Chlamydia is the most common sexually transmitted disease in Minnesota, particularly among minority groups, which tend to have less access to health care.
Minnesota's epidemic of sexually transmitted diseases reached a new high in 2008 -- the thirteenth year in a row.
The Minnesota Department of Health on Wednesday reported there were 17,650 new cases of chlamydia, gonorrhea and syphilis last year, a 3.5 percent increase over 2007. The rate increased despite a significant drop in the number of gonorrhea cases.
Rates for all three of the sexually transmitted infections have been rising since 1996. They are particularly high among minority groups, which tend to be poorer and have less access to health care, state health officials said. Rates are expected to continue rising, especially with state and local government budget cuts. Legislation introduced this year to address the problem is not expected to pass.
"The reality is we are not likely to have many more resources than we do now," said Peter Carr, head of the health department's STD division. "And the problem keeps getting bigger."
The majority of new cases in 2008 were chlamydia, 14,350 in all, up 7 percent from 2007, according to the department's annual STD report. Some of the increase probably is due to better tests and more frequent screening, officials said.
New chlamydia cases have more than doubled since 1996. Early in the epidemic, the highest rates were in Minneapolis and St. Paul. Now the disease is growing more rapidly in the suburbs and areas outside the Twin Cities, officials said. Both of those areas saw an 11 percent increase over 2007. Nearly 70 percent of all cases occurred in people ages 15 to 24.
In general, Minnesota's increase in STDs is comparable to increases nationally. "What surprised us ... was the sudden and large increase in [chlamydia] cases among males," said Carr. "We saw a 13 percent increase among 15- to 24-year-old males."
Puzzling over disparities
Hispanics have a chlamydia rate six times higher than whites, while blacks' rate is 16 times higher. In Minnesota, the rate among blacks is nearly twice the national average.
Chlamydia is a silent disease with few detectable symptoms. Routine testing is the only way to find it. Untreated, it can lead to infertility in some women and, in rarer cases, among men. An infected pregnant woman can pass the infection to her fetus, causing premature delivery, infant pneumonia and serious eye infections leading to blindness.
Gonorrhea, the second most commonly reported STD in Minnesota, declined by 12 percent last year, with 3,036 new cases. Most were among racial minorities.
Sexual behavior does not account for the higher rates among minority groups, officials said. Teenagers and young adults of all races tend to have the same rates of sexual activity and condom use, they said. However, minorities tend to be poorer, have less access to health care and health insurance, reducing their likelihood of being tested and treated. Moreover, STD rates have been higher in those communities for years, perpetuating what health officials describe as a self-sustaining epidemic.
New syphilis cases also jumped sharply, up 40 percent in 2008 to 163, almost all among young gay men.
Last year, a bill to provide $1.3 million for screening and education failed to pass the Legislature. This year a similar bill introduced by Sen. John Marty also is expected to fail, as his proposal requires schools to teach comprehensive sex education.
Search for solutions
"We provided 56,000 STD tests in 2008," said Connie Lewis, vice president of external affairs for Planned Parenthood Minnesota, North Dakota, South Dakota. "But the need exceeds our ability to meet it. We have to focus on solutions."
Marty's bill also would require the health department to devise a five-year plan to address the problem, something that already may be in the works.
Carr said the department plans to devise a statewide prevention strategy for all sexually transmitted diseases, including AIDS, that may include ideas already proven effective.
For example, officials at the Dakota County Public Health Department used a Medica Foundation grant to provide guidance to doctors and nurses to encourage more STD screening. The Minneapolis Department of Health and Family Support has used federal grants to create a peer-to-peer education and screening program called Seen on Da' Streets, aimed at young black men. In the past five years, the peer educators have talked to about 11,000 young men, city officials said.
"There is no silver bullet," Carr said. "The answer is to try and get as many entities involved as possible."
Josephine Marcotty • 612-673-7394