Opinion | STIs can be kept in check but cannot be neglected
The Oct. 16 editorial " Sickness that does not have to be " is a welcome focus highlighting a treatable communicable disease problem that unfortunately has been around a long time in a frequently neglected fashion.
In the 1960s and 1970s, the Communicable Disease Center trained epidemiologists to work nationwide with state and local governments to identify and treat infected or suspected venereal disease carriers and break the cycle of infection. Epidemiology investigations, antibiotics and identification of the carriers were very effective. But neglect has caused the diseases to again thrive and spread.
We should make every effort to routinely test pregnant women and suspected carriers and identify infected carriers to use the U.S. public health infrastructure. Syphilis in its late stages left untreated can cause serious systematic neurological infection, death or disability. Gonorrhea and chlamydia can create serious medical complications if left untreated.
Gerald A. Fill, Alexandria
The writer is a former field investigator for the Centers for Disease Control and Prevention.
An Oct. 16 editorial on sexually transmitted infections cited underfunded health departments, mental health, substance use, impermanent housing and other social determinants of health and health-care access barriers as key reasons for the recent sharp rise in STIs. And while gonorrhea, syphilis, chlamydia and other STIs do present serious risk factors for the transmission of HIV, we should consider how to leverage our prevention successes in HIV as a way to address the rise in STIs.
As pre-exposure prophylaxis (or PrEP, a one-pill-a-day HIV prevention) uptake continues to increase in some of the traditional HIV/AIDS epicenters, we're seeing new cases of HIV come down, in some places significantly. Rather than look at PrEP as a license to engage in risky sex behaviors, we can use this growing HIV prevention infrastructure to meet at-risk individuals where they are with comprehensive and inclusive sexual health counseling, increased STI screening, family planning and reproductive health needs, and access to prevention, care and treatment that is free of judgment and stigma.
HIV specialists are doing this on the front lines. Now is the time to expand those lessons to care providers in all settings throughout the country.
Bruce J. Packett II, Washington
The writer is executive director of
the American Academy of HIV Medicine.
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