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Post-pandemic rise in sexually transmitted diseases imminent, experts warn

Public health experts worry that a 'hot vax summer' could lead to new spikes in infections spread through sex.
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Posted at 8:28 AM, Jul 01, 2021
and last updated 2021-07-01 09:28:54-04

(NBC News) - As Americans start to emerge from the pandemic, public health experts and doctors have a dire warning about a possible new health crisis this summer, one that involves a different type of infection: sexually transmitted diseases.

“We are expecting the summer of love,” said David Harvey, executive director of the National Coalition of STD Directors. “People are going to be connecting this summer as they come out of the pandemic and we think that is unfortunately going to drive STI rates even higher,” he said, referring to sexually transmitted infections.

Already many Americans are throwing away masks and preparing for a modern-day version of the Roaring '20s, complete with partying, drinking and, yes, lots of casual sex.

"It’s about making up for lost time,” dating expert and internet personality Serena Kerrigan said. “We’re literally burning our tie-dye sweatpants and people are really excited to go out and look good and feel good.”

Her attitude about the summer seems to align with a wider feeling of people being ready to emerge from their pandemic cocoons.

But public health experts are warning about an expected explosion of STDs that started even before the pandemic hit.

STDs have been skyrocketing for years. More than 2.5 million infections were reported in 2019, according to the latest data from the Centers for Disease Control and Prevention released in May. Cases of chlamydia have increased by 19 percent since 2015. Gonorrhea was up 56 percent in the same time period. Even more alarming, syphilis jumped 74 percent.

“It was the sixth consecutive year of the highest STI numbers in American history,” Harvey said. “Those numbers were only made worse by the pandemic,” as clinics shuttered and the number of people getting tested tanked.

Even when clinics reopened, many people were still reluctant to come in out of fear of the coronavirus, said Dr. Meera Shah, chief medical officer of Planned Parenthood’s Hudson Peconic New York region.

“I had people telling me I would have come in sooner, but I was afraid of Covid,” she said. “This fear did cause folks to delay care and not receive care.”

A study published in May found that screening for STDs in the U.S. dropped by 40 percent from the start of the pandemic in late February 2020 to April 2020. Testing rebounded in June 2020, but by then, positivity rates for chlamydia and gonorrhea had both increased from the year before.

“We are still not seeing the volume of testing that we had in 2019,” said study author Dr. Harvey Kaufman, senior medical director for Quest Diagnostics. “We’ve been losing the battle for years.”

Adding to the screening challenges, disease intervention specialists who do contact tracing of STDs were shifted to help state health departments with Covid-19 efforts. Many still haven’t been brought back in.

“It’s going to take us a couple of years to recover,” Harvey said.

Full return to party culture?

But while people may have stopped testing for STDs, they didn’t stop having sex.

“Now that folks are vaccinated and kind of resuming normal activities, dating, dating on apps, the STIs that had gone undiagnosed and untreated may have been spreading during the pandemic, and now folks are maybe going to be spreading them even more,” Shah said.

Doctors and public health experts say part of the underlying problem appears to be a change in attitudes about safe sex, particularly among young people, who accounted for half of all infections, according to the CDC.

Over the last few months, Lisa Wade, a Tulane University associate professor who focuses on sociology, gender and sexuality studies, has interviewed 145 students at the school, asking them about hookups, friendships and relationships.

“One thing I struggle to figure out as I’ve been doing these interviews is … is condom use normal or abnormal?” said Wade, author of American Hookup, which focuses on the culture of sex on college.

Some students told Wade, ‘I used it every time. I don’t get any pushback.’

Other students said, "if you want to use one ... the guy will try and change your mind and talk you out of it.”

Wade also found that students were more comfortable getting tested for Covid-19 than STDs, which was shrouded in the stigma of bad behavior.

“If you asked someone if they’ve been tested for STIs recently, that could mean you needed to be tested for some reason that’s bad, like, not having safe sex,” she said.

The behavior isn't limited to college-age students. A 2019 CDC survey of high school students found that nearly 50 percent didn’t use a condom the last time they had sex. It’s an issue that Dr. Joy Friedman, a pediatrician and adolescent medicine specialist at the Einstein Medical Center, sees in her Philadelphia clinic all the time.

“There are a lot of STIs in the communities we serve,” she said. “I often hear that using condoms is not particularly popular.”

Friedman said that patients often tell her they feel like there’s an imbalance of power in relationships and that teens aren’t comfortable asking their partner to use a condom. Some even feel that it can be self-incriminating, as if they’re asking to practice safe sex because they did something wrong.

But while college students became used to taking Covid-19 precautions, those lessons didn’t translate to better protecting themselves against STDs. As students return to campus this fall, Wade expects a full return to party culture.

“There is a sense of deprivation,” she said. “When school picks up again, that party culture will come back in full force — and that goes along with hookup culture.”

Back in New York, Kerrigan said the party culture is already back. She’s been going to events nightly. Her latest venture is a card game which helps people “reconnect” at a time when many may have not had that type of connection in a while.

Though ever aware of safety, Kerrigan says her card game comes with condoms.

“There’s always going to be a risk,” she said referring to infections. “But I also think it comes down to education and normalizing safe sex and being vocal about it.”