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Doctors 'disheartened' by St. Louis region’s high ranking for STD rates

The chlamydia bacteria, stained and viewed at 500 times.
National Cancer Institute | Dr. Lance Liotta Laboratory
The chlamydia bacteria, stained and viewed at 500 times.

Rates of three common sexually transmitted diseases have risen to a record high level nationwide, and St. Louis continues to rank high among cities, according to federal data released Wednesday.

The St. Louis region recorded 14,961 cases of chlamydia in 2015, the 17th highest per-capita rate in the country. Rates of syphyllis stayed relatively steady at just over 400 cases in the metro area. The city of St. Louis, however, measured the highest rate of both chlamydia and gonorrhea among counties and independent cities. 

“We’ve seen closures of publicly funded STD clinics around the country, and St. Louis is similar in that we have very few options for people to get tested and treated,” said Dr. Brad Stoner, medical director of the St. Louis STD/HIV Prevention Training Center.

The infections may show no symptoms, but can have serious consequences if left untreated.

Leaders at the Centers for Disease Control and Prevention called for mobilizing and expanding public health services, particularly for gay and bisexual men and pregnant women.

“STD rates are rising, and many of the country’s systems for preventing STDs have eroded,” Dr. Jonathan Mermin, the CDC’s director of the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, said in a statement. “We have reached a decisive moment for the nation.”

In St. Louis and St. Louis County, historically high rates of STDs led public health officials to announce a joint prevention effort at the end of 2015, so the results of those actions would not show up in the new federal data. The decision did not include additional funding, but the departments conducted two outreach events in recent months at Fairground Park in St. Louis and the St. Louis County Department of Public Health in Berkeley, said Dr. Fred Echols, the county's Director of Communicable Disease Control Services.

"What's happening in St. Louis is essentially a mirror for what's happening on a national scale," Echols said. "There are numerous challenges that we face. We continue to use data to guide our initiatives to target at-risk populations."

In particular, Echols said, people who lack health insurance or regular medical care are less likely to have easy access to STD tests. Sexually transmitted infections such as human papillomavirus, herpes and trichomonaiasis are not routinely reported to the CDC. 


"The annual surveillance report captures only a fraction of the true burden of STDs," Echols said. 

According to public health officials, nearly a third of new STD cases in the St. Louis region affect people under 25. Teenage girls between the ages of 15 and 19 are particularly at risk.

“We need a primary prevention focus, getting sexual health, medically accurate information into the hands of young people with trustworthy adults who are willing to have these conversations with them,” said Dr. Katie Plax, medical director for the SPOT — a Washington University initiative that offers free walk-in medical care, counseling and STD testing to young people between the ages of 13 and 25.

Plax said she’s learning how to encourage young people to prevent STDs by listening to her patients. Tests should be free, confidential and widely available, she said. Efforts should be made to reduce the shame surrounding these conversations.

“If we do our work right, reaching young people in school is a really good strategy,” Plax said. “Asking young people to refer their friends and use their social networks has also been a very helpful strategy to get them tested and get them access to prevention education.”

Follow Durrie on Twitter: @durrieB