Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

STD Prevalence & Prevention in US

Sex Transm Dis Surveill; 2017 Sep 26; CDC

More than 2 million cases of chlamydia, gonorrhea, and syphilis were reported in the US in 2016, the highest number of sexually transmitted diseases (STDs) ever, according to a 2016 annual report from the Centers for Disease Control and Prevention (CDC). Details of the study include the following:

  • The majority of the new diagnoses (1.6 million) were cases of chlamydia.
  • There were 470,000 gonorrhea cases and nearly 28,000 cases of primary and secondary syphilis.
  • Young women accounted for nearly half of all diagnosed chlamydia cases, while surges in syphilis and gonorrhea are increasingly affecting new populations.
  • Syphilis rates increase by nearly 18% overall from 2015 to 2016.
  • >600 cases on congenital syphilis were reported in 2016.
  • Gonorrhea increased among both men and women in 2016; however, the sharpest increases were seen among men at 22%.
  • Men who had sex with men (MSM) make up the majority of syphilis cases.

The CDC stresses the urgent need for prevention, including the call for healthcare providers to make STD screening and timely treatment a standard part of care, especially for pregnant women and MSM.


Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2016. Atlanta: U.S. Department of Health and Human Services; 2017.


According to the CDC, after years of progress in the battle against STDs, where improvements in screening and identification led to historically low rates of gonorrhea and syphilis, as well as improved detection and treatment of chlamydia, the progress has now “unraveled.” The rates of both syphilis and gonorrhea are again increasing and, with over 1.5 million cases of chlamydia, the consequences of infertility, ectopic pregnancies, and chronic pelvic pain will be seen for years to come.1 Chlamydia trachomatis is the most common notifiable condition in the US, and the rates are highest among adolescent and young adult females. In family planning clinics, screening detected chlamydia in 9.2% of those aged 15–19 years and in 8.0% of those aged 20–24 years. The increase in the rate of GC is particularly concerning in the context of increasing antimicrobial resistance in GC isolates. Dual therapy with ceftriaxone and azithromycin is the only CDC recommended treatment for gonorrhea at present, and there is concern about the emergence of multidrug resistant gonorrhea with high-level resistance to ceftriaxone.2,3 STD education is important for primary prevention, as well as in diagnosising, treating and discussing ongoing prevention once STDs have occurred. —Neil Skolnik, MD

  1. Bolan G. Foreword. 2016 STD surveillance. Accessed October 7, 2017.
  2. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Morb Mortal Wkly Rep. 2015;64:1–137.
  3. Ohnishi M. Is Neisseria gonorrhoeae initiating a future era of untreatable gonorrhea?: Detailed characterization of the first strain with high-level resistance to ceftriaxone. Antimicrob Agents Chemother. 55(7):doi:10.1128/AAC.00325-11.

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