Americans are going without condoms, even as STI rates soar.
Chlamydia cases have more than doubled in the past 20 years, according to data from the Centers for Disease and Prevention (CDC).
The pandemic is thought to have further fueled the boom due to an under-reporting of infections.
Covid may have led to increased transmission, the CDC said, as limited access to health care during the lockdown meant people stayed infected longer and had more chances to overcome their STDs.
Last year, cases of chlamydia, gonorrhea and syphilis rose to 2.5 million. In 2017, the three STIs accounted for 2.3 million cases.
At the same time, less than half of men use condoms, compared to between 75 and 55 percent since 2011.
And increasing numbers of women are relying on women who use birth control, according to an annual family planning report from the Bureau of Population Affairs.
Men who have sex with men are at greater risk of infection than heterosexuals because they are more likely to have multiple new partners and STDs spread easily in small groups of people.
Experts say this is due to the greater availability of drugs to prevent HIV and pregnancy.
David Harvey, executive director of the National Coalition of STD Directors, told the Washington Post: “In the past, young people who used condoms were very afraid to use them because of the risk of HIV or an unwanted pregnancy. You now have more options to prevent these things.”
There are also now treatments that enable HIV-positive people to live long and full lives, while the morning-after pill is more readily available for women.
Some fear that will change after the Supreme Court decision Roe v. Wade will change, and sales skyrocketed shortly after the announcement.
Gonorrhea has been on the rise since 2012, with male rates per 100,000 being significantly higher in men than in women
Syphilis has seen a sharp increase per 100,000 since 2012, with a higher incidence in men again. In the last twenty years, the number of cases has increased more than 27-fold
Chlamydia has seen a steadier rise since 2012. But since 2001, cases have more than doubled
The graph above shows the percentage of high school students who used a condom the last time they had sex. Use has declined since 2003 — the 2019 rate is now below the 1997 rate, an annual CDC survey found
John Guggenmos, a bar owner in Washington DC, said he saw the decline in condom use in his bars in real time.
He said: “It was a staple in the 90s: vodka was behind the bar and condoms at the front door.
“Now they just don’t get used to it, they get knocked over, so we just stopped. There are some behind the bar, but who’s going to ask a barman for one?’
The advent of pre-exposure prophylaxis (PrEP) to prevent HIV, taken as daily pills or injections, has meant that people who have had unprotected sex have a much lower risk of contracting HIV.
But this made them vulnerable to other infections such as gonorrhea, chlamydia and syphilis.
Approximately 783,242 cases of chlamydia were reported to the CDC in 2001, increasing dramatically to 1,628,397 in 2021.
And chlamydia rates in 2021 are about twice as high in women as in men.
Syphilis is also on the rise – the number of cases has increased more than twentyfold from 6,103 in 2001 to 171,074 last year.
In 2011, three-quarters (75 percent) of men used condoms as their primary method of birth control, but according to state family planning surveys, that figure is now just 42 percent.
And the percentage of high school students who used a condom the last time they had sex dropped from 63 percent in 2003 to 54 percent in 2019, according to an annual government survey.
About half of sexually transmitted infections in 2018 occurred in people aged 15 to 24 years.
Several health departments across America have reported an increase in bareback sex among men who have sex with men.
If the rate continues to rise, “it could disrupt progress toward ending the HIV/AIDS epidemic,” CDC researchers said.
In 2019, the US announced an ambitious plan to completely eradicate HIV in the country by 2030.
It is not certain that PrEP is responsible for an increase in STIs, as studies suggest that PrEP users are less likely to use condoms at the same time, but are also screened more often because you have to take an STI test to get the to get drugs.
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Crystal Leahy is an author and health journalist who writes for The Fashion Vibes. With a background in health and wellness, Crystal has a passion for helping people live their best lives through healthy habits and lifestyles.
