In the lobby of the Umatilla County Health Department, among the Christmas decorations, is a sign that announces “FREE CONDOMS.”
This isn’t Christmas cheer gone wild, but rather part of an effort to reduce STDs. The United States is experiencing what the Centers for Disease Control and Prevention calls “steep and sustained increases in sexually transmitted diseases.”
The report shows gonorrhea, chlamydia and syphilis all trending alarmingly upward.
“Oregon is following the national trend,” said Tim Menza, who manages the state’s HIV/STD prevention program. “We logged 6,000 cases of gonorrhea in 2017, up from 1,000 in the year 2000 — that’s about a sixfold increase.”
The gonorrhea spike is especially alarming. The CDC received reports of 555,608 cases in 2017, an increase of 75.2 percent since 2009 and 18.6 percent over the previous year. The increase involved both men and women, and all racial and ethnic groups.
Gonorrhea can lead to scarring, infertility, arthritis, heart valve damage and inflammation in the lining of the brain. The last time gonorrhea rankings came out in 2017, Umatilla County had the third highest rate in the state.
“Our rates were pretty low, but in 2013, they started picking up,” said Joe Fiumara, director of Umatilla County’s public health department.
Umatilla County had a low of four cases in 2012, increasing to 88 by 2016, then dropping to 67 the next year. With 82 cases so far in 2018, Fiumara said, the county is on pace to equal or slightly surpass 2016 numbers.
Chlamydia and syphilis also increased nationally and statewide last year.
Chlamydia is most common. The CDC received reports of 1.7 million cases of chlamydia, compared with 1.6 million in 2016. In addition, syphilis diagnoses rose steeply from 17,375 cases to 30,664. In the 90s, some thought syphilis had disappeared until it came back strong.
Again, Umatilla County isn’t exactly following the wider trend. Instead of increasing, numbers dipped a bit. Last year, the county reported 323 cases of chlamydia compared with 264 cases so far this year. There were zero cases of syphilis in 2018, compared with seven in 2017.
However, not all cases are reported, not by a long shot. Many affected people don’t know they’re walking around with an STD.
“It’s common to have no symptoms,” Fiumara said. “Someone can go for quite a while before they know there’s a problem.
He urged regular screening for those at risk.
Menza attributes the national explosion in STDs to several factors.
With improved treatments for HIV/AIDS, the fear of dying from the disease has subsided. As a result, people are more relaxed about engaging in risky sexual behavior.
Also, with years of cutbacks in federal funding for the screening and treatment of STDs, money is tight. Menza said one consequence of reduced funding is fewer disease intervention specialists who track down people testing positive for STDs. The specialists work the phones and sometimes knock on doors.
In Umatilla County, when the health department gets a positive report of an STD, a communicable disease nurse contacts the affected person via phone or text.
“We talk about the risk factors and provide an opportunity for treatment,” Fiumara said. “We try to get contact information and do followup with partners. We hope they listen and take heed.”
Testing and treatment for gonorrhea and chlamydia is fairly cheap, he said, while treating syphilis is more expensive. However, he said, “we don’t turn anyone away for lack of ability to pay.”
Prevention is the better and less-risky way to go. Those condoms available at the Umatilla County Public Health Department aren’t for decoration — they protect against STDs.
“They’re not 100 percent,” Fiumara said, “but they’re close.”
He urged routine screenings, available by appointment at the Pendleton office on Mondays and Tuesdays and Hermiston on Thursday and Fridays.