In 12 years, chlamydia rate doubles, screening funds flat

Last year more than 14,000 Minnesotans tested positive for chlamydia. That's more people than live in the city of Bemidji.

Chlamydia is the most common sexually transmitted infection in the state, yet the state seemingly hasn't done enough to stop the spread. Infection rates have doubled in the past 12 years.

The Minnesota Department of Health on Tuesday is holding a statewide summit to draw attention to the problem.

The agency said it's asking for help from the community because it doesn't have the money it needs to tackle the problem alone.

The money issue is familiar in times of tight budgets, but the Health Department has never had money to spend on chlamydia prevention.

The federal government gave the Health Department $750,000 last year to pay for chlamydia testing, treatment and disease surveillance. Prevention money wasn't included in the grant.

The state of Minnesota gave even less for chlamydia prevention and treatment -- lawmakers didn't give the agency any direct funding to deal with chlamydia.

Candy Hadsall is an STD specialist at the Health Department. She said if Minnesotans want to stop the chlamydia epidemic, they need to come up with a new game plan.

"It isn't going to come from the Health Department," Hadsall said. "It's going to have to come from the people of Minnesota who say that having this level of chlamydia is unacceptable."

To get the ball rolling, the Health Department has created the Minnesota Chlamydia Partnership. The partnership includes business leaders, educators, health professionals and others who will share ideas with the agency on how to reduce chlamydia rates. One strategy the partnership hopes to address is the quality and availability of sexual health education.

Traditionally, Minnesota has relied on the schools to pass along prevention messages about sexually transmitted diseases such as chlamydia. But over the past fifteen years, many schools have cut back or eliminated their sex education programs.

Hadsall said kids need to be told that the only way to avoid getting chlamydia from an infected person is to abstain from sex or use a condom. But that message is controversial.

"It's a huge political issue," she said. "A lot of people believe that if we provide education to young people around how to protect yourselves if you're being sexual, they think that that is promoting kids to have sex."

Hadsall said the fact is, many young people are having sex. Sixty-nine percent of the Minnesotans who had positive Chlamydia tests last year were between the ages of 15 and 24.

Dr. Amy Gilbert treats adolescent patients at The Annex Teen Clinic in Robbinsdale. As a matter of routine practice, the clinic tests all of its teens for chlamydia, regardless of their reasons for seeking care.

Gilbert says most patients who have the bacteria don't experience the burning sensation or a discharge that sometimes signals the disease, so they have no idea that they're infected, making it even easier to spread.

At Gilbert's clinic, 12 percent of boys and 8 percent of girls tested positive for the disease in April, May and June 2010.

"You don't feel anything," Gilbert said. "Most girls and guys too don't have any symptoms. So, they're often surprised."

The disease is not a welcome surprise. But the good news is their positive test gets them the antibiotics they need and they get better.

Gilbert said untreated chlamydia is like a ticking time bomb. It's a major cause of infertility in the U.S.

"It can cause scarring in the fallopian tubes, so that the egg can't get through," Gilbert said. "So it's a significant cause of infertility. Sometimes it will cause chronic, ongoing pelvic pain that can no longer be treated by antibiotics because it's due to scarring, rather than to the presence of the bacterium anymore."

It can also cause potentially life-threatening ectopic pregnancies, where the egg gets fertilized in the scarred fallopian tubes and implants there, rather than the uterus. For males, long-term inflammation of the sexual organs can also cause infertility.

Gilbert said it's shocking that Minnesota isn't dedicating any money toward preventing chlamydia.

"This is not an inner city problem -- this is everywhere," she said. "And legislators throughout the state should know that and should be fighting to decrease chlamydia."

There have been attempts at the Legislature to fund STD prevention.

Rep. Maria Ruud, DFL-Minnetonka, is a nurse practitioner at a clinic in Uptown Minneapolis, where she treats many patients infected with chlamydia.

Two years ago, Ruud introduced a bill that would have directed the commissioner of Health to come up with a plan to reduce STD rates. Her bill received a hearing, but it didn't advance.

Ruud says she didn't detect any moral opposition from her legislative colleagues -- just concerns about funding the bill.

"Money is always going to be something that we're going to have to be struggling with," she said.

Ruud says if she's re-elected, she'll probably reintroduce her STD bill during the next legislative session -- even though funding is still a potential roadblock.

She says, at the very least, it would be a chance to make more of her colleagues aware of the state's chlamydia and STD problems.

"It's kind of an education process when you're at the Legislature, for other legislators," said Ruud. "I think you have to introduce the problem and educate legislators, so they have an understanding of what the problem is."

With more prevention money from state lawmakers unlikely for now, the work of the Minnesota Chlamydia Partnership may represent the state's best hope for reducing its STD rates in the short term.

There are signs that federal officials are interested in changing the way they spend money on sexually transmitted diseases.

During a national STD conference in March, the Centers for Disease Control and Prevention described a new effort at the agency to take a more holistic view of sexual health. Hadsall said that would be a huge paradigm shift.

"It will mean that, while we haven't had money or an emphasis on prevention around STDs, we will begin to have that," Hadsall said. "That's clearly one of the things that needs to happen."

Hadsall predicts it will take time to see results. But she hopes in a few years, chlamydia and other STD infections will be tackled in the same comprehensive way as conditions like heart disease and cancer.