Thursday, October 17, 2019
According to an October 2019 report from the Centers for Disease Control in Atlanta, U.S. cases of syphilis, gonorrhea and chlamydia have reached an all-time high.
Metro Detroit is experiencing a similar surge in sexually transmitted diseases according to Dr. Robert McClowry, a Beaumont family medicine physician in Saint Clair Shores.
Data from the Michigan Department of Community Health reveals:
- Cases of chlamydia have risen from 311 per 100,000 in 2008 to 512 per 100,000 in 2018, the highest rate since 1998.
- Cases of gonorrhea rose from 97.5 cases per 100,000 in 2014 to 169 per 100,000 in 2018, the highest rate since 2006.
- Syphilis is also on the upswing with 4 cases per 100,000 reported in 2006 to 17 cases per 100,000 in 2018.
A strong, doctor/patient relationship can make all the difference in addressing key factors in the epidemic, such as stigma and lack of awareness, Dr. McClowry stressed.
“You should be able to talk to your doctor about anything,” Dr. McClowry explained. “If you can’t, find another doctor.”
Sexually transmitted disease prevention should be a standard part of primary medical care, McClowry stressed.
“My patients often tell me I’m the first person who’s talked to them about risk and prevention,” Dr. McClowry said. “We, as medical professionals, should be doing a better job of getting the information out to the community, especially to young people.”
In talking to patient, McClowry refers to STDs as “Sexually Transmitted Infections” to reduce the stigma “and because many times, the infections do not cause symptoms.”
“No one thinks twice about educating about the spread of influenza or strep throat,” Dr. McClowry said. “Chlamydia is easier to prevent than the flu, in my opinion. But, it isn’t happening. The way in which our society views sex prevents patients and docs from talking to each other about this very important topic.”
McClowry advocates for appropriate STD screening at each visit.
“One of most common misconceptions among physicians and patients is that STD’s produce symptoms. It’s very common for STDs to be asymptomatic. Which is why routine screening – and appropriate screening – is so important,” he said.
There may be a higher risk in Lesbian, Gay, Bisexual and Transgender (LGBTQ) youth, according to the National Institutes of Health.
“This population requires increased and specific screening,” Dr. McClowry said. “For example, gonorrhea and chlamydia screening really should be happening at sites of contact in certain populations. ‘Did someone screen your throat?’ I always ask. In certain populations, over 50% of infections occur in extra-genital locations.”
To improve the flow of information, Dr. McClowry promotes a “normalization of care.”
“This means I screen teens, without their parents in the room, as well as individuals who have been married for 50 years,” Dr. McClowry said.
Dr. McClowry says primary care doctors should offer:
- HIV Screening and treatment
- Pre-exposure prophylaxis (PrEP) – access to HIV-prevention medication, which at-risk individuals can take daily to prevent infection
- Expedited partner therapy - treating the sex partners of patients diagnosed with chlamydia or gonorrhea with prescriptions or medications, without first examining the partner
Each of these practices, research shows, is highly effective in reducing infection rates.
“Untreated STDs have serious complications, such as pelvic inflammatory disease, infertility, getting other STIDs, and increasing risk for HIV,” Dr. McClowry said. “These are all highly preventable. My goal is to prevent complications and further infections by addressing them early.”