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The lack of comprehensive sex education in public schools. The Missouri Legislature’s rejection of expanded Medicaid health coverage. Reduced funding for family planning services. And the feeling of invincibility among young people. These are some of the reasons experts cite for the consistently high rate of sexually transmitted infections in the St. Louis area. Each year, local public health advocates dread the release of the sexually transmitted disease report from the U.S. Centers for Disease Control and Prevention because St. Louis city sits at or near the top of the list. While the number of new cases of chlamydia and gonorrhea actually dropped by about 700 in the St. Louis region in 2012, the city still ranks second-highest among counties and independent cities for the two infections, according to the CDC report released Wednesday. Philadelphia County, Pa., had the country’s highest chlamydia rate and Montgomery County, Ala., had the highest for gonorrhea. More than 9,000 new chlamydia cases and nearly 4,000 new gonorrhea cases were diagnosed in St. Louis and St. Louis County in 2012. The number of new syphilis cases in the St. Louis region in 2012 was 95 compared with 92 the year before. Nationally, rates of gonorrhea were up 4 percent from the previous year and chlamydia rates were stable. An 11 percent increase in syphilis from the previous year was attributed primarily to new infections among gay and bisexual men. About half of sexually transmitted infections are diagnosed in people ages 15 to 24. Compared with the rise in gonorrhea nationally, public health experts are concerned that a nearly 10 percent decrease in St. Louis city is not a true decrease in actual infections. “While it’s heartening that rates are down, it’s important not to let our guard down because it could reflect reduced access to care,” said Dr. Bradley Stoner who directs STD prevention training at Washington University and is president of the American STD Association. Sexually transmitted infections are historically difficult to manage, which is why St. Louis and other communities continue to show up at the top of the CDC rankings. “Once they’re up, it’s hard to bring down because the disease is embedded in the community,” Stoner said. ‘EASY AND INEXPENSIVE’ More aggressive prevention and treatment programs are needed to tackle the problem before serious complications develop including infertility and an increased risk of contracting HIV. “Early treatment is easy and inexpensive, but if these diseases are left undiagnosed and untreated they can lead to very serious problems later in life, with incredibly higher health care costs to treat them,” said Paula Gianino, president of Planned Parenthood of St. Louis, where treatment of sexually transmitted diseases is the most common service provided. Gianino speculated that STD rates would be lower if the state hadn’t dismantled in the early 2000s its family planning program that provided a few million dollars a year to provide cancer screenings, contraception and STD testing and treatment to 30,000 low-income women. But another program that could be having a positive impact on STD numbers is expedited partner therapy. Since 2011, health providers in Missouri can dispense multiple dosages of antibiotics for the sexual partners of people who test positive for chlamydia or gonorrhea. Because health experts estimate that fewer than half of people who contract chlamydia and gonorrhea are diagnosed and treated, identifying sexual partners is essential to prevent the continued spread of the infections, which can have no symptoms. Since the closure last fall of safety net provider ConnectCare in north St. Louis, the city has contracted with two urgent care centers and adolescent health clinic the Spot to provide additional STD testing and treatment. The two St. Louis Urgent Care clinics have treated nearly 200 people for sexually transmitted infections, said owner Dr. Sonny Saggar. “You’re going to see a downtick in the numbers once people get better access to care, which they’ve got now,” Saggar said. “I’ll put money on it, the 2014 numbers will go down for St. Louis city.” Dr. Ericka Hayes, an infectious disease specialist at St. Louis Children’s Hospital, said the numbers of teens with sexually transmitted diseases remained “astoundingly high.” “They feel like they don’t need to wear condoms because they have a bit of a Superman complex, and they don’t realize the risks,” Hayes said. “You need to wear protection. Even if you’re not having symptoms, you need to get tested on a regular basis, and you and your partner need to get treated.” Walker Moskop of the Post-Dispatch contributed to this report. Tags Sexually Transmitted Disease, St. Louis, Gonorrhea, Chlamydia Infection, Centers For Disease Control And Prevention
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