Unsafe and Unsexy

Epidemiologist Kristy Michie distributes condoms and educational pamphlets like these to Monterey County youth.

There’s nothing sexy about data, especially this data: Newly released figures from the U.S. Centers for Disease Control show increased infection rates for many sexually transmitted diseases. And the numbers in Monterey County are far worse than national averages, and on the higher end within California.

“We’re very concerned,” says Kristy Michie, an epidemiologist with the Monterey County Health Department.

The data shows a 123-percent increase in gonorrhea cases, a 56-percent increase in syphilis and a 16-percent increase in chlamydia in 2012 in Monterey County.

Nationally, the gonorrhea infection rate increased by 4.1 percent over the same time period, and chlamydia increased by 0.7 percent.

Of all the reportable diseases and conditions – a long list that includes things like animal bites, food poisoning and Lyme disease – chlamydia was by far the number-one disease in 2012, accounting for 47 percent of all the ailments reported by the county Health Department. (That’s consistent with national reporting, where chlamydia is consistently the most-reported disease.)

Michie isn’t sure why the infection rates are so high, but offers up a few theories: Thanks to improved treatments, young people don’t view HIV as a death sentence these days. Health care providers don’t routinely recommend STD testing even when they send samples off to the lab for other tests, like cholesterol. And faced with a sluggish economy, people have less disposable income for regular screening, and the majority of STD infections are asymptomatic.

“When you have to choose between a routine screening or groceries, guess which one you’re going to pick,” Michie says. That seems to hold true for Planned Parenthood, which operates two health centers in Monterey County, with locations in Seaside and Salinas; the nonprofit closed its Greenfield location nearly a year ago due to budget cuts. Visits to the Seaside Planned Parenthood declined by 7 percent last year, and visits to Salinas dropped 2 percent.

“While we don’t know exactly what is causing the high STD rates in Monterey County, we are concerned that patients may not be seeking the care and information they need to prevent and treat STDs,” Planned Parenthood Mar Monte spokesperson Lupe Rodriguez says.

While the county fared badly compared to national rates of STD infections, it’s not the worst offender in the state. (That honor goes to Kern and San Francisco counties.)

Of 58 counties in California, Monterey County’s infection rate was in the top third in 2012 for chlamydia, gonorrhea and syphilis (ranking 14th, 20th and 18th), according to data compiled by the California Department of Public Health.

Infection rates were highest mostly in population centers: Salinas, Seaside, Monterey, Pajaro and Greenfield, and disproportionately affect people of color. Patients of African-American descent were four times more likely than whites to be infected with chlamydia, and six times more likely to get gonorrhea.

Most new infections were in people under age 25, Michie says. But while targeting educational and outreach efforts at the county’s teenagers is an ongoing project, she’s getting the pieces in place for a new focus: educating doctors.

“There are a lot of good providers out there who are already right there with us,” she says, “but there are some I think that would benefit from additional information and encouragement.”

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(1) comment

STD Testing

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