The number of sexually transmitted infections (STIs) remains high in the United States, with more than 2.4 million reported in 2023. However, the latest data from the Centers for Disease Control and Prevention (CDC) show signs the epidemic could be slowing.

In 2023:
• Gonorrhea cases dropped for a second year—declining 7% from 2022 and falling below pre-COVID-19 pandemic levels (2019).
• Overall, syphilis cases increased by 1% after years of double-digit increases.
o Primary and secondary syphilis cases, the most infectious stages of syphilis, fell 10%—the first substantial decline in more than two decades. These cases also dropped 13% among gay and bisexual men for the first time since the CDC began reporting national trends among this population in the mid-2000s.
o Increases in newborn syphilis (known as congenital syphilis) cases appear to be slowing in some areas—with a 3% increase over 2022 nationally, compared to 30% annual increases in prior years.

“I see a glimmer of hope amidst millions of STIs,” says Jonathan Mermin, MD, MPH, director of CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention. “After nearly two decades of STI increases, the tide is turning. We must make the most of this moment—let’s further this momentum with creative innovation and further investment in STI prevention.”

Still, the nation has a long way to go to stop the STI epidemic. Over a million more STIs were reported annually in the United States in 2023 than 20 years prior. Tragically, nearly 4,000 babies in the United States were born with syphilis in 2023. Syphilis during pregnancy can cause outcomes like miscarriage, stillbirth, infant death, and lifelong medical issues. Most of these cases could have been prevented with timely syphilis testing and treatment.

While the STI epidemic touches nearly every community, some geographic areas and populations are affected more severely, including American Indian/Alaska Native, Black/African American, and Hispanic/Latino people, as well as gay and bisexual men. These differences are due in part to deeply entrenched factors that create obstacles to quality health services, such as poverty, lack of health insurance, less access to healthcare, and stigma, experts assert. Several federal efforts are underway to address these disparities. Action at the community level is also key to meaningful progress.

The new data follow important developments and innovations in STI prevention, such as CDC’s guidelines for doxy PEP to prevent bacterial STIs; newly Food and Drug Administration (FDA) authorized self-tests (or at-home tests) for syphilis, gonorrhea, and chlamydia; and a nationally coordinated response to the U.S. syphilis epidemic spearheaded by the National Syphilis and Congenital Syphilis Syndemic Task Force.

However, more efforts are needed to turn around the STI epidemic in this country, experts add, including:
• Prioritizing the STI epidemic at federal, state, and local levels.
• Developing new prevention, testing, and treatment solutions for more populations – including expanding the reach of doxy PEP among groups for whom it is recommended, and conducting more research to determine if it can benefit other groups.
• Investing in robust public health systems and trained workforces with the capacity to provide STI services.
• Delivering STI testing and treatment in additional outreach settings, like emergency departments.
• Making STI services more accessible in local communities.

Source: CDC