Photo credit: Marie Sacha
The Health Department announced on February 2, 2022, increases in gonorrhea and syphilis among people reported as female in New York City during the first half of 2021. The Health Department issued a recent Health Alert noting a 23% increase in gonorrhea cases and a 17% increase in cases of primary and secondary (P&S) syphilis (the stages when syphilis is most infectious) reported among females from the first half of 2019 to the first half of 2021, with most cases among Black or Latino females. Data indicate that sexually transmitted infection (STI) screening in New York City sharply declined during the first half of 2020, making comparisons between 2020 and 2021 difficult.
“We are deeply concerned about increases in sexually transmitted infections (STIs) among female New Yorkers, and we know that many New Yorkers have deferred routine sexual health services, such as STI testing, during the pandemic,” said Health Commissioner Dr. Dave A. Chokshi. “Sexual health care is essential to a healthy life. If you are sexually active, now is the time to re-engage with routine STI testing so that you can seek treatment as soon as possible if you are positive.”
Cases among people reported as Black or Latino accounted for the majority of female gonorrhea cases (58% of female cases with known race/ethnicity) and female P&S syphilis cases (75%) in the first half of 2021. Racial inequities in STI rates can be attributed to long-term structural racism, not biological or personal traits. Structural racism prevents communities of color from accessing vital resources and opportunities, and negatively affects overall health and well-being.
Sexually active females under 25 years of age should get tested for gonorrhea and chlamydia at least once a year. Females 25 years and older should get tested for gonorrhea and chlamydia if they have new or multiple sex partners, if they have a sex partner who has an STI, or if they exchange sex for money or other resources. In New York City, pregnant people must get tested for syphilis three times during pregnancy: at their first prenatal encounter, at 28 to 32 weeks of their pregnancy, and at delivery. Syphilis testing is indicated for all females at increased risk of infection, including sexually active females who have changes in sex partners or behaviors, a sex partner(s) who is diagnosed with an STI, a history of incarceration, or a history of exchanging sex for money or other resources.
The Health Alert includes detailed recommendations for providers on STI screening, testing, treatment, and partner management, including on taking a sexual history to ascertain the type(s) of screening indicated. It also directs providers to the CDC’s STI Treatment Guidelines, updated in July 2021.
STIs such as gonorrhea, syphilis, and chlamydia are common and curable. However, if left untreated, they can cause lasting health effects, including infertility and chronic pelvic pain. Syphilis can cause vision and hearing loss, dementia, and paralysis. When a pregnant person has syphilis, the infection can be passed to the fetus (congenital syphilis), which can cause miscarriage, stillbirth, premature birth, low birth weight, or death after birth. Having an STI can also make it easier to get or transmit HIV. Most STIs have no signs or symptoms early on, so it is important to get tested routinely or if indicated, and treated promptly. Using condoms during sex can help prevent STIs. Expedited partner therapy (EPT), whereby a patient receives extra medicine or a prescription for their sex partner(s), is also available for certain STIs, including gonorrhea and chlamydia.
The Health Department’s Sexual Health Clinics offer low- to no-cost walk-in sexual health services for people 12 years and older, regardless of immigration status. No parental consent is necessary. Services include STI testing and treatment; HIV testing, treatment initiation, and prevention, including pre-exposure prophylaxis (PrEP) and emergency post-exposure prophylaxis (emergency PEP); hepatitis B and C testing; contraception, including emergency contraception; condoms; naloxone; and behavioral health counseling. Select Sexual Health Clinics are currently open and telemedicine services for STI treatment, contraception, and HIV prevention are also available through the NYC Sexual Health Clinic Hotline at 347-396-7959, Monday through Friday, from 9 a.m. to 3:30 p.m. For more information on the Sexual Health Clinics, including services, locations, and hours of operation, visit nyc.gov/health/clinics.
Free condoms and other safer sex products are available at distribution sites citywide. To find a site near you, visit the NYC Health Map and select “Free Safer Sex Products.” For more information on ordering free safer sex products, visit nyc.gov/condoms. Free HIV self-tests are also available for delivery by visiting the NYC Health Map and selecting “Sexual Health Services” and then “HIV Testing.”
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