Executive Summary 

• Sexually transmitted infection (STI) rates are dramatically increasing at a seemingly uncontrollable rate nationwide.  

• Nearly eradicated diseases such as syphilis have made a staggering resurgence, particularly in southern states.  
• Young adults account for nearly half of all newly reported STI cases.  

Introduction 

The Centers for Disease Control and Prevention (CDC) have alerted an increasing STI epidemic with a reported 2.5 million cases in 2022. In response to cases rising, the Department of Health and Human Services (HHS) has launched an STI initiative. One of the STIs experiencing the more drastic growth in cases is syphilis. Both normal and congenital syphilis are on the incline. Steady drug abuse increase might be correlated to the disease’s resurgence. Adolescents have been the largest at-risk population for the epidemic due to both biological and behavioral factors. This public health crisis should be on the forefront of policymakers’ minds approaching the new year and is yet another shortcoming in the very broken American healthcare system.  

The STI Epidemic 

STI rates have been increasingly steading for the past five years. The CDC has noted that gonorrhea, syphilis, congenital syphilis, and chlamydia have all been increasing. HHS’ initiative is still in the implementation period and is expected to last five years. The STI National Strategic Plan is a direct response to the concerning numbers; the plan targets specific at-risk populations such as men who have sex with men, adolescents, and pregnant women. The goals are prevention, harm reduction, accelerating research, and addressing health disparities contributing to disproportionate health outcomes. It will tackle the STIs mentioned by the CDC as well as HPV which is known to lead to cervical cancer in women. Learning from the AIDS epidemic, another crucial aspect of the success of this initiative that HHS addresses is reducing stigmatization and discrimination surrounding STIs. This is particularly important for members of the LGBTQ+ community and black Americans.  

Syphilis  

Syphilis particularly has seen a staunch increase from 2017 to 2021. This is especially notable as at the turn of the century, syphilis was nearly eradicated. Now the once obsolete disease has returned and become a risk for pregnant women especially. Congenital syphilis (CS), syphilis transmitted from the mother to the newborn during birth, has seen a horrifying increase. The disease results in stillborn 40 percent of the time and the remainder are extreme health complications and still potentially death. Along with other maternal health disparities such as access and cost, drug use has contributed a significant amount to these shocking figures. A case study examining the states with the highest level of congenital syphilis found that intravenous drug usage is exacerbating the issue. Southern states have been hit the hardest, with them accounting for over 52 percent of the nation’s CS cases. 

Adolescents and Young Adults 

It is unsurprising that young adults are the population contracting the majority of these STIs however it is still concerning. As previously stated, last year adolescents were over half of the 2.5 million reported STI cases. A major contributor is the decrease in condom usage among young Americans. HHS’ Annual Family Planning Report (FPAR) found that from 2017 to 2021 condom usage from Title X grantees decreased from 65 to 42 percent. A potential explanation could be Gen Z not having experience with an STI epidemic and there is no longer the looming fear of HIV/AIDs. It cannot continue to be ignored however that the variety in sexual education and the continued emphasis on abstinence-only education is hindering healthy sexual behavior from young adults. Another potential consideration is the state of mental health for young Americans. Emerging from the pandemic, anxiety and depression levels have surged. High-risk behavior is attributed to many different mental health conditions.  

Conclusion 

The STI epidemic is being worsened by preventable social measures and is yet another example of the shortcomings of the American healthcare system. Considering the destruction caused by the AIDS epidemic, Americans should be alarmed by these out-of-control disease and infection levels. The United States spends billions more on healthcare than other high-income nations however are health outcomes are depressing and humiliating at best. Clearly the implementation of the health initiatives and social determinants have undermined the impressive spending efforts. As long as these deep systemic factors are not rectified, the nation will continue to suffer at the hands of preventable illnesses.