The Black community in Indianapolis is faring better than the African American population nationwide in terms of rising rates of syphilis and chlamydia.
The Centers for Disease Control and Prevention’s 2018 Sexually Transmitted Disease (STD) Report found that rates of syphilis, chlamydia and gonorrhea have surged for the fifth year in a row. The risk of contracting these diseases disproportionately affects the Black community nationwide. Black women around the nation are 4.7 times more likely to contract syphilis than white women, 6.9 times more likely to contract gonorrhea and 5 times more likely to contract syphilis. Black men are 4.8 times more likely to contract syphilis than white men, 8.5 times more likely to contract gonorrhea and 6.8 times more likely to contract chlamydia.
While Indiana is following the national trend for an increase of these diseases, Indiana’s Black population is less likely to have chlamydia and syphilis, according to the Indiana State Department of Health STD Database. As of February 2019, 33.5% of patients diagnosed with chlamydia were Black, as opposed to 42.3% of white patients. Black patients made up 41.8% of syphilis cases, as opposed to 48.1% for Indiana’s white population. Gonorrhea affects more African Americans in Indiana, however, with 44.9% of new cases of the disease being diagnosed in Black patients, as opposed to 40% for white patients.
Despite decreases in syphilis and chlamydia in Indiana’s African American community, Marion County’s general population has not seen the same improvement. According to a report from the Marion County Health Department from October 2018 to October 2019, 22 new cases of gonorrhea were diagnosed, and the rate of syphilis has increased by nine cases in the county.
The Marion County Public Health Department plans to do more to curb the spread of these and other STDs throughout the county.
“The Marion County Public Health Department’s Bell Flower Clinic (BFC) and STD Control Program are striving to address rising rates of STDs here in Marion County and surrounding areas through a variety of efforts,” the organization said in a statement. “Bell Flower has increased its capacity to respond to STDs and HIV by employing more Disease Intervention Specialists whose work helps to directly intervene in the spread of disease.”
The clinic also plans to add a second mobile unit to further expand testing and treatment services, as well as increase public education communication about STDs and Bell Flower Clinic through an updated website and social media advertisements.
Despite the Black community in Indiana being less likely to have syphilis and chlamydia than the African American population nationally, African American Hoosiers are still at risk for some of the lesser-discussed risk factors, including poverty and racial bias in the medical field.
Dr. Sandra E. Ford, board vice president for the National Association of County and City Health Officials, was not surprised by findings of the CDC report.
“Data highlighting the overrepresentation of sexually transmitted disease in the African American population is disappointing, but not shocking,” Ford said in a press release. “More emphasis must be placed on those issues that present barriers to prevention and care of not only STD’s, but other chronic disease, such as poverty and lack of insurance, as well as racism,” Ford continued. “Until we take a hard look at these factors, we will continue to see broad inequities in disease prevalence that we are currently observing.”
In Indiana, poverty and limited access to health care disproportionately affect the African American community and play a role in the rate of STD transmission. According to the United States Census Bureau’s Small Area Health Insurance Estimates (SAHIE), 22% of African Americans in the state do not have access to health insurance. The Census Bureau reported in 2018 that 28% of African Americans in Indianapolis live at or below the poverty line. These barriers can delay the diagnosis and treatment of STDs, which can result in lifelong damage.
“A central theme is lack of access,” said Wanda Savala, public affairs director for Planned Parenthood of Indiana and Kentucky (PPINK). “Too many people aren’t getting the health care and the education they need, and when there’s not access, they take more risky behaviors, and it makes it more likely they’ll contract an STI (sexually transmitted infection).”
Limited access to routine health care screenings make it less likely that STDs will be detected in the early stages, which is key since STDs are often asymptomatic and can cause permanent damage to the reproductive system. According to the CDC, untreated STDs can result in infertility, pelvic inflammatory disease (PID) in women, damage to internal organs, and in extreme cases, death.
Testing for STDs became a casualty in the Trump administration’s campaign against abortion. A gag rule set in place earlier this year to keep doctors who receive federal funding from performing abortions has made it more difficult for low-income families to get health care. The Title X program provided money to health care facilities around the country to offer health care access, birth control and STI testing to low-income families since 1970.
According to the Title X Family Planning Annual Report in 2016, two-thirds of people the program serves live at or below the federal poverty line, and nearly half of those people lack health insurance. The report found that, of the four million people who rely on Title X for health care, 21% are African American.
“The administration has pushed through a gag rule that says doctors who get Title X funding cannot perform abortions. Planned Parenthood lost funding because we offer abortions,” Savala said. “It’s important to note that Title X dollars never went towards abortions, so this is taking away funding from wellness screenings and STI testing for low income families.”
Contact staff writer Breanna Cooper at 317-762-7848. Follow her on Twitter @BreannaNCooper.