The rise in Sacramento County STDs and the condom dilemma

Sexually transmitted diseases are on the rise in California for the second year in a row. A California Department of Public Health report shows cases are increasing at a faster pace than in the rest of the country.

Despite years and millions of dollars spent on promoting safe sex, sexually transmitted diseases are on the rise in California and more so in the Sacramento area. (Nov. 6, 2016)

Sexually transmitted diseases are on the rise in California for the second year in a row. A California Department of Public Health report shows cases are increasing at a faster pace than in the rest of the country.

I spoke with Staci Syas, Sacramento County’s STD/HIV program manager for the Department of Health and Human Services about the challenges that public health experts face when it comes to STDs.  

“Syphilis was actually an STD that in the late 90’s the public health community thought we could actually eradicate,” Syas said.

Since 2014, Syphilis increased by 9 percent nationally but in California it rose by 29 percent. Gonorrhea jumped 20 percent in the state and Chlamydia is at its highest level since reporting was mandated in 1990.

Especially concerning are stats on young women, ages 15 to 24, accounting for 63 percent of Chlamydia cases and 51 percent of Gonorrhea.

Cheri Greven at Planned Parenthood says, "California received a report in August that says teen pregnancy is down 55 percent since 2000, which is a huge deal, but what we’re finding is misinformation of (patients who) think they’re on the pill and protected.”

In other words, people are using birth control to avoid pregnancy but not wearing condoms to avoid STDs. 

I went to California State University, Sacramento to hear what students have to say about the unpopularity of condoms. Most of them blamed convenience and comfort.

"Sensation is probably a big one, money maybe. You can’t avoid to buy condoms," said one male student.

I've spent enough time in college to know that campuses are never short of condoms. To his point, the student questioned the quality of the free handouts. Point taken.

Another student pointed out that perhaps people don’t wear condoms because they want comfortability and place higher priority on that than their health.

With better access and more options for birth control, like IUDs (intrauterine devices), pills, patches, implants, vaginal rings, etc., they seem to shrug off "curable STDs" like Chlamydia, Gonorrhea and Syphilis and opt for 'bare-backing' instead.

See, the difference is these kids grew up in the post-AIDS crisis era.

“We could look at what was happening with the HIV epidemic in the late 90s,” Syas said. “You had people that were more fearful of contracting HIV, so they were being very conscientious about their condom usage, because they were very terrified, because people were dying very quickly when you were HIV infected.”

It’s not like people aren’t getting infected with HIV. The number of people living with HIV in California rose 18 percent from 2008 to 2013, but a change in diagnosis came with a change of attitudes about the disease, and with it about safe sex.

“After the advent of the antiretroviral drugs, people were actually like, ‘Oh I can actually live a long life with HIV, no longer is it a death sentence,’ their practices, in terms of being safe began to be more lax,” Syas said.

Although sex education in schools, access to information and communication have improved and perhaps become more efficient, there’s always that invincibility problem young people seem to have.

The students I heard from at Sac State said a lot of people just don’t think it will happen to them personally. The main reason for that, some say, is the prevalent stigma associated with STDs.

“I feel like it’s talked about, but I don’t feel like it’s talked about enough,” Said one student. “We have the stats but I don't think anybody comes out and uses themselves as an example."

That’s why Shannon Boodram, a young sexologist and journalist used her YouTube channel to come clean about her diagnosis. She opens her video revealing a secret: “I want to share a secret with you guys. I am a survivor of Chlamydia.”

“I talk to a lot of young people who have Herpes and have other STIs and STDs and so I felt like there has to be someone who comes forward and say: 'hey me too,” Boodram said.

She also addressed an issue I had never stopped to consider. Just like the younger millennials grew up in the post-AIDS crisis era, older Baby Boomers who grew up in the pre-AIDS crisis era could also be avoiding condoms spreading STDs as well.

"People do talk about the rise in STIs with young people and they attribute it to Grindr and Tinder and other apps, but I think we’re in a time when half the population is getting divorced or is going through a divorce,” Boodram said. “(Now) you do have a lot of baby boomers and a lot of Gen Xers who are coming into the dating field for the first time and in their day condoms were not a priority.”

