Marion County health officials are promoting STD testing in light of rising local infection rates. (Courtesy/Marion County Health Department)
Marion County health officials are urging people to get tested for sexually transmitted diseases to fight a five-year rise in local infections.
Reported gonorrhea cases have more than tripled over the past five years, with about 500 county residents diagnosed in 2018.
Chlamydia has also become more common, with nearly 1,900 cases reported in 2018.
As the most common sexually transmitted infection health officials track, chlamydia is “the canary in the coal mine,” Marion County health officer Dr. Christopher Cirino said. A rise in those infections typically means other diseases will increase too.
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Marion County has one of the highest rates of chlamydia and gonorrhea among Oregon counties, state data show. If untreated, those diseases can cause longer-term health problems including infertility.
(Graphic by Rachel Alexander/Salem Reporter)
The rise mirrors Oregon and national trends and is likely due to a mix of factors, Cirino said, including decreased condom use, people using apps to find casual sex partners and recreational drug use, which can both spread infections and cause people to engage in higher-risk sexual behavior.
“People are having riskier sex,” said Katrina Rothenberger, the county public health division director. “Less frequent condom use is definitely a contributing factor.”
Public health departments also have less money to grapple with more STD cases, though that trend is starting to reverse, Rothenberger said.
From 2017 to 2019, Marion and Polk counties spent $463,238 fighting communicable diseases through testing, investigation and treatment, nearly all of it on STDs. The county usually refers people to their own doctor for treatment, but can provide care for people who don’t have insurance or a doctor.
Several years ago, Oregon eliminated some jobs for disease intervention specialists, who helped local health agencies respond to increases in communicable diseases, she said.
Marion County doesn’t have the resources to investigate chlamydia cases to identify how the disease is being spread or notify partners of those infected, Rothenberger said. The county does offer those services for gonorrhea, syphilis and HIV.
Teenage girls and young women between 15 and 24 make up most chlamydia diagnoses, county data shows. Sexually active people 25 and under should be screened for chlamydia and gonorrhea, Rothenberger said.
“We’re especially concerned about people in that age range,” she said.
To encourage testing and treatment, the health department launched a mobile testing van in the spring of 2018 with a state grant. People can receive immediate HIV results and get tested for chlamydia, gonorrhea and syphilis.
County workers travel to local events and festivals, like Cinco de Mayo and this weekend’s Capitol Pride, offering free testing and counseling to anyone.
“They talk with the client about prevention and how to stay healthy,” said Maricarmen Gomez Reyes, who coordinates the testing program.
They also visit places like Chemeketa Community College, local alcohol and drug treatment centers and the ARCHES day center for homeless people to encourage testing for people who might not seek it out on their own.
“You really need to go out to these populations,” said Wendy Zieker, the nurse program manager.
Though they’re far less common, the county has seen an increase in syphilis and HIV, with 22 new HIV infections and 95 new syphilis cases in 2018. That’s up from 12 HIV cases and 25 syphilis cases in 2013.
In Marion County, one in five people diagnosed use methamphetamine or inject other drugs.
In a July 18 letter, Cirino urged local health care providers to test meth and injection drug users for HIV, syphilis and hepatitis C regardless of the reason for their visit.
Men who have sex with men are at higher risk for gonorrhea and syphilis, Cirino said, because anal intercourse most easily spreads those microbes.
Health officials said their goal is to end stigma around testing and treatment and encourage people to have open conversations with sexual partners about their health.
“If you are going to partake in intercourse, one should be able to be comfortable talking about sexual history with that partner,” Cirino said.
Reporter Rachel Alexander: [email protected] or 503-575-1241.