Nationwide, rates of sexually transmitted disease hit record highs in 2017

Kentucky experts say that opioid and meth abuse are contributing to rising rates of STDs in the state, which broke records in 2017.

"It’s just another consequence of our drug epidemic that we are trying to address," said Allison Adams, public health director for the Buffalo Trace District in Northern Kentucky. "When folks have to hide in order to feed their disease of addiction, it’s hard to detect and treat compounding issues like STDs."

Opioid users are at greater risk of contracting communicable diseases because they are more likely to engage in unsafe behavior, like having unprotected sex, said Chang Lee, who manages the state's STD prevention program.

Sharing a needle increases the possibility of transmitting diseases like HIV, Lee said.

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If left untreated, STDs can lead to fertility problems, pregnancy complications, pelvic inflammatory disease and an increased risk of contracting HIV.

Nationwide, STD rates set records in 2017, the fourth straight year of sharp increases, according to the Centers for Disease Control and Prevention. In Kentucky, rates of syphilis increased by 62 percent between 2014 and 2017.

Syphilis rates in Jefferson County were the highest in the state last year, with 46.6 cases per 100,000 people, more than double the statewide average of 16.4. Jefferson County also saw double the state rate of gonorrhea, with 361 cases per 100,000 people, according to state data.

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While doctors typically ask patients to tell them what put them at risk for an STD, Lee said in 2012 they began to hear more reports of drug abuse around the time of contraction — the same time the nation saw a wave of deaths attributed to heroin.

In the Fulton County Health Department, in far Western Kentucky, Nursing Supervisor Debbie Barnes said she finds herself treating the same women over and over again, sometimes with cases so severe they risk becoming sterile.

Both Barnes and Adams know that some women are getting STDs after prostituting themselves in return for drugs.

"With STDs, there’s an element of using your body as a method of payment for the substance that you crave," Adams said.

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High rates of STDs have also been linked to anonymous sex, made more easy through dating apps such as Tinder and Grindr.

Users of dating apps frequently may not know the name or phone number of the person they had sex with, said Julie Moon, infectious disease supervisor in Kentucky's Lexington-Fayette County Health Department.

"We can treat the original patient, but we can’t get to the partners because there’s no information to do that," Moon said. Without treating both partners, the disease spreads.

While Lee said that younger people are most affected by STDs, Moon said that Fayette County has begun to see new infections among people older than 50.

"Before we could target the younger people, but now we have to target all age groups because everyone is having sex and not protecting themselves," she said.

The spread of STDs comes down to condom use.

"It's people not being comfortable when they're in the moment and asking partner to use a condom," said Blake Johnson, an epidemiologist in the Christian County Health Department. "There’s a stigma."

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Once someone has contracted an STD, some face boundaries to treatment, too.

"We’re seeing that the uninsured or those folks that don’t have easy access to health care are affected more," said Adams, of Northern Kentucky. "We are seeing a rise in folks seeking treatment for STDs in our emergency room."

For those that do test positive for STDs, state law mandates that local health departments follow up with them, Lee said. But many fail to get regular testing to check if they've contracted an infection.

In Jefferson County, health officials offer testing at local STD clinics and also go into local correctional facilities to serve those without traditional access to health care.

In other states, doctors are also allowed to provide prescriptions for both partners even if only one has visited a doctor. But Kentucky prohibits the practice, called expedited partner therapy.

"Getting rid of that could potentially reduce the rates of STDs," Caloia said.

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Reach reporter Kate Talerico at ktalerico@gannett.com or at 502-582-4352. Follow her on Twitter @K_Talerico.