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STI Diagnoses Rise, Especially in Rural Areas

— Larger increase versus urban areas

MedpageToday

Medical claims for sexually transmitted infections (STIs) in the U.S. increased over the past decade, across various age groups and geographic areas, and for a number of individual diseases, a new report found.

From 2007 to 2018, claim lines -- or individual procedures or services listed on an insurance claim -- with STI diagnoses as a percentage of all medical claims jumped 76% nationally and nearly doubled in rural communities.

Individual diagnoses of chlamydia and gonorrhea more than doubled, while diagnoses of mycoplasma genitalium more than tripled, according to new data from .

STI diagnoses were up 98% in rural areas compared with a 77% increase in urban areas, which has been documented in media reports that partially attribute the increasing incidence to less access to public health resources, as well as socially conservative views toward same-sex relationships and non-marital sex compared to more urban populations.

Along with an 80% rise in syphilis diagnoses over the time period, the report noted a 149% increase in chlamydia and a 126% rise in gonorrhea, as well as a 197% increase in diagnoses of Mycoplasma Genitalium. Interestingly, drug-resistant Mycoplasma Genitalium recently made the CDC's "watch list" of three pathogens that should be monitored closely, though they have yet to spread resistance widely.

In addition, the report examined the age differences in claim lines for different diagnoses by age group in 2018. For example, the age group with the greatest increase in hepatitis B diagnoses were patients over age 60 (+149%), while the greatest increase in chlamydia diagnoses was among patients ages 19-22 (+90%), and the greatest increase in syphilis was among those ages 23-30 (+74%).

The report also examined diagnoses in gonorrhea by gender, and found that while gonorrhea diagnoses as a percentage of all medical claim lines by gender rose 47% among women from 2007 to 2018, it more than quadrupled among men (+326%).