Testing times

One in five people in the U.S. estimated to have an STI

A man looks at his groin in bed - sexual health/STI
Photo posed by model (Shutterstock)

New research from the CDC estimates one in five people in the U.S. carries a sexually transmitted infection (STI). The study looked at figures from 2018.

Although an alarming statistic, the numbers include many people who are not necessarily infectious. For example, it includes people with HIV, many of whom are on treatment and undetectable and therefore cannot transmit the virus.

It also includes people who have herpes. That virus lays dormant for most of the time in nerve cells and can only be transmitted when people have a flare-up or attack – and these can be infrequent.

Other infections can present without symptoms but may cause problems if left untreated for a prolonged period.

The study determined there were nearly 68 million people with STIs at any point in 2018. Of these, 26 million were acquired in 2018, and half of these new infections were in people aged 15-24.

The infections included in the study were: chlamydia, gonorrhea, trichomoniasis, syphilis, genital herpes, human papillomavirus (HPV), sexually transmitted hepatitis B, and sexually transmitted HIV.

By far, the most commonly reported infection was HPV, which can cause genital and anal warts.

In fact, chlamydia, trichomoniasis, genital herpes, and HPV comprised 97.6% of all prevalent and 93.1% of all newly-acquired STIs.

The study looked at patients by age and gender. It did not look at sexuality, but other studies have found gay and bisexual men are more prone to sexually-transmitted infections than heterosexual men. The authors suggest more work needs to be done to look at the impact on LGBTQ people and different racial minority groups.

Related: Rising cases of “super gonorrhea” concern health experts

The CDC released the data to highlight the expense that goes toward treating what are, largely, preventable infections.

“Proven STI prevention – at all levels – is a cornerstone of protecting America’s health, economic security, and wellness,” said Raul Romaguera, acting director for CDC’s Division of STD Prevention. “There are significant human and financial costs associated with these infections, and we know from other studies that cuts in STI prevention efforts result in higher costs down the road.”

The CDC estimates around $16billion is spent treating people with lifetime sexual health infections. The vast majority of this ($13.7billion) goes toward treating those with HIV. This was followed by treatment for HPV ($755million).

The study suggests more needs to be done to target 15-24 years olds and to make it easier for people to obtain sexual-health screening, including services at pharmacies, walk-in clinics, telehealth screening, and home-testing kits.

“The burden of STIs is staggering,” said Jonathan Mermin, M.D., M.P.H., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “At a time when STIs are at an all-time high, they have fallen out of the national conversation. Yet, STIs are a preventable and treatable national health threat with substantial personal and economic impact. There is an urgent need to reverse the trend of increasing STIs, especially in the wake of the COVID-19 pandemic, which has affected many STI prevention services.”

Related: FDA approves first long-acting HIV medication: a monthly injection

The study demonstrates the importance of getting regularly screened for STIs. The CDC recommends sexually-active gay and bi men have a check-up at least once a year, or every 3-6 months if they have multiple partners.

It also advises gay men to get vaccinated for hepatitis A and B, and, if they’re under 26, against HPV.

You can have the HPV vaccine beyond the age of 26, but you’re already likely to have come into contact with strains of human papillomavirus by then so the younger the better. It’s for this same reason that girls generally receive it while at school. In the UK, the HPV vaccine is now given offered to gay and bi men under the age of 45 who go for sexual-health check-ups.