People Are Still Having Sex. So Why Are S.T.D. Rates Dropping? - The New York Times

Public health officials believe many cases are going undetected as clinics close during the pandemic and testing supplies are diverted to coronavirus screening.

For the first time in years, rates of chlamydia, gonorrhea and syphilis, which had been on track in 2020 to hit record highs in the United States, have taken an abrupt downturn.

In communities across the country, contact tracers for gonorrhea and syphilis, which had already been severely understaffed, have been diverted to Covid-19 cases.

Eighty percent of sexual health screening clinics reported having to reduce hours or shut down altogether sometime during the pandemic, according to a survey by the National Coalition of STD Directors.

In its latest letter last month, the agency recommended that priorities for screening and testing should go to patients with symptoms, women who are under 25 or pregnant, and people at high risk for S.T.D.s, including those with H.I.V.

Patients with chlamydia or gonorrhea are often asymptomatic; only testing, then, detects infection.

Louis County Sexual Health Clinic had no urine test kits for gonorrhea and chlamydia, according to Dr.

One reason that public health officials believe that the drop reflects test shortages and limited clinic access rather than less sexual activity is that the rates of decrease are more pronounced in gonorrhea and chlamydia, for which the test supplies have been affected, rather than in syphilis and H.I.V., which are detected through blood tests.

Doctors and nurses who work in clinics that serve mostly poor and minority patients say that the burden of the extreme service cutbacks and lack of testing falls most heavily on them.

Those who work with teenagers said that many clinics that distribute free condoms have closed.

And now, she said, “they need to know that testing won’t be available.”.

In early April, weekly reports of chlamydia were 53 percent below 2019 numbers, with both gonorrhea and syphilis down 33 percent.

As of mid-June, chlamydia numbers remained depressed but reporting of gonorrhea and syphilis had returned to expected rates.

Whether that translates into sexual activity rather than virtual meet-ups is unclear, he said.

Because those supplies have dwindled, the clinic is resorting to a smaller, more expensive backup system, that can only process several dozen gonorrhea and chlamydia tests a day, said Dr.

transmission should be screened for S.T.D.s every three months, but many clinics have spaced out those screenings to every six months, she said.

A Michigan colleague who had run out of urine testing kits for chlamydia and gonorrhea, she said, was returning to techniques that had been replaced almost 20 years ago: “using older swabs that have to be placed a few centimeters inside the urethra of the penis and twirled around to obtain a specimen.

Harvey, executive director of the National Coalition of STD Directors, said clinics are trying to come up with creative solutions, such as telemedicine visits

In a few districts where the biggest challenge is reduced clinic access, administrators are trying out test kits that allow patients to collect specimens at home, which they then mail to labs

Her young, predominantly African-American and Latino patients, she said, have high rates of STDs because many do not have ready access to health care, and there is pervasive fear and distrust of medical institutions, which the inability to test for S.T.D.s is only exacerbating