In a single year, Alberda helped distribute 146,000 free condoms in Ottawa and Allegan as part of a national campaign: Wear One. The campaign also allows residents in more than two dozen Michigan counties to order free condoms online.
“We have a serious problem, and we have a serious disconnect. People know the importance of condoms” for preventing STDs, Alberda said. “But when you ask them whether they wear them, the answer is very often ‘no.’ We are trying to change that.”
The jump in STDs in this west Michigan county reflects a shocking trend upward across the state, and in the U.S., that has driven combined cases of syphilis, gonorrhea, and chlamydia to all-time highs, according to a report by the U.S. Centers for Disease Control and Prevention.
Chlamydia — already on a sharp upswing for several years — increased 3 percent to more than 1.7 million cases nationally between 2017 and 2018, the most ever reported to CDC. Syphilis cases in its most infectious stages (primary and secondary syphilis) and gonorrhea last year reached the highest number reported since 1991, according to the 176-page report released in October.
Michigan’s numbers are no less unsettling.
The state logged 51,256 cases of chlamydia last year, an all-time high.
That boosted the average rate from about 477 cases for every 100,000 residents in the years 2008 to 2012, to nearly 513 cases for every 100,000 residents in 2018, according to data from the Michigan Department of Health and Human Services.
Recorded cases of gonorrhea, which dropped nearly in half from 2008 to 2014, have since climbed 70 percent to 16,922 cases, inching toward the state’s most recent high of 17,905 cases in 2008. That boosted the average rate from about 120 cases per 100,000 residents in 2008 to 2012, to 169 cases per 100,000 in 2018.
Cases of primary and secondary syphilis, which dropped by 2013 following an earlier outbreak, surged again in 2018 to 654 cases, a tripling of the 216 cases in 2008. That boosted the average rate from 119 cases per 100,000 residents from 2008 to 2012 to 169 in 2018.
Overall, most increases were seen among adolescents, African Americans and men who have sex with men, according to state officials. Nationally, half of all new STDs were acquired by young people ages 15 to 24.
But middle-aged Michiganders aren’t immune.
Five-year average rates for all three infections — chlamydia, gonorrhea and the most infectious states of syphilis — increased between 2014 and 2018 among those aged 30 to 44 years old and those 45 and older.
“What we’re seeing here is much more than better screening. There are also more infections,” said Tory Ervin, a nurse practitioner at Corktown Health Center, a public health clinic near downtown Detroit specializing in care for LGBTQ patients.
Failing to get treated can yield the grimmest of statistics, especially for women.
Untreated, syphilis can be passed to a baby either in utero or during birth. Forty percent or more of children born to a mother with untreated syphilis are stillborn or die soon after birth, according to the CDC.
Yet congenital syphilis — something that penicillin successfully treats 98 percent of the time, according to one oft-cited federal study — has climbed to its highest rate since 1995, and includes 63 Michigan babies in a five-year period ending last year, according to state report.
Last year, the U.S. logged 1,306 cases of congenital syphilis, a 185-percent increase since 2014. Those included 78 stillbirths and 16 infant deaths, according to the CDC.
A national concern
In its October report, the CDC cited poverty, stigma and unstable housing as factors that reduce access to STD prevention and care. The report also faulted cuts to STD programs at state and local levels, reporting that more than half of local programs nationally experienced budget cuts that resulted in clinic closures, reduced screening, staff loss, and reduced patient follow-up and connections to services.
Drug use may contribute, especially in states like Michigan that have been ravaged by opioids. As Bridge Magazine first reported, only in 2018 did the increase in opioid overdose deaths drop, albeit only slightly.
“When we have increases in risky behavior” such as drug abuse, “that translates into an increase in other risky behavior — multiple partners, unprotected intercourse, and all that,” said Dr. Oluwatosin Goje, who leads the Reproductive Infectious Diseases Program at the Cleveland Clinic and is a member of the American College of Obstetricians and Gynecologists.