Sexually transmitted diseases remain a public health challenge during COVID-19 pandemic
Impact of disruptions in care, testing yet to be determined as 2020 data show some STDs decreased, others continued to increase
June 23, 2021
Newly released 2020 data from the Minnesota Department of Health (MDH) show some sexually transmitted diseases (STD) and HIV rates in Minnesota decreased slightly during the pandemic while others continued to increase.
Health officials say the numbers in the 2020 report reflect some uncertainty due to a pandemic-driven reduction in services and testing that may have affected reported cases of sexually transmitted diseases. The annual HIV/STD data report released today showed HIV and STDs overall in Minnesota declining 2%, yet gonorrhea rates increasing 27%. The report also notes a special concern with the increase in cases related to two distinct HIV outbreaks in the Twin Cities metro area and the Duluth area.
The disruptions in preventive care during the COVID-19 pandemic meant fewer STD testing opportunities in 2020, explained Christine Jones, STD, HIV and TB section manager for MDH. She urged Minnesotans to take advantage of the resources that are once again more available.
“This is concerning, especially as MDH and other organizations respond to two HIV outbreaks in the state,” Jones said. “It’s incredibly important that people seek preventive care and testing now in 2021. The HIV outbreaks in the Twin Cities and Duluth area highlight a rise in overlapping issues among people who inject drugs and people who are unhoused. MDH remains committed to supporting community-focused efforts to address these issues.”
Key findings by the numbers
Data from 2020 show STDs remained at very high levels with 33,252 STD cases reported last year compared to 33,725 cases in 2019 – a 1% decrease.
• Chlamydia remained the top reported STD in the state with 21,942 cases reported. That figure reflects an 11% decrease in cases compared to 24,453 in 2019. This is the first time chlamydia rates have decreased since 2009, but with testing and services disrupted by the pandemic, it is not clear whether this represents a true decline of that magnitude.
• Gonorrhea remained the second most reported STD in Minnesota with 10,217 cases reported in 2020, a 27% increase.
• Syphilis cases overall decreased 3% with 1,093 cases in 2020. Despite the overall decline in all syphilis stages, the early, more symptomatic stages increased 8% from 2019 to 2020.
• The number of newly diagnosed HIV infections reported to MDH decreased 18% with 226 cases reported in 2020, compared to 276 in 2019.
• People assigned male sex at birth account for an increasing majority of HIV cases at 84%.
• Over two-thirds (69%) of new HIV cases disproportionately affect communities of color.
• The estimated number of people living with HIV/AIDS in Minnesota is 9,422.
Syphilis outbreak moves to sustained increase
MDH’s response to the syphilis outbreak in Cass and Beltrami Counties continued through 2020. The outbreak was reclassified as a sustained increase of cases in 2021 as a result of changing syphilis trends. Data indicates that the number of new cases is leveling off. However, syphilis continues to impact these counties and remains a critical concern. Testing, monitoring and outreach continue statewide. Providers should also stay vigilant about screening for congenital syphilis, as seven cases were reported in infants in 2020 (66% decrease from 2019).
An HIV outbreak was declared in Hennepin and Ramsey counties in 2020 with cases dating back to 2018, and another outbreak was declared in the Duluth area in 2021 with cases dating back to 2019. Minnesota's outbreak-associated cases have risk factors consistent with the national outbreaks. New infections in the outbreaks are primarily affecting:
• People who use injection drugs or share needles and works.
• People experiencing homelessness or unstable housing.
• Men who have sex with men.
• People who exchange sex for income and other needed items.
“Ways to prevent HIV include consistent condom use and the daily pill to prevent HIV (PrEP),” said MDH Medical Director and State Epidemiologist Dr. Ruth Lynfield. “It is also really important to get tested regularly for HIV and STDs, and if you are diagnosed with HIV, to take and stay on treatment to make the levels of virus undetectable. This is so essential, because people living with HIV who are taking their medications and have an undetectable viral load do not pass HIV through sex.”
MDH funds community-based programs that provide STD and HIV services and prevention resources throughout Minnesota. These programs offer prevention education, testing services and support for people who need care and sterile syringe access.
More information, as well as the complete Minnesota 2020 Surveillance Reports for STDs and HIV, can be found on the MDH website at STD Statistics.