Condom use has decreased despite sexually transmitted diseases such as chlamydia, syphilis on the rise

Condom use has decreased despite sexually transmitted diseases such as chlamydia, syphilis on the rise

Condom use has decreased despite sexually transmitted diseases such as chlamydia, syphilis on the rise


The basket of free studded ultrathin condoms remained full to the brim — a recurring reality that no longer surprised DC health workers who offered HIV testing in a downtown square this month.

Public health authorities are facing a rise in sexually transmitted infections in a world where condom use is steadily declining – and thus one of the most effective ways of controlling the spread of disease.

They’ll laugh at it, or sometimes they’ll pick it up and throw it away,” said Kevins Anglade, a community outreach worker for Whitman-Walker Health, a D.C.-based LGBT health organization that opened in the 1970s as the Gay Men’s Venereal Clinic. diseases. “It’s the new normal, which is very sad.”

The United States recorded nearly 2.5 million cases of chlamydia, gonorrhea, and syphilis in 2021. more than doubled in the past two decades, according to preliminary data of centers for disease control and prevention.

Approximately half of those newly infected last year were among young people aged 15 to 24. Men who have sex with men are more likely to contract infections than heterosexual men because they are more likely to have them more recent partners and sexually transmitted diseases (STDs) circulate more easily in smaller networks of people.

Condoms, once central to STD eradication campaigns at the height of the AIDS crisis, have become increasingly difficult to sell due to medical advances such as long-term contraception and drugs that drastically reduce HIV transmission.

Federal family planning surveys show condoms went from being the top contraceptive for 75 percent of men in 2011 to 42 percent of men in 2021. Church and Dwight, maker of Trojan condoms, flagged a trend of declining condom use to investors in its 2021 annual report.

More studies found an increase in unprotected sex among men who have sex with men. Percentage of high school students who said they were used a condom the last time they had sex fell from 63 percent in 2003 to 54 percent in 2019, according to the government’s annual survey.

“Historically, when young people used condoms, they were generally scared to use them by the threat of HIV or unwanted pregnancy,” said David Harvey, executive director of the National Coalition of STD Directors. “Now they have more options to prevent those things.”

Scientists have recently discovered that HIV-positive people cannot spread the virus if they adhere to treatment that lowers their viral load, prompting a campaign known as “undetectable equals non-transmissible” to focus on treatment as a form of prevention.

Appearance daily tablets and injectable drugs taken as pre-exposure prophylaxis, known as PrEP, to prevent HIV infection has also allowed people to have condomless sex with a drastically lower risk of contracting HIV while still being susceptible to other fluid-borne diseases and skin-to-skin contact. .

Health officials challenge the perception that syphilis, chlamydia and gonorrhea are treatable disorders, although those infected risk permanent complications including infertility and organ damage.

John Guggenmos, a longtime D.C. gay bar owner, said condoms have gone from being a fixture at his establishments to being largely out of sight as customers prefer PrEP to prevent HIV.

“That was a staple of the ’90s: you had vodka behind the bar and condoms at the front door,” Guggenmos said. “Now they’re just not used, they fall over, so we just stopped. They are behind the bar, but who will ask the bartender for them?”

Does PrEP trigger an increase in others sexually transmitted infections are a controversial issue among researchers. Studies show that PrEP users are less chance to use condoms, but they are also subject to the obligation regular screening for SPI to receive the medicine.

“In getting diagnosed and treated soon after they get an infection, they are less likely to pass it on to others,” said Zandt Bryan, who leads STD prevention for the Washington State Department of Health.

Some experts say racial and income disparities in PrEP use underscore the need to promote condoms as a solution as well — especially among high school and college students who are still forming their sex habits.

“There are a lot of people who decide they don’t want to take the pill and have a distrust of the medical community,” said Brian Mustanski, director of the Institute for Sexual and Gender Health and Minority Well-Being at Northwestern University, which designed the online educational program that the study showed that it was effective in increasing condom use among young men of color. “We should not give up on reminding people of the value of condoms and teaching people how to use them properly.”

Officials at Whitman-Walker, an LGBT health center in D.C., say interest in condoms tends to be higher in majority-black neighborhoods where HIV rates are higher and PrEP use is lower. Several older African-American men were among the few who picked up condoms at a recent group event.

But LGBT health care providers often rely on government grants for their disease prevention work and say they lack funding for robust condom distribution campaigns as public health agencies prioritize other forms of prevention such as PrEP.

“There’s a lot of emphasis on treatment,” said Rama Keita, director of community health at Whitman-Walker. “It’s a tough place we’re in right now.”

Davin Wedel, president of Global Protection Corp., which supplies condoms to governments and nonprofits, said public health agencies have been placing fewer orders since the advent of PrEP. But he said sales have begun to recover in recent months as officials raise the alarm over a rise in sexually transmitted infections, a demonstration that public health has not abandoned condoms even if they are no longer in the spotlight.

“I can’t imagine a situation where condoms won’t be valuable, but at the same time we have to continue working to develop more effective tools to prevent these infections,” said Leandro Mena, who heads the Centers for Disease Control and Prevention. Department for the Prevention of Sexually Transmitted Diseases.

Scientists and health officials are now focused on vaccine development, affordable at-home testing and post-sex medications as the next generation of weapons to combat sexually transmitted infections.

The most promising option is an oral antibiotic taken as soon as possible after sex to prevent bacterial STDs, a strategy known as post-exposure prophylaxis.

Preliminary data from a study funded by the National Institutes of Health showed that the method was effective against gonorrhea, chlamydia and syphilis. It’s the CDC developing a clinical guideline use an antibiotic to prevent sexually transmitted diseases in gay and bisexual men and transgender women who have HIV or are taking HIV prevention drugs – groups presented at NIH study.

Although more home STD testing kits are entering the market, they are not affordable or widely distributed. Experts hope they will eventually be available as rapid tests for the coronavirus.

There are no vaccines for syphilis, gonorrhea or chlamydia on the horizon, but officials hope they can eventually join the arsenal along with vaccines to prevent hepatitis B and HPV.

“There’s all this effort going on globally to create a tool that’s not a condom because we’re finally getting it: People don’t like condoms,” said Jim Pickett, a longtime HIV activist who consults for public health agencies. “And no matter what we do, we’re not going to get the kind of use out of them that would be needed to really make a dent.”

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