Pandemic did not slow STI spread in U.S.

Sexually transmitted infections kept rising in the United States over the last three years, according to a new report, proof the pandemic didn’t stop Americans from having unprotected sex with multiple partners. But experts differ on which part of the population is responsible for the continued increase.

According to the report, the rate of sexually transmitted infections among people who have insurance coverage from sources other than Medicare and Medicaid rose by 4.8 percent between 2020 and 2023. The nonprofit FAIR Health released the report earlier this month after compiling data based on a repository of 47 billion insurance claims.

The increase follows a decadelong trend, according to the U.S. Centers for Disease Control and Prevention. The CDC collects state statistics on syphilis, gonorrhea, and chlamydia. It reported that the number of cases of syphilis in the United States skyrocketed by 79 percent between 2018 and 2022, while gonorrhea cases rose by 11 percent.

While the CDC and FAIR Health agree that STI numbers continue to climb, they differ on which segment of the population contributed more to the rise.

FAIR Health says Americans over age 65 saw greater increases than any other age group, with STI cases among older Americans surging 24 percent since 2020. But a representative from the CDC told me all age groups saw modest increases, with their data showing that adults under age 40 still have the highest STI rates.

One possible reason for the discrepancy is that FAIR Health’s numbers also included human papillomavirus (HPV) as well as HIV and AIDS. According to the nonprofit, the number of adults over age 65 contracting HPV grew by 32 percent. FAIR Health’s data comes from private insurance and Medicare claims, excluding patients on Medicaid. The CDC collects case information on STIs from reports transmitted by local health departments.

Most sexually transmitted infections are not life-threatening if treated early. Syphilis, gonorrhea, and chlamydia can be treated with antibiotics. HPV can be prevented with a vaccine. HIV cannot be cured, but drug therapy can keep it from progressing in many cases.

Historically, cases of sexually transmitted infections are higher among young age groups. But health experts I spoke with said the rising STI rates among older Americans is concerning. A 2018 AARP survey showed that 40 percent of seniors between ages 65 and 80 were sexually active, and two-thirds of those surveyed remained interested in sex. Some experts also suspect that drugs for erectile dysfunction and hormone replacement have helped older men and women increase sexual activity. But many of them are not thinking about protection or the potential for infections.

“So many seniors don’t think of safer sex practices like condom use as being relevant for them,” said Fred Wyand, director of communications for the American Sexual Health Association.

Clinical psychologist and author Juli Slattery is president of Authentic Intimacy, an organization she co-founded to promote Biblical sexuality. She told WORLD in 2018 that the rise in STI rates is a reminder of men and women falling short of God’s design for sex to occur only in a marriage between one man and one woman.

“God created sexuality to teach us about covenant,” she said. “The reason that the Bible has rules against having sex outside of marriage is because sex is meant to be a way of celebrating and cementing a covenant promise.”

At the same time, Slattery acknowledged that everybody is vulnerable to temptation and the risk of giving or getting an STI. “We all are carrying scars, but that’s why we believe in a God that’s a redeeming God,” she said.

Mainstream health educators say doctors aren’t well-equipped to teach people about protecting themselves from STIs. Michelle Melville-Kashon, community development coordinator at Sexual Health Alliance, said that doctors typically don’t talk to STI patients about curbing risky sexual behaviors.

“[Doctors] get the training to explain the medical diagnosis, explain what the treatment is going to be, and explain the prevention,” Melville-Kashon said. “So your diagnosis is syphilis, we’re going to treat you with this antibiotic. To prevent this in the future, use condoms, you know, and that is kind of it..”

Melville-Kashon’s organization, which trains sexual health counselors, operates with the assumption that many Americans will have more than one sexual partner in their lifetime. The CDC takes a multi-pronged approach. It stresses abstinence, which it says is the “surest way” to avoid STIs, as well as having only one sexual partner. But it also recommends condom usage, vaccination, and STI testing.