This is the case of Jennifer Vaughan, a 45-year-old Bay Area mother of three who contracted HIV from a man she was dating after her divorce.

Vaughan told me about the shock of getting such an unusual diagnosis.

“I wasn’t a drug user, I wasn’t a gay man,” Vaughan said. “Like, really this was not something I was concerned about at all.”

She had been sick for some time and doctors couldn’t explain what was wrong with her until one doctor suggested an HIV test.

“He was nervous and he said I really don’t know how to tell you this, but you have tested positive, you have HIV,” Vaughan said. “And my mouth just dropped."

Vaughan first posted her story on Facebook and then on YouTube. She said she wasn’t doing it so much for public awareness but just to inform her friends and acquaintances.

After coming out with the news, she said she has realized how much her story serves as a cautionary tale to everyone, defeats myths and fears about the disease, and it also inspires people to get tested and stay protected.

“It’s like, when you know you have it, you get on medication you stop passing it,” Vaughan said. “People that don’t test don’t know they have it. They continue to pass it. So get tested, get medicated, and know you have it! Big deal!”

The good news, The California Healthy Youth Act implemented in January 2016 mandates a comprehensive age-appropriate sex education program for all middle and high-schoolers, significantly expanding the topics and the time our youth learns about sex and healthy relationships.

Here are some more stats on STDs, according to the California Department of Public Health:

With 189,937 reported cases in 2015, Chlamydia was the most common reportable disease in California and is at the highest level since reporting was mandated in 1990. According to the CDPH, there was a 9 percent increase in cases in 2015 compared with the year before.

  • Numbers showed young women age 15 to 24 had the highest rates among all women.
  • Rates among Black teens and young adult women were highest of any group and 3 to 5 times higher than white young women.
  • In Sacramento County, there were 8,427 cases of Chlamydia compared to 7,684 cases in 2014. Of which, 68.4 percent women and 31.5 percent men.
  • San Joaquin County saw just a slight bump in cases reported in 2015 when there were 3,554 cases of Chlamydia compared to the 3,522 reported the year before. Among those reprted, 70.5 percent women and 29.4 percent men.

Gonorrhea cases (54,255 reported) and rates had sharp increases across all regions of the state with an overall 20 percent rate increase compared with 2014.

  • Between 2014 and 2015, male rates increased 22 percent, whereas female rates increased 15 percent.
  • Rates were highest for males and females under 30.
  • African American rates were five times higher than whites.
  • In Sacramento County, there were 2,871 cases of gonorrhea, of which, 47.1 percent were women and 52.7 percent were men. There were 2,223 cases in 2014.
  • In San Joaquin County, there were 1,251 cases of gonorrhea, of which, 46.7 percent were women and 53 percent were men. There were 985 cases in 2014.

Syphilis continues to increase across all regions of California with an overall 29 percent jump (4,890 reported cases) compared with 2014 cases.

  • Of those cases reported, 63 percent of cases were men who have sex with men. 
  • Much like the other STDs, women of reproductive age saw a 46 percent increase.
  • African American male rates were twice as high as white males
  • The number of Infants born with congenital syphilis increased third consecutive year, 39 percent over 2014 cases.
  • In Sacramento County, there were 224 cases of primary & secondary syphilis, of which, 9.8 percent were women and 90.2 percent were men. There were 114 cases of early latent syphilis, of which 16.7 percent were women and 83.3 percent were men.
  • In San Joaquin County, there were 130 cases of Primary & Secondary syphilis, of which, 29.2 percent were women and 70.8 percent were men. There were 68 cases of early latent syphilis, of which 32.4 percent were women and 67.6 percent were men.

HIV cases in California have seen a decrease in cases over the years.

  • The rate of new Stage 3 HIV, or AIDS, cases and AIDS deaths in California decreased 29 percent and 17 percent, respectively, from 2008 to 2013. The rate of new HIV diagnoses and HIV deaths decreased 15 percent and 12 percent, respectively, during those 6 years.
  • As a testament to better medicine, patients with both AIDS and HIV are increasingly living longer. The number of people living with AIDS and HIV in California rose 12 percent and 18 percent, respectively.

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