For many, isolation has been an inescapable part of life during COVID-19. However, new sexually transmitted disease (STD) data indicate that people are still managing to get together and contract more than just the coronavirus.
In 2021, more than 2,000 babies were born with syphilis that they contracted from their mothers, according to preliminary Centers for Disease Control and Prevention (CDC) data on STDs. That figure represents a 108% year-over-year increase.1
While the data are still being tallied, they describe a steady march of congenital syphilis. In 2010, only 29 states and the District of Columbia had at least once case, according to CDC statistics. In 2019, 43 states and Washington, D.C. had at least one case.1
The CDC data also tell another story — one that, on the surface, is slightly deceptive. In 2019, cases of chlamydia and gonorrhea were up 19% and 56%, respectively.2 Then from 2019 to 2020, chlamydia and gonorrhea declined by 14% and 7%, respectively.3
Why did congenital syphilis increase while other STDs decreased? The answer, the CDC says, is that screening decreased. For safety reasons, clinics may have reduced screenings, and symptomatic people may have stayed home out of fear of contracting COVID-19.3
COVID-19 vaccines and prevention protocols may ease some of this hesitance. Common STD symptoms, such as a burning sensation during urination, itching, and genital sores, require immediate attention from a healthcare provider. However, some may experience no symptoms, highlighting the need for periodic testing.
Untreated STDs can lead to long-term illnesses and infertility. The good news is that most STDS can be treated. Protective measures, such as condoms, can reduce the risk of contracting an STD. They’re not perfect, however, underscoring the need to familiarize yourself with the symptoms of common infections.
Knowing what to look out for can help you address STDs before they cause long-term harm to the individual or spread within a community. Here’s what you need to know about eight common STDs.
1. Human Papillomavirus (HPV)
Public awareness surrounding HPV has increased in recent years, due in large part to the availability of an HPV vaccine. You may have noticed advertisements for this new prevention, which has become a routine vaccine for children ages 11 and 12.4 And there’s good reason for the marketing blitz.
The CDC estimates that there were about 43 million cases of HPV in 2018, with many occurring among those in their teens and 20s. Some, but not all, types of HPV cause genital warts.5
These pink or flesh-colored bumps can itch, cause discomfort, and bleed.6 More worrisome are strains of the virus that can cause cervical cancer, cancer of the penis or cancer of the mouth and throat. Healthcare providers can detect HPV, which is one of the most common STDs in the U.S., with a routine PAP smear. For those not already vaccinated, seeking a vaccination can reduce much of this risk by protecting against strains most likely to cause cancer.5
Herpes is one of the most contagious — and costly — STDs around. A 2022 BMJ Open study estimated that the annual cost of suppressive therapy can range from $240 to $2,580 per year.7
There are two viral strains: herpes simplex type 1 (HSV-1) and herpes simplex type 2 (HSV-2), both of which are sexually transmitted and cause genital herpes. Oral herpes can show up as cold sores or fever blisters, as well as genital or anal sores. Like syphilis, herpes can affect fetuses, especially following a new infection in the first trimester.8
History is filled with famous and infamous syphilis patients, one of whom was Al Capone. Ultimately, the mobster’s deteriorating condition sent him from the famed Alcatraz Island prison to his deathbed.9
Like many of the STDs in this article, syphilis is tied to social determinants of health. A 2022 Sexually Transmitted Diseases study points to homelessness, an HIV diagnosis, and a history of tobacco or drug use as risk factors for this STD, which is caused by a bacterium called Treponema pallidum.10
Direct contact with a syphilis sore, called a chancre, can lead to transmission. The infection may begin with a round, firm, painless sore located on the penis, vagina, anus, or mouth. Sometimes, these sores go unnoticed, because they are painless, and then symptoms clear. However, the infection continues to advance, during this stage. If untreated, later stages of the disease can damage the heart, blood vessels, liver, bones, joints, and skin.11
You might recall a much-publicized ad campaign that featured Baby Boomers declaring their readiness to be cured of Hepatitis C. The profile of the disease skyrocketed when a new therapy became available in 2014.12
Hepatitis, a disease that leads to liver inflammation and fibrosis, can be transmitted sexually and other ways. It comes in several forms, though the symptoms are all similar: tiredness, nausea, vomiting, stomach pain, dark urine, and yellowing of the skin and eyes.13
Sometimes sexually transmitted, Hepatitis A virus (HAV) is typically found in feces. It can spread within a household from close personal contact, food or water contamination, and international travel. An HAV vaccine is available.14
Hepatitis B virus (HBV) is also sexually transmissible. Infection often occurs through the exchange of bodily fluids, but it can also occur by sharing needles or be passed from mother to child during birth. A vaccine is also available for this virus. There is a more chronic form of HBV, which can lead to serious liver damage including scarring, cancer, liver failure, and death.15
