How did you like the 15th century? Not so much? Too bad because syphilis is making a comeback.

According to a new report issued last week by the Centers for Disease Control and Prevention, there has been a spike in the number of cases of sexually transmitted diseases like chlamydia and gonorrhea, but syphilis came out on top with a whopping 19 percent rise over just last year. The spike was felt most by young people ages 15 to 24.

As usual, experts immediately looked at questions of public funding. Jonathan Mermin, director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention for the CDC, told NPR that “more than half of state and local STD programs have experienced budget cuts . . . [and] our ability to prevent STDs is only as strong as the public-health infrastructure to support it.”

But there are likely other explanations for what’s going on here. Some experts have pointed to the “Tinder effect,” the idea that online hookup sites are making casual anonymous sex easier and more common than it used to be. It’s true that millennials generally are less likely to be sexually active in their 20s than previous generations and the age of first sexual intercourse has ticked upward in recent years, but it seems that the segment of the population who are having casual sex are having more of it and more of it anonymously.

In an article for Vanity Fair last year, author Nancy Jo Sales asked young people how Tinder is different from just going out to a bar. As one young man replied, “You could talk to two or three girls at a bar and pick the best one, or you can swipe a couple hundred people a day — the sample size is so much larger. It’s setting up two or three Tinder dates a week and, chances are, sleeping with all of them, so you could rack up 100 girls you’ve slept with in a year.”



It’s always hard to persuade young people that they’re not invincible. But the threat of living with 500-year-old diseases should help.

In 2015, the AIDS Healthcare Foundation (AHF) put up billboards in California encouraging users of dating apps Tinder and Grindr to get tested for sexually transmitted diseases. Tinder responded with a letter demanding that the group take down the ads: “These unprovoked and wholly unsubstantiated accusations are made to irreparably damage Tinder’s reputation in an attempt to encourage others to take an HIV test offered by your organization,” the letter read. “While Tinder strongly supports such testing, the billboard’s statements are not founded upon any scientific evidence and are incapable of withstanding critical analysis.”

But earlier this year, Tinder added a locator for STD testing to its app.

The problem with casual, anonymous sex via apps is twofold: You’re more likely to catch something from one out of 100 hookups, and you’re less likely to inform your former partners if you find out you have something. Indeed, you’re unlikely to ever encounter one of them in person ever again.

But what about prevention? If you went to school in the ’90s, you were subject to an unending barrage of sex education — much of it devoted to preventing HIV/AIDS. And the threat repeated by teachers, public-health workers and television ads was clear. As the Keith Haring poster put it, “Silence = Death.” There were photos of cadavers and funerals, images of war and people in mourning. If you don’t use a condom, the message went, you’re signing your own death warrant.

Chlamydia and gonorrhea just can’t compete. Sure, some sexually transmitted diseases can lead to infertility, but most effects of STDs can be cured with antibiotics. In other words, it is hard to put the fear of God in young people with these kinds of problems. As Josh Bloom of the American Council on Science and Health notes, drugs now allow HIV-positive people to have unprotected sex without passing it on to uninfected partners. “And if they do, so what? You take a pill or two per day and live a mostly normal life.”

Bloom suggests that the rise in syphilis among gay men is “very good, albeit indirect, evidence that the reduced fear of HIV infection is a very important factor in driving up the rates of other STDs.”

How did you like the 15th century? Not so much? Too bad because syphilis is making a comeback.

As for the rise in cases among young women, Kay Hymowitz of the Manhattan Institute notes, “Kids are a lot more afraid of getting pregnant than getting a disease that only needs a little cipro.” Indeed, that may be one reason why teen pregnancy has continued to fall even as the rates of sexually transmitted diseases have risen.

Young people may simply be using forms of protection other than condoms — IUDs have become more common. Birth-control pills have become more easily obtained from doctors and clinics and cheaper too. Young people can continue to protect against pregnancy even while not using prophylactics.

But the effects of these STDs are not negligible. If left untreated, about 10 to 15 percent of women with chlamydia will develop pelvic inflammatory disease, according to the CDC, which can lead to infertility.

Meanwhile, some new strains of gonorrhea have been detected that seem to be resistant to antibiotics. Syphilis is hard to detect because its symptoms look like a lot of other ailments. If untreated, it can remain latent in the body for years. In the late stages of syphilis, “The disease may damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints.”

It’s always hard to persuade young people that they’re not invincible. But the threat of living with 500-year-old diseases should help.