Pandemic-related “Sexual Distancing,” Declines in Testing Cause Drop in Reported STDs

September 24, 2020

Sexually distancing and declines in STD testing due to COVID-19 may have caused the recent decline in reported cases of syphilis, gonorrhea, and chlamydia in the US.

Reported cases of sexually transmitted diseases (STDs) in the US have decreased since the coronavirus disease 2019 (COVID-19) pandemic started, according to new data reported during a Centers for Disease Control and Prevention (CDC) roundtable discussion at the agency’s 2020 STD Prevention Conference.

US cases of STDs had been on the rise before the pandemic hit, but according to the CDC, the current decline was not unexpected and may be attributed to sexual distancing caused by shelter-in-place orders and decreases in testing due to pandemic-related clinic closures.

“STD increases are not a new issue,” said Gail Bolan, MD, director of the CDC’s Division of STD Prevention, at the roundtable discussion held September 14, 2020. “Even before COVID-19, the United States was already battling steep, sustained increases in syphilis, gonorrhea, and chlamydia.”

New preliminary data from 2019 presented at the roundtable discussion showed there were approximately 1.76 million cases of chlamydia, 602 000 cases of gonorrhea, and 123 000 cases of syphilis, with a 20% increase in syphilis cases among newborns. Although this data is not yet final, it represents increases across each reported STD compared with 2018 data.

Also, reported STD cases in the first 2 months of the year were above 2019 levels but that changed once COVID-19 hit and most Americans were living under some form of shelter-in-place order.

“Compared to the same period in 2019, weekly reported chlamydia cases were 53% below 2019 levels. Weekly reported gonorrhea cases were 33% below 2019 levels, and weekly reported primary and secondary syphilis cases were 33% below the equivalent period to 2019,” said Hillard Weinstock, MD, MPH, chief of the surveillance and data management branch for the CDC’s Division of STD Prevention.

Weinstock stressed, however, that this decrease, “may be an underestimate.” For example, the CDC noted that during the height of COVID-19 restrictions, 28% of STD and HIV testing sites in the St. Louis region were closed, 63% operated with modified services, and 8% operated with no changes. Overall, as a result, chlamydia and gonorrhea testing decreased 45% and an estimated 5000 HIV tests were missed.

“Despite our challenges, I believe it is possible to mitigate the current STD increases, even in the midst of a pandemic. It will require new commitments and continued innovation on the ground,” said Bolan.