The release of the Centers for Disease Control’s annual report on sexual health in the US coincides with the post-holiday season in a manner that will dismay anyone whose New Year celebrations were on the wild side and which highlights the importance of sexual health education in this country. The release of the 2012 results may prove to be even more important once data from the next few years is available for comparison, since it will mark the turning point between the old system and the new one put in place by the Affordable Care Act. The impact on sexual health remains to be seen, but some changes in the provision of sexual health care have already been implemented. The wider access to STD screening and treatment through Obamacare may help to counteract the reduction in sexual health services provided by charitable organizations struck hard by the economic crisis, potentially creating a positive effect from the disruption of the healthcare system.
The State of the Nation’s Sexual Health
The CDC data for the year 2012 shows that cases of sexually transmitted diseases continued to rise nationwide, with some cities showing particularly significant increases in the numbers of cases being detected. The overall rise in gonorrhea cases in the US was 4.1 percent over the previous year, although the increase in detected cases was particularly high in men, at 8.3 percent. A similar pattern was observed with syphilis, with the number of cases increasing by 11 percent nationwide, and being particularly prevalent in men. The one piece of good news in the report was that rates of chlamydia detection had stabilized in 2012, with an overall increase of just 0.7 percent. However, , the CDC cautions that many cases of these three diseases still remain undiagnosed, and that the overall burden of STDs in the US will also be underestimated by these figures since there are many other sexually transmitted diseases that are not routinely reported to the CDC. The situation is also complicated by the fact that approximately 80 percent of people infected by an STD will not be experiencing symptoms, according to Kwikmed.org, which, in combination with a lack of awareness and the stigma often associated with STDs can dissuade them from seeking testing and treatment.
A Turning Point?
The 2012 figures suggest that more needs to be done to educate people about their sexual health and the means that can be taken to protect themselves, including condom use, changing sexual behaviors, undergoing regular screening and learning to discuss this issue frankly with both sexual partners and medical professionals. The question now will be what will happen to these figures over the course of the next twelve months, as the introduction of the Affordable Care Act changes the way many people access and pay for their healthcare. Once the figures for 2013 and 2014 become available, will we be seeing the beginning of a new trend in sexual health, and will it be an improvement or a further increase in the prevalence of STDs?
The Future of Sexual Healthcare
Healthcare experts remain divided in their predictions about the impact Obamacare will have on the health of the nation, but the impact on sexual health is perhaps more predictable. The expansion of Medicaid and health insurance that will cover preventative screening is likely to enable many more people to protect themselves against STDs. The impact is likely to be felt most in those groups that the CDC’s report identifies as at highest risk of STDs, including young people and sex workers, who may previously have found it difficult to access or afford screening. Indeed, better access to sexual healthcare has been one of the points that advocates of the new system have tended to emphasize, sometimes in a manner that has been criticized as overly suggestive or potentially intrusive. If the changes successfully increase detection and treatment rates, the 2013 and 2014 results could begin to show rates of gonorrhea and syphilis in decline.
However, a drop in rates for 2013/14 would not necessarily indicate an improvement in the nation’s sexual health, since it could also occur if access to sexual health services was in decline. Whatever the impact of changing health policies will be, access to sexual health care services is likely to remain blighted by the continuing impact of the economy on non-governmental organizations that have been attempting to provide free health services, including screening and treatment for STDs to those who are most in need. Reporting rates for STDs have declined in some parts of the US as a result of the loss of these kinds of services, which means that there are more people out there with untreated STDs. Some of the changes implemented under the Affordable Care Act, such as the expansion of Medicaid in some states, could help to target these people and provide them with a new route to treatment.