Bexar County has an STD problem. And it’s not going away anytime soon.
Texas’ Department of State Health Services documented 18,125 cases of syphilis, chlamydia and gonorrhea in the county during 2017, down slightly from the 19,066 cases reported the prior year — but still up an alarming 16 percent from five years ago.
Statewide, the numbers are worse, with 2017’s 201,646 cases up 5 percent from a year ago and up 23 percent from five years ago.
Those statistics come as state and federal lawmakers whack funding for family-planning groups such as Planned Parenthood, which offer STD education, testing and treatment. They also come as Texas Attorney General Ken Paxton challenges the Affordable Care Act in a Fort Worth courtroom.
“We still have an access-to-care problem,” said Coleen Bridger, director of the San Antonio Metropolitan Health District, which oversees health policies affecting the city and Bexar County. “People who don’t have health insurance often don’t go to the doctor until they’re too sick to work — and that’s frequently the case with STDs.”
The Trump administration last month shortened the funding period for grants to groups that provide family-planning services, including STD education, and it’s a safe bet that plenty of similar funding attacks will emerge when the Texas legislature convenes in January.
Bridger also points to the need for a variety of education, testing and treatment options to combat STDs, including those provided by family-planning groups. Such services are essential as health officials struggle to convince younger, sexually active people to limit their number of partners, use condoms and regularly get checked.
“We’ve got an entire generation that didn’t experience the AIDS epidemic of the ’90s,” Bridger said. “They’ve become nonchalant.”
STD outcomes aren’t as potentially devastating as an AIDS diagnosis, but they can have life-changing effects if untreated. Both chlamydia and gonorrhea can lead to infertility, for example.
Bexar County isn’t alone in facing the problem.
Last month, the Centers for Disease Control released data documenting “steep and sustained” STD increases nationwide. Around 2.3 million cases of syphilis, chlamydia and gonorrhea were diagnosed in 2017, up by 200,000 from the prior year and marking the fourth consecutive year of increases.
“We need policymakers to invest in making STD testing and treatment more accessible for everyone, rather than less,” said Dr. Gillian Dean, Planned Parenthood’s senior director of medical services. “It’s critical that people everywhere have regular access to preventive care and community services, both before and after health crises emerge.”
Getting Schooled
Beyond access to treatment and testing, Bexar suffers from a problem facing the rest of the state: early access to sex education and contraception.
A research report by Texas Freedom Network found that 83 percent of Texas school districts taught abstinence-only or no sex education during the 2015-16 school year. While that’s down from the 96 percent the group discovered when it did a similar study eight years earlier, the number of districts still clinging to abstinence-only remains high.
And since the legislature voted in 2009 to drop health education as a high school graduation requirement, the number of districts providing no sex education instruction has soared, reaching more than 25 percent for the 2015-2016 school year, according to TFN research.
“What’s clear is that ignorance doesn’t protect anybody, and it certainly doesn’t protect young people from sexually transmitted diseases,” TFN Communications Director Dan Quinn said. “In many cases, sex education in the state of Texas is an exercise in ignorance.”
Local Fight
Still, local health officials are working to break the trend.
The Metro Health District provides free STD testing and treatment via a mobile van that allows it to reach frequently missed populations. What’s more, chlamydia and gonorrhea rates are down from last year in Bexar County.
This spring, Councilman William “Cruz” Shaw launched the “I Know My Status” campaign, which urged residents to test their HIV status. As a result of the campaign, Metro Health did more HIV tests in the month of April than it had for all of 2017.
With state and federal lawmakers more concerned about ideology than public health, it may take a lot more of such homegrown efforts to keep STDs from reaching a crisis level.
“With a lot of public health issues, where the rubber hits the road is in the cities and the counties,” Metro Health’s Bridger said.