Like HBV, sexual intercourse can also spread Hepatitis C virus (HCV), which is carried by blood, semen, and other bodily fluid. Unfortunately, there is no HCV vaccine to protect from getting HCV, though there are treatments available. This STD also can lead to liver failure and death.16
Unlike the other STDs in this article, trichomoniasis, sometimes called “trich,” is a parasitic infection caused by the parasite Trichomonas vaginalis.17 Though one of the most curable STDs, trichomoniasis has serious implications for pregnant women, according to a 2021 International Journal of Obstetrics and Gynaecology review. This parasitic infection can lead to preterm delivery, low birthweight, and pre-labor rupture of membranes, researchers have found.18
In women, symptoms of trichomoniasis can include itching, burning, redness or soreness of the genitals; discomfort with urination is common, as is a thin discharge that can be clear, white, yellowish, or greenish with an unusual smell. In men, symptoms can include itching or irritation inside the penis, burning after urination or ejaculation, or some penile discharge. Because men generally don’t experience symptoms, they often don’t know they’re infected, don’t seek medical attention and so spread this parasite to additional partners on accident. Without treatment, this infection can stretch on for months or years.17
Gonorrhea was so problematic in 19th-century England that parliament passed a law to thwart “the perilous infirmity of burning.” There’s also evidence that the disease plagued the Roman army as far back as 100 BCE.19
In more modern times, gonorrhea may be on the rise due to the pandemic.20 Furthermore, according to the CDC, an antibiotic-resistant strain of the disease is becoming increasingly common making it more difficult to treat. The agency is monitoring its spread.21
The Neisseria gonorrhea bacterium, which thrives in warm, moist areas such as the urethra, eyes, throat, vagina, anus, and the female genitalia and reproductive tract, is responsible for this disease. Among the common signs are genital discharge, and a burning or painful sensation during urination. Untreated women may experience pelvic inflammatory disease (PID), which can lead to infertility and death without medical intervention.22
The bacterium Chlamydia trachomatis is responsible for this STD, which can have no signs or symptoms. Others, however, may experience burning during urination or abnormal vaginal or penile discharge.23
Like gonorrhea, chlamydia can also lead to PID in women and subsequent infertility, ectopic pregnancy,24 or chronic pelvic pain.23 The U.S. Preventive Services Task Force updated its guidance on chlamydia in 2021. According to the new guidelines, all sexually active women ages 24 and younger should be screened. Furthermore, screenings should be routine for women 25 and over who are at increased risk of infection.25
8. Human Immunodeficiency Virus (HIV)
If you’re a commuter, you may have seen ads plastering trains and buses for pre-exposure prophylaxis (PrEP), a drug that helps prevent human immunodeficiency virus (HIV) infection.26 PreP is one of two recent HIV advances, the other being a drug that can be taken after a suspected exposure.27 Lastly, for those already infection, anti-HIV drugs can push the virus into remissions, although presently there is no cure. Thus, anti-viral drugs must be taken regularly for the rest of their life.
These new developments are good news, as the implications for HIV are serious. HIV can lead to AIDS—the acquired immune deficiency syndrome. This STD, which weakens the immune system, can be life-threatening if left untreated.28 According to the CDC, among new cases of HIV in 2019, 65% stemmed from male-to-male sexual contact, 23% originated from heterosexual contact, 7% came from injection drug use, and 4% stemmed from male-to-male sexual contact and injection drug use.29 A mother can also pass HIV to her child.30
During early-stage HIV, people may experience swollen glands, fever, muscle aches, headaches, or extreme fatigue lasting for 2-4 weeks. Then, the disease progresses to “clinical latency,” during which symptoms can vanish for years, depending on whether a person receives treatment. During late-stage HIV, known as AIDS, the virus has so weakened the immune system that unexplained and significant weight loss can occur, along with night sweats, fever, frequent and severe rare infections, persistent dry cough, and unusual skin rashes.31
According to the CDC, nearly 37,000 Americans were diagnosed with HIV in 2019. Luckily, that’s a 9% decrease from 2015 to 2019.29 Condoms are an effective, though not perfect, method of preventing the virus.32
Unfortunately, STD treatment delays are common. In a 2013 Open AIDS Journal study, nearly a third of men and women delayed seeking STD care or treatment for more than seven days. Common reasons for delays included fear of being blamed by a partner, lack of time, or that it was just too difficult to get tested.33
These delays equate to increased STD transmission, as well as increased risk of severe complications. For example, untreated PID can lead to scarring of the fallopian tubes and infections with syphilis, gonorrhea or herpes increases the risk of contracting HIV.34 Consequently, untreated PID leads to infertility in about one in 10 women, according to the American College of Obstetricians and Gynecologists.35
The future implications—for your partners and future children—are clear: If you’re experiencing STD symptoms or have engaged in behavior that increases your risk, get tested and seek treatment without delay.
