Following an announcement by the county office of Health and Human Services that the rate of sexually transmitted infections has dropped around the county, Planned Parenthood of the Pacific Southwest said Monday there could be a “silent crisis” of unreported STIs.
According to the county figures, STI rates declined for a second consecutive year in 2024, mirroring a statewide trend.
Some of the most commonly reported STIs in San Diego County are Chlamydia, gonorrhea and syphilis, all of which declined in the official numbers between 2023 and 2024.
But Planned Parenthood officials suggested the numbers aren’t as low as they are reported. Frontline clinical data from PPPSW through a screening initiative has uncovered hundreds of previously undiagnosed STI cases, including an 8.5% positivity rate for Chlamydia and a 3.2% rate for Syphilis in San Diego County, resulting in 50 additional positive cases of syphilis per month.
“As clinicians, we know that what we don’t test for, we can’t treat,” said Dr. Antoinette Marengo, chief medical and transformation officer for PPPSW. “This data proves that STIs like Syphilis and Chlamydia are not relics of the past — they are active, silent health crises in our community. By increasing our screening rates by up to 35%, we are finally seeing the true scope of the need in San Diego County.
“Every one of these 50 additional monthly Syphilis diagnoses represents a person who can now avoid long-term neurological damage, transmission to a fetus when pregnant, or transmission to a partner. Our proactive approach is shifting the needle from reactive treatment to true preventive medicine.”
The county’s HIV, STD and Hepatitis Branch of Public Health Services recorded the following numbers for 2024:
Chlamydia was down 7.4%, from 17,720 cases in 2023 to 16,414 in 2024. Women ages 20-24 have the highest infection rates. Gonorrhea decreased 9.5%, from 6,651 cases in 2023 to 6,021 in 2024. Men ages 25-29 show the highest rates. Syphilis (primary & secondary) dropped 35.8%, from 481 cases in 2023 to 309 in 2024. Infection rates are highest among men ages 25-34. Syphilis (congenital) dropped 9.5%, from 36 cases in 2023 to 31 cases in 2024. Three stillbirths or neonatal deaths occurred in 2024, the most since 2019.County health experts said many factors likely caused the decrease, including state investment in STI prevention and control at the local level, improved access to routine screening and improvements in diagnostic testing, including rapid or point-of-care tests.
“These numbers are encouraging but there is still work to be done,” said Dr. Sayone Thihalolipavan, county public health officer. “We need to focus on decreasing cases of maternal syphilis, and babies born with congenital syphilis.”
Planned Parenthood suggests that fewer people are being tested than should be due to a variety of factors, including fear of immigration raids and slashed funding for family planning organizations such as PPPSW.
“This work is more necessary now than ever before. As federal attacks on reproductive health care — such as the Planned Parenthood “defund” — threaten access to critical care nationwide, Planned Parenthood remains the primary care provider for essential services for millions,” Marengo said.
“When political efforts aim to shutter clinics and dismantle the safety net, it is the most vulnerable among us who suffer from undiagnosed infections and preventable health complications.”
STIs are spread through sexual contact involving genitals or bodily fluids, and some can be spread from a pregnant person to a fetus. They can be caused by viruses, bacteria, fungi or parasites.
Anyone who is sexually active can contract an STI, and some can be life-threatening if left untreated.
County leaders last week recommended that anyone who is sexually active establish a sexual health routine that includes screening, testing, vaccination and regular visits with a health care provider.
San Diego County operates three walk-in sexual health clinics that offer testing, diagnosis and treatment for STIs. More information is available at sandiegocounty.gov.
For the full list of Planned Parenthood’s services, visit planned.org, or call 888-743-7526.
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