Rates of sexually transmitted diseases, or STDs, are on the rise in Contra Costa County according to the most recent data released by the county’s Department of Health Services.
Chlamydia, gonorrhea, and early syphilis cases—in males in particular—have been steadily rising since 2006 according to the figures, which were released in July.
These three STDs are often measured together because, along with HIV, health care workers are required by law to report each case to local health authorities. In 2015, Contra Costa had more than 4,700 cases of chlamydia, 1,300 cases of gonorrhea and approximately 140 cases of syphilis. A decade ago, the county had almost 2,700 cases of chlamydia, 815 cases of gonorrhea and just 17 cases of syphilis.
Men have significantly higher rates than women of all of the reported STDs except chlamydia. For that infection, women’s rate of infection is twice as high as men’s, and the rate of infection among African American women is nearly five times higher than that of all men.
Although steadily climbing, the county’s STD rates are slightly below state averages. For example, 1 in 206 people in California have chlamydia, the most common STD. In Contra Costa, that number is 1 in 236.
But the rising number of cases in Contra Costa mirrors a trend in the nation as a whole, said Dr. Nishant Shah, a clinician who worked at the North Richmond Center for Health for five years and currently works at the West County Health Center and Contra Costa Health Services.
Nationally, according to the Centers for Disease Control and Prevention’s 2015 STD surveillance report, published last month, the rates of chlamydia, gonorrhea and syphilis—the three most commonly measured STDs nationwide—began going up in 2014 for the first time in eight years. Since then, they’ve only continued to rise.
“We don’t like seeing these types of numbers going up,” said Christine Leivermann, HIV/AIDS and STD Program Director at Contra Costa Health Services.
There are multiple explanations for the trend, she said, including improved reporting through electronic health records, growing drug use that can result in infections from shared needles and risky sexual activity—and new patterns of human behavior.
“Sex is wired into our DNA,” said Leivermann, and “there’s not much of a traditional dating pattern going on anymore.” When people casually date or sleep with one person and then move on, she said, that “may put them at a higher risk for STDs.”
Shah agreed. He said that increased testing based on CDC guidelines may partially account for the uptick—more people getting tested means that previously unknown infections will be recorded. However, he said via e-mail, some of the trend is also likely influenced by “changes in sexual behavior among youth.”
Leivermann emphasized that everyone who practices unsafe sex is at risk of STD infection.
“It occurs everywhere,” she said, “and it doesn’t discriminate” in terms of age, race, or socioeconomic status.
Shah said that increases in gonorrhea and syphilis rates are worrisome because “they alert us to the increased risk of HIV transmission.”
That’s because gonorrhea and syphilis are diagnosed less often than chlamydia, the most common of the three STDs, he said, and as a result health experts see them as predictors of risky sexual activity that can leave people susceptible to contracting HIV.
Rising rates of syphilis, however, are particularly concerning because the infection—though treatable with penicillin—can have severe consequences, including neurological damage and permanent vision loss, said Abraham Arrendondo, a spokesperson for the California Department of Public Health, via e-mail.
Syphilis is also especially dangerous in pregnant women, because it can be passed easily to infants during pregnancy and childbirth and is life threatening. The California Department of Public Health recorded six stillbirths due to congenital syphilis statewide in 2014, up from one case in 2012.
“In Contra Costa we have had lots of women who are pregnant who have a positive syphilis test,” said Leivermann. While they have not confirmed any case of congenital syphilis, she said, “We’ve had a lot of babies that we’ve been worried about.”
Efforts to slow or reverse increasing STD rates in Contra Costa County currently include encouraging more frequent STD testing, following up with people who have tested positive, and reminding them to contact their sexual partners. So far, said Leivermann, there are no plans for large campaigns to increase testing or public awareness.
“Campaigns cost money,” she said, “and money is one thing that we don’t have.”