• Rates of sexually transmitted infections (STIs) appear to be leveling off after decades of rising in the US, according to the latest statistics from the CDC.
• STIs remain at record levels, but new cases of chlamydia and syphilis may finally stabilize, while gonorrhea cases have fallen for two years in a row.
• Large STI disparities persist for certain populations, with adolescents, gay men, and people of color bearing most of the burden.

Meanwhile, cases of poxincluding reporting for different disease stages and congenital syphiliscontinued to grow. However, there has been a steep decline in syphilis cases compared to previous years.

More than 2.4 million cases of chlamydia, gonorrhea and syphilis were reported last year; the vast majority (1.6 million) were chlamydia, followed by gonorrhea (600,000) and syphilis (209,000).

Overall, the total number of STIs decreased by 1.8% between 2022 and 2023.

While new cases of gonorrhea, chlamydia and syphilis — the three most common STIs — are still at or near record levels, experts are cautiously optimistic about the new CDC data.

“We are at an inflection point of the epidemic. This report is encouraging in several areas, but it also shows that we have a lot of work to do.” Bradley Stoner, MD, director of the Division of STD Prevention at CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, told Healthline. “We still have a lot of STIs in the U.S., and they’re not evenly distributed,” he said.

The data confirm discrepancies in disease burden, Stoner noted. STI rates are not evenly distributed, with certain groups including gay and bisexual men, people of color, and young adults (ages 15-24) being disproportionately affected.

Syphilis, an STI that can lead to serious health problems, including nerve and brain damage, remains the most pressing concern for doctors, and especially congenital syphilis, which is when the disease spreads to a baby during pregnancy.

In 2023, syphilis cases increased by 1%, marking a decline of more than 10% from the previous year and the first substantial decline since 2001.

But the US still reported nearly 210,000 cases, the highest number since 1950.

“I think the most important part of the report is that we have seen a decrease in the increase in syphilis cases. The fact that the overall rate of syphilis increased by only one point. This is really profound,” David Weismiller, MD, ScM, professor of family and community medicine at UNLV’s Kirk Kerkorian School of Medicine, told Healthline.

There were also nearly 4,000 cases of congenital syphilis reported in 2023, the highest number of cases since 1992. Of these cases, 279 resulted in congenital syphilis. birth of death and infant death.

Jake Scott, MD, clinical associate professor of infectious diseases at Stanford Medicine, called the congenital syphilis statistics “alarming.”

“Congenital syphilis should never occur. No child should die of syphilis. It’s so preventable,” Scott told Healthline.

Gonorrhea, a sexually transmitted infection caused by the bacteria Neisseria gonorrhoeae, is spread through genital contact and bodily fluids.

This STI can infect the genitals as well as the rectum, eyes, throat, mouth and female reproductive tract. Although it may be asymptomatic, it may include common symptoms of gonorrhea painful urination and discharge from the penis or vagina.

The disease fell to historic lows in 2009, but then rose for more than a decade. CDC data shows that 2023 marks the second consecutive year of decline in the U.S.: Gonorrhea decreased by 9.2% between 2021 and 2022 and by 7.7% between 2022 and 2023.

Chlamydia, also a bacterial STI, is often asymptomatic, but left untreated can cause permanent damage to a woman’s reproductive system, making her difficult or impossible to get pregnant. Symptoms may include painful urination and discharge.

Cases of the disease have been on the rise for about two decades, except for a brief, unexplained decline between 2011 and 2013.

Cases of chlamydia decreased during the COVID-19 pandemicsame as the rates of other STIs, but later recovered. Experts believe the decline has more to do with a lack of sexual health resources at the time, including screening for the disease, rather than changes in sexual behavior.

“Society has reopened and STIs have increased past pre-COVID levels. What we think happened was a lack of clinical care because the STI clinics were closed for the most part,” Stoner said.

The most recent data indicate that chlamydia has returned to pre-pandemic levels, but, the authors of the CDC report warn, this may be an artifact of reduced chlamydia screening.

It is too early to tell whether or not 2023 will signal a renewed downward trend for U.S. STIs. Experts stressed the need for more resources, especially for STI education and screening and safe sex practices.

“One of the goals of our field is to destigmatize STIs so that people are not afraid to ask for the tests they want or need and that doctors can have those discussions with their patients,” Stoner said.

Scott said that while the report is “encouraging”, discrepancies in care need to be addressed.

“Almost half of STI cases were in people aged 15 to 24, so this is a clear sign that we are failing to provide effective sex education to those ages. We don’t provide enough resources not only in terms of education, but also routine testing and treatment“, he noted.

“It’s basically like the morning-after pill for sexually transmitted infections … And it’s clearly quite effective in reducing rates of gonorrhea, chlamydia and syphilis,” Scott added.

“STIs are often spread without any awareness and without any symptoms. So for that reason, when people are sexually active, especially if they’re sexually active with multiple partners and if they’re not using the protective barriermeaning condoms, then regular screening tests are essential because that will be the only way to diagnose,” Scott said.

The three most common STIs in the U.S. — chlamydia, gonorrhea and syphilis — remain at or near record levels, but may level off, according to a new CDC report.

The data shows that 2023 marked two years of declining cases of gonorrhea and chlamydia, which have since returned to pre-pandemic levels.

Syphilis and congenital syphilis remain alarmingly high, however, the number of new cases in 2023 increased by only 1%, representing a decrease of about 10% from the previous year.

The use of condoms (or other protective barriers) and regular screening remain the most effective tools for preventing STIs.