“Monkeypox floods these programs and interrupts our ability to diagnose and treat other STIs,” said David Harvey, executive director of the National Coalition of STD Directors. “It highlights the fact that safety net clinics that provide essential services are in desperate need of federal support.”

Public health officials warn their limited resources could be stretched even further and outbreaks could proliferate if a lawsuit in Texas succeeds in eliminating Obamacare’s requirement that insurance cover services such as drug tests. STDs and HIV prevention drugs.

Leandro Mena, director of the CDC’s Division of STD Prevention, told POLITICO that chronic underfunding of public health programs is largely to blame.

“More than two decades of flat funding, taking into account inflation and changing demographics, has effectively reduced the purchasing power of public health dollars and resulted in the reduction of STI services at the local level,” said mena. “This reduction in testing, treatment and partner services likely contributed to these increases in STIs.”

Additionally, opioid and methamphetamine use – which has increased dramatically during the pandemic – is leading to both more HIV and hepatitis infections among people who share needles and the spread of other STDs, as more and more people trade sex for drugs and have unprotected sex.

Declining condom use, especially among young people, and taboos around sex that deter people from talking to their GP about STD prevention and treatment are also fueling the rise in rates, Mena said.

CDC data revealed that the total number of infections in 2021 broke the record number of documented STIs in the United States in 2020, rising from 2.4 million to 2.5 million.

Gonorrhea increased by 2.8%, reaching almost 700,000 infections in 2021. Chlamydia, which had decreased in 2020, increased by 3% last year.

And rates of congenital syphilis – babies who contract the disease in the womb – have soared by 24%. More than 2,600 babies were born with syphilis in 2021, up from 529 in 2000 when the country seemed on the verge of eliminating the disease.

Meanwhile, progress in preventing new HIV infections, which are tracked separately, has slowed during the pandemic, and some parts of the country, including San Francisco, are even seeing HIV rates rise for the first time in nearly two decades. ‘a decade. Officials warn that without much more funding, the United States may not meet its goal of ending the spread of the virus by 2030.

The rise in these preventable infections worries public health workers who hoped the Covid-19 pandemic would convince lawmakers to invest more in testing, vaccines, treatments and outreach to at-risk groups to protect the public. entire population.

But that didn’t happen.

Instead, the Covid disruption has exacerbated problems caused by years of budget cuts to STD programs and widespread stigmatization of poor people of color and LGBTQ communities where infection rates tend to be high. higher, according to health experts and government officials.

When Covid hit, many testing clinics closed or reduced their hours, and many patients stopped getting regular checkups for fear of catching the virus. Workers who had been tracing contacts for STDs were reassigned to Covid, meaning fewer people were told they had been exposed. For months, basic testing supplies like glass vials and swabs were in short supply.

While many services have been restored and medical supply chains repaired, federal funding remains stagnant. Earlier this year, Congress approved funding well below what health departments are asking for for Title X family planning clinics that provide STI testing to uninsured and low-income patients. And Republican lawmakers are voicing their opposition to the administration’s new calls for $4.5 billion to fight monkeypox — which Harvey and other health officials say would ease some of the pressure on the STI clinics that distribute the vaccine and test for the virus.

“It’s not about the money; you’ve received incredible amounts of money,” the North Carolina senator said. Richard Burer (RN.C.), the top Republican on the health, education, labor and pensions committee, told Biden administration public health officials during a hearing on Wednesday.

Sen. Richard Shelby (R-Ala.), the senior Republican in charge of appropriations, agreed.

“I don’t know there’s an epidemic there and we just have to have all this money at the same time,” he told reporters earlier this week.

Other challenges are looming. In particular, health workers and government officials fear that a lawsuit backed by former Trump administration officials could further worsen the STD crisis.

A Texas federal judge ruled last week that government advisers who decide what minimum services insurance must cover under the Affordable Care Act have no power to do so, and that requiring the coverage of things like the HIV prevention drug PrEP violates employers’ religious rights.

The judge has yet to say whether his ruling will apply only to the conservative business owners who filed the lawsuit, all of Texas, or the entire country, and requested additional information by Friday. If implemented nationwide, the ruling has the potential to remove insurance coverage for preventive care services like STD testing for nearly 170 million Americans.

Democratic policymakers and advocates see the case as a potential cataclysm, warning it could drive up health insurance premiums, bring back high costs that deter people from seeking STD testing and treatment, and slow progress in the treatment of chronic and infectious diseases.

“Choosing and choosing what kind of basic health care is included in an employer-sponsored plan is both discriminatory against people who need significant health care and contrary to how health insurance works, where everyone shares all the costs”, Bobby Scott (D-Va.), chair of the Education and Labor Committee that has jurisdiction over health policy, told reporters on a recent call. “What if someone objects to out-of-wedlock births for example and asks why they should pay for half of all births as part of the costs they have to share?

“If you can choose, it’s no longer insurance,” he added.

Krista Mahr contributed to this report.