How Did STI Rates Change During the First Year of the COVID-19 Pandemic?

Sexually transmitted infections (STIs) are a global health issue. Recently, the Centers for Disease Control and Prevention (CDC) shared data on how STI rates changed during the first year of the COVID-19 pandemic.

Initially, during the first few months of the COVID-19 pandemic in 2020, STI rates decreased. At that time, lockdown measures and social distancing requirements were put in place by governments around the world. These measures almost certainly had an impact on people’s sexual behaviors by restricting opportunities to meet new sexual partners, keeping some couples apart who did not live together, and encouraging people to limit the number of contacts in their “quarantine bubble,” possibly further affecting their number of sexual partners.

In addition to changes in sexual behavior decreasing STI rates in March and April of 2020, reduced STI screening may have contributed to the lower STI rates. Since many health centers and hospitals were overburdened by COVID-19 cases, resources were shifted away from other illnesses and health concerns and toward COVID-19 activities. In some cases, clinics could only accept patients who were exhibiting symptoms. Because many STIs do not have symptoms, some STIs may have gone undiagnosed.

What’s more, the beginning of the pandemic brought increased unemployment and with it, increased barriers to care such as lack of insurance and/or funds for wellness check-ups. This could mean that less people were doing recommended routine STI tests, so the number of cases went down.

Despite the dip in STIs during the initial lockdown period, STI rates subsequently rebounded during the second half of 2020, exceeding 2019 STI rates in many cases. For example, there was a 10% increase in reported gonorrhea cases in the U.S. from 2019 to 2020, as well as a 7% increase in primary and secondary syphilis cases. Syphilis cases in babies (which occur when a mother passes syphilis to her baby during pregnancy) increased by 15% from 2019 to 2020, and by 235% from 2016 to 2020. On the contrary, reported cases of chlamydia declined 13% from 2019 to 2020, but this could have been due to reduced STI screening and not an actual drop in chlamydia numbers.

There are several possible explanations for the increased rates of most STIs during the first year of the COVID-19 pandemic. Perhaps most importantly, COVID-19 put an enormous stress on the world’s health care systems and caused many resources to be diverted away from other public health initiatives to go toward the pandemic. This means that efforts/campaigns to prevent the spread of STIs may have received less funding and attention in 2020, just like those of many other health causes.

The pandemic also introduced many previously unknown elements into STI tracking, (e.g., the temporary decline in STI testing due to quarantine measures and medical supply shortages,) which likely confounded the results. Therefore, CDC experts caution individuals to interpret the numbers with this in mind.

Nevertheless, STIs remain an important health issue. They can be spread to more individuals and cause more serious health problems if they are left untreated. As such, communities can benefit from STI prevention efforts such as comprehensive sexual education, training for health care professionals, and appropriate screening options.

Resources:

Centers for Disease Control and Prevention (CDC). (2022, 12 April). Impact of COVID-19 on STDs. https://www.cdc.gov/std/statistics/2020/impact.htm

Centers for Disease Control and Prevention (CDC). (2022, 12 April). New data suggest STDs continued to increase during first year of the COVID-19 pandemic. https://www.cdc.gov/media/releases/2022/p0412-STD-Increase.html