Philadelphia Medicine Spring 2020 - 14

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The U.S. Suffers Record High
STD Cases... And It's a lot
Worse in Philadelphia
By: Alan Miceli, Editor

exually transmitted diseases (STDs) have hit a record high
nationally. The most recent statistics in the U.S., from 2018,
show disturbing trends in syphilis, gonorrhea and chlamydia.
And as bad as the national statistics are, the Philadelphia numbers
are far worse.
While the national rate for syphilis, according to the Centers
for Disease Control and Prevention (CDC), are at epidemic levels,
the rate for the disease in Philadelphia is more than twice as high.
Nationally, there are 10.8 cases of syphilis per 100,000 people, while
in our city the rate is a staggering 26 cases per 100,000 people.

Key to Skyrocketing STD Rates - Men Having Sex
with Men
But the key driver of the skyrocketing sexual disease statistics
continues to be men having sex with men (MSM). The CDC reports
that in 2018 MSM represented 54% of syphilis cases even though
they represent only 4% of the population. Syphilis cases among
MSM is 104 times higher than the syphilis rate among men who
have sex only with women.

In 2018, about half the MSM with primary and secondary
syphilis in this country were also infected with HIV. "We are not
The city's rates of gonorrhea and chlamydia also far exceeded the keeping up with the resurgence of STDs in this country," says Dr.
national numbers. The chlamydia rate was 1,278 cases per 100,000, Gail Bolan, director of the CDC's Division of STD Prevention.
more than double the national average of 540 per 100,000, and the "Clearly transmission is outpacing our detection and treatment efforts."
city's gonorrhea rate of 456 per 100,000 is also more than double
In Philadelphia, the typical gay man who has syphilis has on
the national rate of 179 per 100,000.
average, one different sexual partner a week, and that partner is often
anonymous. Partners are found on websites such as GRINDR. The
app describes itself as "The world's #1 FREE mobile social networking
A Spike in Congenital Syphilis Cases
app for gay, bi, trans, and queer people to connect."
There has been a spike nationally and locally in congenital syphilis
The app goes on to say "it's the place to be to see people nearby
cases. In the U.S., the number of pregnant women contracting
based
on your location, chat and share private photos... filter your
syphilis rose 40% in 2018, resulting in 94 infant deaths and stillbirths.
search to find what you want, send your location and make it easier
Teenage girls between the ages of 15 and 17 are at the highest to meet."
risk, according to the CDC, because they are often not truthful with
Dr. Lenore Asbell, medical specialist for the STD Control Protheir physicians about their sexual behavior. The CDC says many
gram
of the Philadelphia Department of Public Health, says such
congenital syphilis cases are caused by women having sex in exchange
sites
make
it much easier to have sex with someone without even
for drugs. CDC research also shows that doctors and other health
knowing
the
person's name. "Part of the problem is that so many of
care providers are less likely to discuss or offer STD screening to
the
partners
are
anonymous. The use of social media is often the way
these young women.
people meet partners now. We know that people are meeting their
The Pennsylvania Department of Health reports that one of every partners on some of these local apps. That does lead to being less
two sexually active young people will get an STD by the age of 25 likely to know your partners, know anything substantial about them."
and not even know it.
Deja Alvarez, a trans woman and a local LGBTQ advocate and
The CDC recommends that health care providers complete a activist who works in public health, said much of the increase in
sexual history for their female patients; test all pregnant women for syphilis cases may stem from the increasing use of apps. "There's
syphilis; treat women infected with syphilis, immediately; confirm more online access to each other. That can make it a lot easier to
syphilis testing at delivery, and report all syphilis cases to your local have encounters."
health department.
14 Philadelphia Medicine : Spring 2020

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Philadelphia Medicine Spring 2020

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