SALT LAKE CITY — Health officials in Salt Lake County say they are shifting resources to tackle an alarming rise in sexually transmitted diseases.
All four STDs that the health department tracks — chlamydia, syphilis, HIV and gonorrhea — are on the rise, said Salt Lake County Health Department epidemiology supervisor Lynn Beltran.
But it is gonorrhea, an infection spread through sexual contact that can lead to infertility if left untreated, that appears to be going viral.
"For so many years, in my position, I would hear from the community, from legislators and various other leaders in the community that we don’t have an STD problem here in Utah or in Salt Lake County," Beltran said. "And the data says the exact opposite."
"We have a significant problem here," she continued. "And if we continue to bury our heads in the sand, it's only going to get worse.
Five years ago, Salt Lake County saw an average of 200 gonorrhea cases per year, Beltran said. That number started rising in 2012, then jumped to 669 in 2013 and 989 in 2014.
Last year, the county recorded a preliminary count of 1,028 cases of gonorrhea — more than five times reported levels in 2010.
Finalized numbers will be released in the department's annual infectious diseases report later this summer. But in the first quarter of 2016, gonorrhea cases are already 40 percent higher than in the same period last year, according to Beltran.
With limited resources, Beltran said the outbreak is forcing the department to reshuffle funding from other areas. Grants can help, but those can take a long time to approve and often require years worth of data.
"Our need is right now," Beltran said.
Need for education
The Salt Lake County health department is trying to increase education for providers who may never have seen a gonorrhea case until recently, she said. And the department is hoping to launch a media campaign on STDs starting this summer to encourage the public to get regular screenings.
Based on interviews with patients and their sexual partners over the past few months, Beltran said the majority of infections are among 15-34 year old white men and women. That is surprising given that STDs have historically been disproportionately prevalent in black and Hispanic communities, she said.
And although STDs also tend to be more prevalent in people with a history of incarceration and men who have sex with men, Utah’s gonorrhea outbreak seems to be increasing fastest in the general population, she said.
A significant portion of patients are also being diagnosed at hospitals and hospital-affiliated clinics rather than free or low-cost clinics, she said.
Beltran attributed the outbreak to use of dating apps like Tinder that help facilitate casual encounters and more sexual partners. “Sex is literally at your fingertips,” she said.
Beltran said health officials have been unable to keep up with the fast-changing culture around relationships and sex, and she advocates for comprehensive sex education in schools.
"I can't help but wonder if that's where Utah is falling down the most," she said. "We need to be competing with this paradigm shift through education and it's not happening."
A bill to implement comprehensive sex education in Utah schools stalled in the 2016 Legislature after legislators said sex education should be left to parents.
"This is a very, very serious discussion," said Rep. Mike Noel, R-Kanab, at the committee meeting where lawmakers ultimately voted down the bill. "And it gets into the very personal things of family responsibility of parents, responsibility of individuals."
And Jeremy Boberg, CEO of Utah Addiction Centers, testified about concerns that comprehensive sexual education could be seen as promoting sex.
"Unfortunately, too many of our youth are introduced to sexuality prematurely, (leading to) significantly greater curiosity that often leads to age-inappropriate and escalating behaviors," said Boberg. "Inappropriate sexual-related behaviors come from this."
Karrie Galloway, CEO of Planned Parenthood Association of Utah, said young people should be educated on how to practice safe sex and empowered to ask about their partners' sexual history.
"It doesn't matter where you meet people — if it's on a dating app, if it's at a basketball game," Galloway said. "If you don't have the conversation and you're not in the practice of having safe sex, you're at risk."
Historically low rates
Utah has historically had lower STD rates than other states, according to Centers for Disease Control and Prevention data. In 2013, Utah ranked 38th out of 50 states for syphilis rates, 44th in terms of gonorrhea and 48th in terms of chlamydia.
Chlamydia, which sees about 4,500 cases a year in Salt Lake County, remains the state's most frequently reported communicable disease.
But Utah’s gonorrhea rates are rising faster than those of the U.S. as a whole and are likely to overtake the national average at this pace, according to Beltran.
"It's a whole new world," she said. "It's a whole new game. And we're trying to figure out how to compete with it."
Beltran says people should get screened annually for STDs. Those with multiple sexual partners should consider getting screened more than once a year.
She encourages patients to be truthful with their medical providers about their sexual behavior — including disclosing extramarital affairs.
“A lot of people think, ‘That’s not me. I’m not at risk. I’m not with those people,’” Beltran said. “But anyone who is sexually active is at risk.”