Lopez, 21, gets regular testing for sexually transmitted diseases –
has been since she was a teen. However, when she asked her primary
care physician about getting tested, she said he was surprised.
who is a college student in California, said her doctor said the
majority of people don’t ask about them. For herself, Lopez usually
goes to Planned Parenthood for testing because the staff always asks
the questions that must be asked.
the increase in the number of STDs around the nation, public health
officials are urging primary care doctors to take the initiative and
ask patients for screening and treatment.
Coalition of STD Directors Executive Director David Harvey said the
organization knows doctors are not going what they have to do screen
for STDs, which is why there is a rise in STD rates. Harvey said the
blame also lies in funding cutbacks and a reduced public awareness
about the risks that have led to the STD infection rise.
Centers for Disease Control and Prevention have put into place
guidelines for yearly screening for people who are sexually active.
One such guideline is to test all sexually-active women – 25 and
under – for chlamydia or gonorrhea. Men who engage in sexual
activity with other men should be tested for syphilis, gonorrhea and
the recommendations, testing doesn’t typically happen. In fact, in
2015, half of sexually active women between 16 and 24 years of age
who have Medicaid or a private health plan got tested for chlamydia.
to CDC information, the rates for three common STDs are at a record
high. Between 2016 and 2017, syphilis rise 11 percent, gonorrhea rose
by 19 percent and chlamydia increased by seven percent. There was
also a 44 percent increase in the number of congenital syphilis –
babies born with syphilis whose mother had it while pregnant or
of those cases were in California.
is very important since most STD infections have no obvious symptoms.
STIs that don’t get treated can cause serious health complications
such as infertility, chronic pain and death.
Division of STD Chief Medical Officer Dr. Laura Bachmann said primary
care doctors play an important role in combating the rise in STD
rates. She said if they fail to ask the right questions and don’t
screen patients, most STDs are missed.
said state governments lack the money needed to battle the increased
number of STI cases, mainly due to the federal STI funding staying
stagnant. He said federal funding for 2017 was $152.3million – the
same amount as eight years before.
believe there are numerous reasons why doctors don’t routinely
screen and treat STDs such as the worry of not being compensated for
offering these STI services. They may also lack the current testing
and treatment recommendations. In 2015, the CDC updated its
common problem is that many doctors are hesitant to talk about sexual
health with patients. In one study, one-third of teens who get yearly
visits had no talks about sexual health.
of Alabama at Birmingham School of Medicine professor Dr. Edward Hook
said the situation is the result of doctors waiting for patients to
start the conversation about sexual health. He said doctors are
concerned that asking patients about their sex life and history will
come off as rude and offensive.
Academy of Family Physicians President Dr. Michael Munger said he
remembers conversations with patients about sexual health being
uncomfortable. He said it’s a challenging conversation, but it’s
important to have it. If doctors don’t bring it up, who is going
to, Munger said.
Nola, is a writer in Los Angeles who said he gets tested for STDs
every six months, but at the LGBT Center instead of his doctor who he
said rarely asks him about his sexual health. He said the LGBT
Center’s staff comes across as more knowledgeable about sexual
health than his own doctor.
also have other health problems they have to immediately address in
the short time they see patients, which is why talking about sexual
health isn’t a huge priority.
Brewer is a nurse practitioner is a Northeast Community Clinic in
Hawthorne, California who regularly screens women for STIs as part of
their health exams. She said many of her colleagues would give her
their cases instead of dealing with the conversations.
She said doctors are concerned about high blood pressure and diabetes, which is why sexual health often takes a back seat.
County Public Health Department recognizes that STIs are an important
issue, which is why they have sent representatives to area doctor’s
offices to teach them how to talk about STDs. They also provided them
with information on sexual history questions, screening
recommendations and treatment guidelines.
Los Angeles County Medical Association will also use social media and
other efforts to spread the word to the doctors about the epidemic,
which is the way people should be seeing it.
Heidi Bauer is head of the state’s Department of Public Health STD
Control Branch, and she said the state wants to educate doctors to
ensure they screen their patients routinely. She said the department
offers both online and in-person training for doctors to learn more
about STDs and allows them to download information with the latest
also urges the federal government to ensure its own screening
recommendations are more inclusive. For example, right now the only
time a woman is tested for syphilis is if she is pregnant. Bauer said
there has been a huge rise in the number of people with syphilis and
a lack of testing for this difficult to diagnose STD.
Bachmann said the CDC is going to look at implementing newer recommendations within the next year.