St. Louis continues to have some of the highest rates of two common sexually transmitted diseases in the country.
The ranking persists in spite of the fact that number of cases of both diseases actually fell in the city between 2011 and 2012.
But Washington University in St. Louis infectious disease specialist Dr. Bradley Stoner says even though that trend sounds like good news, it may just mean that fewer people are getting tested.
“As access points decrease, what happens is testing goes down,” Stoner said, “So, fewer cases are detected. And my concern is even though rates are down, this could very well reflect a decrease in access points for people seeking care.”
Stoner says some groups are more at risk than others.
In St. Louis, African Americans are diagnosed with chlamydia at almost seven times the rate of whites, he says. That disparity increases to 15 times for gonorrhea.
Stoner blames a lack of access to health care.
“Over the last 10 to 20 years, there has been a reduction in the number of facilities that specialize in STD treatment. And people are ending up in emergency rooms, and urgent care settings and other places that don’t see a lot of cases. And you lose that concentration of expertise," Stoner said.
Left untreated, chlamydia and gonorrhea can cause serious health problems, including infertility in women.
The CDC report did have information that could be interpreted as good news: Per capita rates of syphilis staying low in St. Louis. But Stoner called that disease a “smoldering powder keg."
“The concern with syphilis is that it’s increasingly concentrated in men who have sex with men. And up to 75 percent of these individuals are HIV-infected," Stoner said. “So, it’s a twin epidemic of syphilis and HIV. And each disease can aggravate and amplify the symptoms and transmissibility of the other.”
Nationally in 2012, syphilis rates remained unchanged for women, but rose by almost 15 percent for men.
If it goes undetected, syphilis can eventually lead to heart disease, blindness and dementia. A pregnant woman can pass the disease to her unborn baby, who could die of it.
Follow Véronique LaCapra on Twitter: @KWMUScience