Rates of both chlamydia and syphilis in Miami-Dade have nearly doubled since 2006, according to new statistics from the Florida Department of Health.
The rise in sexually transmitted diseases is an unsettling and largely unnoticed trend, said Alex Moreno, the clinical program manager for the adolescent medicine division at the University of Miami Miller School of Medicine.
“It’s all on our back burner,” Moreno said. “That’s the scary thing.”
There were 400 cases of chlamydia per 100,000 residents in 2013. In 2006, there were 200. Syphilis has similarly increased, jumping from 8.4 cases per 100,000 to over 16 in the same seven years, according to the health department numbers.
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Chlamydia can cause fertility problems if left untreated. Syphilis causes sores and rashes and may lead to paralysis and, eventually, if untreated, even death.
Already, the Miami metropolitan statistical area had the highest rate of diagnosed HIV infections in the country in 2011, according to the latest data from the Centers for Disease Control.
Miami-Dade County has a slightly lower rate of chlamydia than the state as a whole, but a higher rate of syphilis. Statewide, the rate of chlamydia is 419 per 100,000 residents in 2013 and the rate of syphilis is 7.9 per 100,000 residents.
Younger people in Miami-Dade were generally more likely to have STDs, the numbers indicated. Since 2009, STDs in the 25-to-34 age range have increased by 5 percentage points.
And even though STDs in people under 25 have decreased by 8 percentage points, that same age group is significantly more likely than any other age group to have an STD, accounting for 56 percent of all cases of chlamydia, gonorrhea and syphilis in Miami-Dade in 2013, according to the statistics.
Chlamydia in particular is pushing the numbers up — 70 percent of all reported cases of chlamydia are among adults ages 15-24, according to the CDC.
The CDC said the increase in syphilis nationally is driven by men, particularly gay and bisexual men.
The rising number of infections has led to speculation about cause, with possibilities ranging from a lack of understanding about the diseases to an increasingly promiscuous culture.
People often neglect to use condoms during oral sex, said Isa Chinea, operations manager in the STD prevention program at the health department. This leads to a dangerous game of chance, she said. Both chlamydia and syphilis can be spread by unprotected vaginal, anal and oral sex.
Additionally, testing is a hard sell when there are no symptoms, as is often the case with chlamydia, dubbed “the silent disease,” Chinea said.
For adults, there is usually a stigma associated with STD testing, but with the younger generation a lack of education is more likely to be the problem, UM’s Moreno said.
Teenagers can be tested for STDs in Florida without notifying parents, but they may not know that’s allowed.
“As a norm, kids really don’t know the law and they don’t know how to access the services,” Moreno said, “but they’re not afraid to get tested once they know.”
Lackluster education should be blamed, in part, on the tone set in Tallahassee, Moreno said. Florida’s statutes on health education say that during any instruction on AIDS, sexually transmitted diseases or health education a school shall: “Teach abstinence from sexual activity outside of marriage as the expected standard for all school-age students while teaching the benefits of monogamous heterosexual marriage.”
The Miami-Dade school system has adopted a more comprehensive health education curriculum, said Rosa Pache, the project manager of the HIV/STD prevention education program for Miami-Dade Public Schools. Though health education in Miami-Dade teaches the benefits of abstinence, it also shares methods of safe sex for those who choose to be sexually active and has a policy of inclusiveness for all sexualities, she said.
Some say the STD increase may be the result of a more prolific hook-up culture, which may lead to a higher frequency of sexual activity with unfamiliar partners. Social media sites and phone-dating apps like Tinder allow people to find sexual partners quicker and easier than ever before.
Both the Florida Health Department and Miami-Dade schools are working to decrease the number of STDs in South Florida. The health department has expanded its testing sites and includes a mobile STD/HIV testing unit.
Pache said the Miami-Dade school system is helping develop an app that will allow students to find testing locations.
Efforts like these have likely increased the number of people tested each year in Miami-Dade, said Lori Jordahl, the health department’s STD program consultant for STD/HIV prevention and control program. But she doesn’t think that accounts for the increase in STD rates.
“I wish that was the only reason,” Jordahl said.
Health department officials said they will continue fighting STDs, though their warnings sometimes fall on deaf ears.
“It’s tough because people don’t always want to hear the messages that you’re trying to give,” Jordahl said. “They don’t feel it personally until someone they know and love [has an STD].”