STI Epidemic 2025: Why Rates Are Surging Post-Pandemic and How to Stay Safe

STI rates were already rising before COVID-19 — but the pandemic accelerated the trend significantly and the post-pandemic recovery has not reversed it. In 2025, chlamydia, gonorrhea, syphilis, and congenital syphilis are all at or near record highs in the United States and many other countries. Understanding what is driving the surge helps identify what responses are actually needed.

• Syphilis cases more than doubled in the US between 2018 and 2023, with congenital syphilis rising over 750% since 2012

• The pandemic disrupted STI testing and treatment services globally, creating a wave of undetected and untreated infections

• Recovery of sexual health infrastructure has been incomplete in many areas

• Budget cuts to public health — including at the CDC level — are reducing the capacity to respond

• Individual testing, treatment, and prevention remain the most effective personal responses regardless of systemic factors

Pre-Pandemic Trends: Already Going Wrong

The STI epidemic did not start with COVID-19. US rates of chlamydia, gonorrhea, and syphilis had been rising consistently for nearly a decade before 2020. Gonorrhea cases rose by 111% between 2009 and 2019. Syphilis cases quadrupled in the same period, with the most alarming increases in congenital syphilis — babies born with syphilis acquired from infected mothers — which had been a rare condition in the US for decades but was resurging rapidly. The drivers were well-understood: reduced access to public sexual health services, inconsistent condom use, changing sexual behaviours associated with dating apps, and the increasing prevalence of antibiotic-resistant gonorrhea strains making treatment harder.

How the Pandemic Made Things Worse

COVID-19 hit an already stressed sexual health infrastructure at speed. Sexual health clinics closed or drastically reduced capacity. Community outreach and testing programmes stopped. Condom distribution halted. Partner notification services were suspended. Healthcare workers were redeployed. For people who contracted an STI during 2020–2021, accessing testing and treatment was genuinely difficult in many areas. Infections that would have been caught and treated were instead allowed to persist and spread. The backlog of undetected STIs created during this period continued to generate new infections long after clinics reopened.

The particular vulnerability of pregnant women to syphilis screening delays during the pandemic contributed directly to the spike in congenital syphilis cases that followed. Syphilis is entirely preventable in newborns with timely screening and treatment — but only if healthcare access is maintained.

Post-Pandemic: Incomplete Recovery

Sexual health services did reopen, and some indicators have improved. But the recovery has been uneven. Rural areas, which had fewer services before the pandemic, have seen less recovery. LGBTQ+ health centres that were particularly hard-hit by funding cuts during the pandemic years have not all returned to pre-pandemic capacity. Workforce shortages in public health have reduced the availability of trained sexual health professionals. And the public health budget environment in the US — including proposed and implemented CDC funding cuts — has created new threats to the services that remained.

Who Is Most Affected

The burden of the current STI epidemic is not evenly distributed. Congenital syphilis is concentrated in the American South and in rural areas with limited prenatal care access. Young people aged 15–24 continue to account for the largest share of chlamydia and gonorrhea diagnoses. Gay, bisexual, and other men who have sex with men represent a disproportionate share of syphilis and HIV diagnoses. Black and Hispanic Americans face significantly higher STI rates than white Americans, reflecting structural inequalities in healthcare access rather than individual behaviour. These disparities are not new, but the current epidemic is deepening them.

What Individuals Can Do

The structural drivers of the current STI epidemic — funding cuts, healthcare access gaps, racial health disparities — require systemic responses that individuals cannot provide on their own. But there are concrete individual actions that matter: getting tested regularly (the CDC’s recommendations have not changed even as resources to implement them are strained), using condoms consistently, getting the HPV vaccine if not already vaccinated, and ensuring that any positive test result is followed by treatment and partner notification. At a broader level, supporting organisations that provide sexual health services and voting for representatives who prioritise public health funding are relevant civic actions.

Tips

• Get tested annually — at minimum. In the current high-prevalence environment, more frequent testing is appropriate for anyone with multiple partners.

• Use condoms — consistently, including for oral sex in higher-risk settings where pharyngeal gonorrhea is a genuine concern.

• Know your local services — find your nearest sexual health clinic and health department testing site before you need it. Services may be harder to access than before the pandemic.

• Ensure prenatal syphilis screening — if you are pregnant or planning pregnancy, confirm that syphilis testing is included in your prenatal panel. Do not assume it is automatic.

• Notify partners — if you test positive, telling recent partners allows them to test and treat, which directly reduces the burden on the wider community.

Frequently Asked Questions

Is congenital syphilis preventable?

Completely. Every case of congenital syphilis represents a failure of prenatal care — syphilis is detectable through a routine blood test and curable with penicillin during pregnancy. When that test is performed and treatment is provided in time, babies are not born with syphilis. The current epidemic of congenital syphilis reflects gaps in prenatal care access, not the inherent difficulty of preventing it.

Why are STI rates rising even in places with good healthcare?

Even in areas with good healthcare, several factors drive rising rates: reduced public health infrastructure for outreach and testing, increasing rates of unprotected sex among some populations, the decline in consistent condom use, and the expanding geographic reach of antibiotic-resistant gonorrhea. Good healthcare reduces the harm of STIs but does not prevent new infections without the behavioural and structural elements also being in place.

Is the rise in STIs linked to dating apps?

Partially. Dating apps have been associated with increased numbers of sexual partners and increased rates of casual sex in some populations, which can accelerate STI transmission. However, this is not the primary driver. The structural factors — reduced public health services, inconsistent testing, antibiotic resistance — are more significant. Dating apps can also be used to promote STI testing and partner notification.

What is happening with antibiotic-resistant gonorrhea?

Gonorrhea has developed resistance to every first-line antibiotic previously used to treat it. Current treatment relies on injectable ceftriaxone. Emerging resistance to ceftriaxone has been documented. A pipeline of new treatments exists but has not yet produced a reliable alternative. This makes prompt treatment of gonorrhea, test of cure, and reporting of treatment failures more important than ever.

How does funding affect STI rates?

Directly. Public health funding supports the clinics, outreach workers, contact tracers, and laboratory capacity that detect and respond to STI cases. When funding is cut, fewer cases are detected, treatment is delayed, and partner notification — which prevents onward transmission — is less complete. The relationship between public health investment and STI rates is well-documented.

Get Tested

Whatever the systemic context, the practical step available to you right now is testing. Fast, confidential testing is available at sexual health clinics and online.

Related reading: The Rise of Antibiotic-Resistant STDs · The Most Common STDs in the US · How Often Should You Get Tested? · Syphilis: Early Symptoms and Treatment