Lack of fear, 'stale message' factor into chlamydia spike in Maryland

Dr. John Cmar said a lack of fear among young people regarding sexually transmitted diseases has become a major source of frustration in the medical community.

Now that many people can live relatively normal lives with HIV, thanks in part to great advancements in treatment, Cmar said, many don’t hesitate to have unprotected sex. Working to educate the public about the health risks associated with STDs is something Cmar and others in the medical field are trying to improve upon, especially during April which was STD Awareness Month.

According to the Center for Disease Control and Prevention, the U.S. records 20 million STD cases annually, costing the nation’s health system $16 billion in direct medical costs.

Cmar said a dangerous mindset has played a role in a spike of certain STDs through the years, including chlamydia. According to figures from the Maryland Department of Health and Mental Hygiene, the total number of cases of chlamydia reported in 2012 was 26,534. This is up from 16,904 in 2003.

“The message has gotten stale,” said Cmar, assistant director of the Division of Infectious Diseases at Sinai Hospital. “People just don’t fear STDs like they did in the 1980s at the height of the AIDS epidemic.”

Baltimore City was among those jurisdictions that experienced a significant spike in recorded chlamydia cases during that time. The city recorded 7,715 cases of chlamydia in 2012, compared to 6,486 in 2003. Also during that span, Prince George’s County went from 3,212 cases in 2003 to 6,037 in 2012 while Montgomery County went from 998 to 2,421 during that span.

Cmar said one reason for the spike is that many youth are engaging in oral sex and not aware they can contract an STD in that manner. According to the U.S. Office of Adolescent Health, 51 percent of 15- to 24-year-olds had oral sex before they first had sexual intercourse.

“Many young people are having unprotected oral sex and just don’t think they can contract STDs that way,” Cmar said.

Dr. Patrick Chaulk, Baltimore City Health Department Assistant Commissioner, Bureau of HIV/STD Services, said there are several factors contributing to the increase in chlamydia, which he added is often under-reported.

This is because, in part people with chlamydia aren’t aware of their symptoms and don’t seek testing. He added that new urine tests now available are making detecting the disease easier.

Chaulk said the chlamydia increase comes at a time that gonorrhea rates have dropped dramatically across the state. In 2003, the state reported 8,067 cases of gonorrhea compared to 5,686 in 2012. In Baltimore City, the recorded cases of gonorrhea dropped from 4,000 to 1,944 during the same timespan.

“The issues we are dealing with go beyond just medical care.” Chaulk said. “Issues surrounding HIV, STDs and (tuberculosis) are also associated with unstable housing, poverty and lack of education. Those are issues that a doctor can’t fix. These are policy issues that the legislative bodies need to take on.”

Also of concern for Chaulk is the spread of STDs among young African American gay males. According to the Henry J. Kaiser Family Foundation, in 2010, male-to-male sexual contact accounted for 51 percent of new HIV infections among blacks overall and 72 percent of new infections among black men.

Chaulk said the city Health Department has set up a website, , as part of an outreach effort to Baltimore’s LGBTQ community in regard to STDs and other health concerns.

“While STDs can be treated fairly well today, they are still chronic diseases,” Chaulk said. “The problem is in many cases, while medical care can control an STD, it can’t cure it.”

Compounding all of those issues, Chaulk said, is the use of social media in seeking out sex partners, often anonymously.

“There are many social media sites and apps out there that people just plug in where they are and what they are looking for before engaging in sexual activity,” Chaulk said. “We’re still trying to figure out how to deal with that.”


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