, there is an epidemic of desperation and drug use, which is also causing an unprecedented outbreak of hepatitis A. Homeless people and meth addicts, particularly in the Central Valley, trade sex for drugs and shelter. Fresno County led the state in congenital syphilis, with 51 cases, up from two in 2012.
Pregnant addicts fear losing their children if a doctor sees that they’re using, and undocumented immigrants often don’t know where to get care and now fear deportation. “A third of our cases with congenital syphilis have no prenatal care at all,” said Bauer.
In both Californias, there still is the stigma that comes with sexual health issues. Health officials say part of the spike might be due to a reticence to speak frankly to doctors, partners or kids.
“Sex is a part of life, like breathing and eating,” Bauer said. For the sake of our health, we should start talking about it that way. Lives, after all, depend on it.