The U.S. saw a record number of cases of sexually transmitted diseases in 2017, marking the fourth straight year of sharp increases in gonorrhea, syphilis and chlamydia, according to preliminary data from the Centers for Disease Control and Prevention.
The trend is exacerbated by the fact that gonorrhea could soon become resistant to antibiotic treatment, the CDC said in a statement Tuesday. Prevention efforts have also stagnated, and people are using condoms less frequently, said one expert.
"We are sliding backward," Jonathan Mermin, director of the agency's national STD center, said in a statement. "It is evident the systems that identify, treat and ultimately prevent STDs are strained to near-breaking point."
Since 2013, syphilis cases have risen 76 percent to 30,644, while gonorrhea diagnoses have increased 67 percent to 555,608. Chlamydia is the most commonly reported STD with almost 1.7 million cases in 2017, up from just over 1.4 million in 2013. Almost half of chlamydia cases were in girls and women ages 15 to 24.
Most STDs go undiagnosed and untreated, the CDC said, which can cause infertility, stillbirth and an increased risk of HIV. The diseases can be treated with antibiotics, but gonorrhea has become resistant to nearly every class of antibiotics except ceftriaxone. Doctors typically prescribe a single shot of ceftriaxone that's followed by an oral dose of a different antibiotic, azithromycin.
More than 4 percent of gonorrhea samples were resistant to azithromycin in 2017, up from 1 percent in 2013. The CDC is concerned that such resistance could eventually extend to ceftriaxone, which would make the disease untreatable by any current antibiotic.
"We expect gonorrhea will eventually wear down our last highly effective antibiotic, and additional treatment options are urgently needed," said Gail Bolan, director of CDC's Division of STD Prevention.
Gonorrhea cases in men nearly doubled to 322,169 in 2017 compared with 2013, the CDC said. Among women, gonorrhea diagnoses rose almost 18 percent to 232,587. The disease reached a high point in the late 1970s with more than a million cases annually. The figure had gradually declined until the past four years, according to CDC data.
David Harvey, executive director of the National Coalition of STD Directors, said the rise is due to stagnant federal funding for prevention efforts, a lack of screening and a decrease in condom use. He cited a lack of awareness that some methods used to prevent other sexually related conditions -- such as IUDs and a pill to reduce the risk of HIV -- don't protect against common STDs.
CDC funding for prevention efforts has hovered around $157 million for the past 18 years, Harvey said.
"The field desperately needs new resources," he said.