North Carolina has some of the highest rates of sexually transmitted diseases in the country. The state has the dubious honor of ranking in the top 10 on three Centers for Disease Control and Prevention lists for 2016:
- #5 for gonorrhea
- #6 for chlamydia
- #8 for syphilis
Dr. Gail Bolan, of the CDC's Division of STD Prevention, wrote in an open letter that teens and young adults account for the most chlamydia and gonorrhea infections reported, and syphilis is now rising in that population. Bolan also wrote that syphilis and HIV rates are highest among men who have sex with men. She added that more pregnant women are passing congenital syphilis to their children than in recent years.
Durham County Department of Public Health Medical Director Arlene Seña points out that a disproportionate number of states with the highest infection rates are in the South. Seña points out that many rural communities lack access to sexual health education and regular medical evaluation, which can impact disease transmission rates.
Elizabeth Finley is a spokeswoman for Shift NC, a nonprofit that advocates for teen and young adult sexual health initiatives in North Carolina. Finley says stigma is a barrier to health care access for young people, as many don't know about doctor-patient confidentiality.
"When young people don't know that they can get confidential care, they don't go to get tested or treated for STDs," said Finley. "And when they don't get that testing and treatment, the STDs then spread."
Finley says Shift NC encourages medical professionals to ask young people about their sexual health at every visit, and to encourage condoms as a backup to other contraception.
Durham has the second-highest rate of syphilis transmission in North Carolina, according to the North Carolina Division of Public Health. Syphilis rates are linked with HIV infections. However, Seña of the Durham Health Department noted that syphilis rates dropped over the last year. She said that's probably due, in part, to increased community education initiatives promoting STD testing and condom use among men who have sex with men as well as transgender women.
The Durham Health Department has been awarded CDC funding to begin studying the syphilis and HIV transmission in this community. The health department will host a regional syphilis summit next week to discuss social dynamics in this population and how community organizations can best serve them.
"We want to actually brainstorm, so it's not just about research," said Seña. "It's about thinking about what works, what kind of communication, other strategies that we can sort of use... to reduce syphilis and HIV."
Seña points out that heterosexual men and women are also at risk of syphilis, which can cause serious problems for babies who are infected in utero.