- Congenital Syphilis: Preliminary 2020 Data. Centers for Disease Control and Prevention. Accessed January 28, 2022.
- Sexually transmitted disease surveillance, 2019. Centers for Disease Control and Prevention.
- 2020 STD Trend Report. Centers for Disease Control and Prevention.
- Human papillomavirus (HPV) vaccine. Centers for Disease Control and Prevention.
- STD facts – human papillomavirus (HPV). Centers for Disease Control and Prevention.
- Genital warts symptoms & treatment. Avert.
- Lee SWH, Gottlieb SL, Chaiyakunapruk N. Healthcare resource utilisation pattern and costs associated with herpes simplex virus diagnosis and management: a systematic review. BMJ Open. 2022;12(1):e049618.
- STD facts – genital herpes. Centers for Disease Control and Prevention.
- The infectious disease that sprung Al Capone from Alcatraz. PBS NewsHour.
- Ford JS, Shevchyk I, Yoon J, et al. Risk factors for syphilis at a large urban emergency department. Sexually Transmitted Diseases. 2022;49(2):105-110.
- STD facts – syphilis. Centers for Disease Control and Prevention.
- FDA approves new hepatitis C drug, Harvoni. Kaiser Health News.
- What is viral hepatitis? Centers for Disease Control and Prevention
- Hepatitis A Questions and Answers for Health Professionals. Centers for Disease Control and Prevention.
- Hepatitis B Questions and Answers for Health Professionals. Centers for Disease Control and Prevention.
- Hepatitis C Questions and Answers for Health Professionals. Centers for Disease Control and Prevention.
- Trichomoniasis – CDC Fact Sheet. Centers for Disease Control and Prevention.
- Gerwen OV, Craig-Kuhn MC, Jones AT, et al. Trichomoniasis and adverse birth outcomes: a systematic review and meta-analysis. BJOG: An International Journal of Obstetrics & Gynaecology. 2021;128(12):1907-1915. Accessed January 27, 2022.
- Jose PP, Vivekanandan V, Sobhanakumari K. Gonorrhea: Historical outlook. JSSTD. 2020;2(2):110-114.
- Pinto CN, Niles JK, Kaufman HW, et al. Impact of the COVID-19 pandemic on chlamydia and gonorrhea screening in the U.S. American Journal of Preventive Medicine. 2021;61(3):386-393.
- Antibiotic resistant gonorrhea. Centers for Disease Control and Prevention.
- Gonorrhea – CDC Fact Sheet (Detailed Version). Centers for Disease Control and Prevention.
- Chlamydia – CDC Fact Sheet (Detailed). Centers for Disease Control and Prevention.
- den Heijer CDJ, Hoebe CJPA, Driessen JHM, Wolffs P, van den Broek IVF, Hoenderboom BM, Williams R, de Vries F, Dukers-Muijrers NHTM. Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility: A Retrospective Cohort Study Among Primary Care Patients. Clin Infect Dis. 2019 Oct 15;69(9):1517-1525. doi: 10.1093/cid/ciz429.
- US Preventive Services Task Force. Screening for chlamydia and gonorrhea: US Preventive Services Task Force recommendation statement. JAMA. 2021;326(10):949-956.
- PrEP (Pre-Exposure Prophylaxis). Centers for Disease Control and Prevention.
- PEP (Post-Exposure Prophylaxis). Centers for Disease Control and Prevention.
- About HIV. Centers for Disease Control and Prevention.
- Basic Statistics. HIV Basics. Centers for Disease Control and Prevention.
- Ways HIV Can Be Transmitted. Centers for Disease Control and Prevention.
- Symptoms of HIV. HIV.gov.
- HIV Prevention. Centers for Disease Control and Prevention.
- Malek AM, Chang CCH, Clark DB, Cook RL. Delay in seeking care for sexually transmitted diseases in young men and women attending a public STD clinic. Open AIDS J. 2013;7(1):7-13.
- STDs and HIV—CDC Fact Sheet. Published April 12, 2022. Accessed May 18, 2022.
- Pelvic Inflammatory Disease (PID). American College of Obstetricians and Gynecologists.