Poll: Americans Unaware STIs Are Common and Increasing

Alicia Ault

February 19, 2020

Even as the number of sexually transmitted infections (STIs) continues to increase in the United States, with record highs again in 2018, a new poll shows that American adults are woefully unaware of how common the infections are.

Just over one third (36%) of those polled by the Kaiser Family Foundation said they were aware that STIs had become more common among Americans during the past decade. By contrast, 11% thought STIs had become less common, 15% thought the rates had stayed the same, and 38% said they didn't know enough to say.





Although the Centers for Disease Control and Prevention (CDC) has reported that more than half of Americans will have an STI in their lifetime, only 8% of respondents said they were worried that they might contract an infection this year. Concern was highest among the youngest respondents ― those aged 18 to 29 years ― with 20% indicating that they were personally concerned about infections.

Black and Hispanic respondents were more likely to say they were concerned about contracting an infection in the next year as compared with white respondents (13% for each, vs 5%), which may reflect the higher rates of STIs in these populations.

Given the common nature of STIs, it's not surprising that 54% of the poll respondents said that either they or someone they knew has had one.

Incidence Rising, Data Show

According to the most recent CDC data, in the United States in 2018, there were more than 115,000 cases of syphilis, 580,000 cases of gonorrhea, and 1.7 million cases of chlamydia, the most ever reported.

From 2007 to 2018, the number of STI diagnoses, as a percentage of all medical insurance claims, rose 76%, according to a recent report from Fair Health, an independent nonprofit organization that collects data from private insurance and Medicare claims. The increase was greater in rural areas than in urban areas (98% vs 77%).

The greatest increases were for Mycoplasma genitalium infections (197%), chlamydia (147%), gonorrhea (126%), and syphilis (80%), according to the Fair Health report. The greatest increase in chlamydia claims occurred among persons aged 19 to 22 years; the largest rise in syphilis claims occurred among 23- to 30-year-olds.

The largest increase in hepatitis B claims (149%) was among persons older than 60. The rate of increase was not reported for other age groups.

For Discussions, Age Matters

Kaiser found that large majorities of those polled were very comfortable or somewhat comfortable discussing STIs with their physician or sexual partner, with the exception of those older than 65.

Overall, 84% said they were comfortable talking about STIs with their physician or healthcare provider or with their sexual partner (75%). This is a turnaround from 20 years ago, when Kaiser found that more than a third of poll respondents were uncomfortable discussing STIs with a partner and that 31% were uncomfortable talking with a physician about undergoing testing for STIs (compared to 15% in the most recent survey).

For respondents older than 65, 77% said they'd be comfortable discussing an STI with their physician, compared with 88% of 50- to 64-year-olds and 83% of the youngest cohort, those aged 18 to 29 years. Only 60% of older Americans said they'd discuss an STI with their partner, compared with 79% of 18- to 29-year-olds.

Older adults were also less likely to know someone who had an STI. Only 36% said they or someone they knew had one, compared to 54% of those aged 18 to 29, 63% of those aged 30 to 49, and 57% of 50- to 64-year-olds.

People aged 65 or older were also significantly less likely to correctly identify whether particular STIs can be cured, according to the poll data. Only 15% knew that human papillomavirus (HPV) is not curable, and just 34% knew that chlamydia is curable.

Education Still Lacking

Older Americans are not alone in needing more education, the poll found.

Almost all respondents were aware that someone who is asymptomatic can still spread the infection, including during pregnancy and childbirth. A large majority also knew that people may have an STI but not know it.

But a large proportion did not know that certain STIs can be cured. Just over half the respondents correctly answered that gonorrhea and chlamydia are curable — an uptick from a 1998 poll, when 48% said gonorrhea could be cured, and 32% said chlamydia could be cured.

Moreover, just under half knew that syphilis could be treated with medication.

Half were unsure whether HPV could be cured, whereas almost 70% were aware that genital herpes is not curable with medication.

"Awareness that both genital herpes and HPV are not curable with medications has not changed over the past two decades," the Kaiser report states.

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