Viewpoints

As California ranks worst in nation for STIs, we need to address public health crisis

Some STDs at record highs in the U.S.

The Centers For Disease Control and Prevention released data showing that doctors diagnosed more than 2 million people with syphilis, gonorrhea or chlamydia in 2016. That's a record high in the United States.
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The Centers For Disease Control and Prevention released data showing that doctors diagnosed more than 2 million people with syphilis, gonorrhea or chlamydia in 2016. That's a record high in the United States.

California has long been a leader on forward-thinking policies, but the state is falling behind in addressing a major public health crisis: the continuing spread of HIV, hepatitis C (HCV), and sexually transmitted infections (STIs).

In recent years, California has seen a record rise in cases of STIs and a spike in the number of stillbirths caused by syphilis. California now ranks first among all states for the total number of cases of chlamydia, gonorrhea and syphilis.

California also leads the country in new cases of HIV, with over 5,000 diagnoses each year. More than 151,000 Californians are now living with HIV. Nearly half of them lack consistent care or access to treatment.

Indeed, it’s far too hard to even get an HIV or STI test in much of California. Outside of major urban areas, testing sites are rare, and access to rapid testing is low.

More than 400,000 Californians are currently living with hepatitis C, and most don’t even know it. Rates of chronic HCV have increased dramatically in recent years among young people, likely due to increases in injection drug use.

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Fortunately, there are clear solutions to this crisis. Highly effective tools now exist for these health conditions that can dramatically reduce new infections, ensure people receive life-saving care and treatment, and in the case of HCV and STIs, a cure. For the first time ever, public health leaders believe it’s possible to end these epidemics. What California needs is the political will to get the job done.

This week, a coalition of over 130 community organizations released a statement calling on Gov. Newsom and the Legislature to create an End the Epidemics task force. The task force would be charged with setting targets for ending the HIV, HCV, and STI epidemics and identifying priority programs, policies, and strategies for achieving these targets.

Other states are ahead of California. In New York, for example, Gov. Cuomo established a task force to end the HIV epidemic by 2020. New HIV infections have dropped by 20 percent over the last four years. New York now plans to establish an HCV elimination task force.

Even the Trump Administration got the message. In his State of the Union address, the president unveiled a national plan to end AIDS, targeting 48 highly impacted counties around the country. Eight of these counties are in California.

Scott Wiener - crop
Sen. Scott Wiener Credit: Lorie Leilani Shelley

Assemblymember Todd Gloria OFFICIAL.jpg
Assemblymember Todd Gloria

While we have our doubts that this president will do what it takes to end the HIV epidemic, given his administration’s focus on abstinence-only education and attacks on proven harm reduction strategies like safe injection sites — his recognition of the issue is a step forward.

As Chair and Vice Chair of the California Legislative LGBT Caucus, we know all too well how these preventable conditions impact our communities. Gay and bisexual men account for roughly three-quarters of HIV and early syphilis cases. Some estimate that around a quarter of transgender women, and more than half of black transgender women, live with HIV.

The statistics are particularly alarming in communities of color. Black people have rates of new HIV diagnoses, chlamydia and gonorrhea nearly five times those of whites. While black people are just under six percent of the population in California, they account for nearly 12 percent of HCV cases. Rates of new HIV diagnoses among Latinx individuals are nearly double those of whites. Bold action is needed to address the root causes of these health inequities, including stigma and institutional bias, poverty, unemployment, lack of access to healthcare and unstable housing.

With its aggressive implementation of the Affordable Care Act, California has laid the groundwork to end these epidemics. Yet, achieving this goal will require renewed commitment from elected officials and strategic investments in public health.

California has the tools, resources, and knowledge to do what it takes to end these epidemics. Now, Gov. Newsom and the Legislature must act. Together, we can get the job done.

Senator Scott Wiener represents San Francisco and northern San Mateo County, and Assemblymember Todd Gloria represents portions of San Diego County. They serve, respectively, as Chair and Vice Chair of the Legislative LGBT Caucus.
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