Local and national health experts say the coronavirus pandemic has limited the ability to test and treat sexually transmitted infections (STI).
Annual STI cases have risen each year since 2013 and the issue has been exacerbated as resources have been reallocated for COVID-19 testing and treatment, according to an April Centers for Disease Control and Prevention (CDC) statement.
Sarah Rudman, Santa Clara County assistant public health officer, said the county reflects the national trend.
“We have seen the same pattern that the state and country have been reporting of year over year, pretty scary rises in rates of all reportable STIs culminating in 2019 having the highest reported rates that we think we’ve ever seen, at least in the last 20 years,” she said in a Google Teams call.
But, Rudman said reported cases dropped by 50% in 2020, breaking the trend.
“That’s not actually good news that rates are going down,” she said. “[It’s] really bad news that people didn’t get tested last year during the height of the pandemic.”
Whether the declines in reported cases are due primarily to real decreases in transmission, or decreased or delayed diagnosis and reporting remains to be seen throughout the coming years, according to a county health department report titled “Sexually Transmitted Infections and HIV Epidemiology Annual Report, 2019 and 2020.”
The Santa Clara County Public Health Department decreased and changed some of its health services during the beginning of the pandemic including shifting staff to COVID-19 care and redirecting supplies like cotton swabs, specific chemicals and machinery to testing sites, Rudman said.
“We were able to reopen pretty quickly once we understood how to do it safely for our staff and our clients,” she said. “We’re still not quite up to pre-pandemic levels, just while we try to make sure that there’s still space in the clinic for social distancing, good safety practices within the clinic . . . because some of our staff have been redirected to COVID-19 response.”
The largest demographic contracting STIs are college-aged people, according to the CDC statement.
Dianna Zamora-Marroquin, director of public affairs for Planned Parenthood Mar Monte, said college students are more likely to become infected for multiple reasons. Planned Parenthood Mar Monte is about 10 minutes southeast of SJSU’s main campus.
“It’s a unique environment where there’s a lot of communal living spaces,” Zamora-Marroquin said. “There's also oftentimes a lack of education around how certain STIs are transmitted and what can be done to either prevent them or where [people] can go to access that healthcare.”
Emily Rosenfield, wellness and health coordinator at SJSU, said the Student Wellness Center is dedicated to supporting students that fall into the age range of those most at risk: 15-24 years old.
“A major challenge is that STIs often don’t cause any symptoms, so it’s possible to share an STI with a partner without knowing,” Rosenfield stated in an email. “This is why it’s especially important for everyone who is sexually active to talk with their healthcare provider about STI testing.”
The university’s sexual health resources have remained available through the pandemic, according to Rosenfield’s statement.
“COVID-19 has not affected the Student Wellness Center’s resources to test and treat STIs,” she stated. “The Student Wellness Center is open and available to meet students’ sexual health needs in a variety of ways, including in person and telehealth appointments and STI testing through our onsite lab.”
Thousands of condoms have been distributed through the university’s Condom Co-Op program while free safer sex kits can be picked up or delivered through the Student Wellness Center, Rosenfield stated.
Aside from college students, the spread of STIs also disproportionately affects Hispanic and Black individuals and gay and bisexual men, according to the CDC statement.
Rates of STIs in Hispanic individuals are two times that of non-Hispanic white people, while rates for Black individuals are five-to-eight times that of non-Hispanic white people, according to the CDC report.
Gay and bisexual men account for half of all 2019 syphilis cases and experience gonorrhea rates 42 times that of heterosexual males, according to the same report.
Jo Valentine, associate director of the Office of Health Equity in the CDC’s Division of STD Prevention, said the CDC is focused on treating the hardest-hit populations.
“To effectively reduce these disparities, the social, cultural and economic conditions that make it more difficult for some populations to stay healthy must be addressed,” Valentine stated in the CDC report. “These include poverty, unstable housing, drug use, lack of medical insurance or regular medical providers and high burden of STDs in some communities.”
While the pandemic has emphasized inequities in healthcare, it also exposed certain tools that will benefit healthcare going forward including the use of telehealth, Zamora-Marroquin said.
“In more rural areas, there was a spike in farm workers [using telehealth] because they were able to take phone calls from the field if they had a 10 minute break and could talk to their doctor,” she said.
The pandemic has forced healthcare providers to reach patients’ demands, Zamora-Marroquin said, encouraging ingenuity in medical care.
“[The pandemic] has empowered us to understand that ‘no’ isn’t an acceptable answer,” she said. “The answer is no longer ‘no’ if we need something. The answer is: ‘What is a creative way to make this happen?’ ”
