‘Kind of a crisis’: Florida STD rates surpass pre-pandemic levels

The pandemic did what public health officials have struggled to do for the past 15 years — put a dent in the number of reported cases of bacterial sexually transmitted diseases in Florida.

But in just two years, the combined rate of chlamydia, gonorrhea and syphilis has rebounded and surpassed pre-pandemic levels, Florida Department of Health data shows.

Florida recorded 762 cases per 100,000 residents of the STDs in 2022, the most recent data available. It’s the highest recorded rate since 1990, when fear of HIV led people to more use of condoms and fewer sexual partners.

Other than a small blip during the pandemic, STD rates in Florida have trended upward since 2009 and increased by 42% during the past decade. A similar trend is playing out nationally too, especially syphilis cases, which have risen by 79% over the past five years.

“This is kind of a crisis,” said Jennifer Janelle, a University of Florida associate professor who studies infectious diseases.

The spread of congenital syphilis —where an infected mother passed the illness to her infant during pregnancy — is especially alarming in Florida, Janelle said. The state recorded 122 cases out of every 100,000 Florida births in 2022, up 47% from the previous year.

Approximately 40% of babies born to women with untreated syphilis can be stillborn or die as a newborn. It can also cause bone damage, severe anemia and nerve problems that cause blindness or deafness.

“It’s a major issue that we’re seeing these increased rates,” Janelle said. “The baby can have a lot of complications.”

Hillsborough County is the hotspot for bacterial STDs in the Tampa Bay region with 932 cases per 100,000 residents, far in excess of the state average.

One factor behind the increase is that people are less worried about catching HIV and other STDs, Janelle said.

People at higher risk of catching HIV such as men who sleep with men can reduce their chances of contracting the disease by 99% by taking pre-exposure prophylaxis commonly known as PrEP. Those who have a sexual encounter that potentially exposed them to HIV can take antiretroviral drugs such as Truvada.

Janelle said there needs to be more public health messaging about STDs and that questions about sexual history should be a routine part of an annual checkup. STDs can be asymptomatic and also localized in one part of the body such as the throat or urethra, she said.

“Some people don’t know because they really have no symptoms,” she said. “We have to encourage people to get tested on sexual behaviors rather than perceived risks — that’s important messaging I’d love to see more of.”

Leon County, which includes Tallahassee, recorded the highest rates of STDs with 1,760 cases per 100,000 people, more than twice the state average.

Florida Department of Health officials say that rate is skewed upward by the presence of roughly 80,000 students at Tallahassee Community College, Florida Agricultural and Mechanical University and Florida State University, which is consistently ranked as one of the top party schools in the nation.

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The department’s Leon office assists with testing on Tallahassee’s college campuses, which includes on-site mobile screenings and access to treatment. It also provides twice-monthly STD testing and offers routine, opt-out syphilis screening for women of childbearing age at the Leon County Jail, said department spokesperson James Williams in an email.

The department’s Bureau of Communicable Disease also recently began funding a radio public service announcement addressing the risks of congenital syphilis and the treatment options available in Leon.

“The proactive approach of widespread testing and education within Leon County further contributes to the identification and reporting of STD cases, leading to higher reported rates compared to other areas where testing may not be as comprehensive,” Williams said.

At Florida A&M, workers from the university’s student health services office meet with students in residence halls and partner with local community agencies to provide health education and training, said Tanya Tatum, director of Student Health Services.

Condoms are available for free at campus clinics and some bathrooms. They’re even part of the food pantry in residence halls, Tatum said.

Leon’s high STD rate isn’t just down to students, she said, citing the frequent influx of legislators, their staffers and lobbyists to Tallahassee.

Some young female students still feel that carrying condoms has a stigma attached, she said. Women are also more accustomed to getting checkups than men, who may put off seeking treatment. Her office is exploring providing students with home collection kits.

“If we can catch one and not have five, that’s a plus in my book,” she said.

Still, she worries that young people now have a perception that there’s a shot or medicine for everything so it doesn’t occur to them to weigh safety over pleasure.

“There just not the real understanding of consequences,” she said. “I see that in more than their attitude toward their health. This is the instantaneous generation — everything is in this moment.”