Racial disparity, access to care are among the factors keeping STI rates elevated in Greater Peoria
Sexually transmitted infections remain a major health concern in the Greater Peoria area.
The Peoria City/County Health Department issued its 2022 report on STIs at this week’s board of health meeting. The findings show Peoria's rates are higher than state and national averages, and that race, education, poverty and access to care are among the key factors.
The report shows a 27% drop in gonorrhea cases from the previous year, but syphilis cases increased by 11% and chlamydia infections also ticked higher.
“We're still seeing the same trends that we have seen historically here in Peoria County,” said PCCHD epidemiologist Tracy Terlinde. “Our rates continue to be highest among our African American residents, highest in our 61603, -04 and -05 zip codes (and) in the 15-29 year old age group.”
Terlinde noted overall syphilis rates have increased four times since 2017, and are highest among individuals in their 20s. She said the higher concentration in the indicated zip codes increases the likelihood of choosing a sexual partner with an STI.
“Rates of chlamydia among our African American females are nine times that of their white counterparts, and for African American males are more than 15 times that of their white counterparts,” she said. “The drastic difference is also observed in rates of gonorrhea, where African American females are nine times that of their white counterparts and African American males are more than 30 times that of their white counterparts.”
The Tazewell County Health Department also reports a drop of almost 30% in gonorrhea over the past two years, with the disease most common among age 20-34. However, confirmed chlamydia cases saw a spike of more than 20%, and the incidence rate is 2.7 times what it was in the previous year.
Deric Kimler serves as the executive director for Central Illinois Friends, an organization that provides free sexual health testing, treatment, and services for those facing higher barriers to accessing care. He said the region's STI rates suggest a number of things.
“One, hopefully it says we're doing our job in terms of destigmatizing getting tested and destigmatizing talking about sexual health,” said Kimler. “You can't lower STI rates unless you increase access to care, and destigmatize being able to talk about comprehensive sexual health. When you don't talk about sexual health, when you just pretend the abstinence is the only way to protect yourselves, those are the locations in the geographical areas to have higher rates.”
Terlinde said disparities based on race, economic status, gender and gender identity, age and other characteristics have systemically presented obstacles to health care.
“This can create a disproportionate burden of preventable disease,” she said. “Individuals who experience health disparities may not trust health care systems or worry about the stigma of having an STI and may not come in and get tested.
“So we do when we highlight disparities of populations and places, we don't want people to say, ‘Oh, I don't have to worry about that. I don't fall into that group.’ But this is where we're seeing it, and this is where we need to do our outreach. We need to focus on that: anybody who is at risk of an STI and having sex with multiple partners, you need to be tested.”
Kimler said increasing education and overcoming the stigma around STIs are the first steps.
“In our field, we hear a lot of language of, ‘Oh, they're dirty,’ or ‘I'm clean,’ or, ‘I have clean sex.’ Well, there's no such thing as any of that. Right? There’s actually no truth in those sayings,” he said. “The reality is, if you've ever been sexually active, period – even with a condom – you should get tested for all STIs, including herpes, and you should have an education about HPV (human papillomavirus infection), and what makes sex safe and consensual.
“What a lot of people think is safe sex is a condom; you put on a condom, you use it and it's fine. Actually, that's not the case. Everything lowers your rates of transmission, but there's still always a chance of transmission during sexual activity. So we're having one-on-one education, to go in depth about how to give consent, how to gain consent, how to protect yourselves with the types of sex you're having. That's where it all starts.”
Terlinde noted the drop in gonorrhea rates is actually a bit of a red flag, pointing out the infection is asymptomatic almost 80% of the time.
“That is something that we're keeping our eye on,” she said. “When people typically get tested for an STI, they're tested for both gonorrhea and chlamydia. So that is on our radar, on why it did decrease. It is important that we advocate and educate and do outreach on extra genital testing, as urine samples alone can miss 70-80% of chlamydia or gonorrhea cases.”
Kimler noted that while Peoria and central Illinois rank comparatively high in the state and the nation, the U.S. leads the world in STIs.
“And if you look at what United States does differently than what other countries do, it’s that we don't have regular access to preventative services (and) we don't talk about sex the way that other medical institutions do in other countries,” said Kimler. “We look at sex as faux pas — ‘just don't have it.’ Even though it's the creation of life, we have a hard time talking about it, right?
“It's actually the greatest thing that ever happened to each and every single person that ever walked on this earth, because it gave us life. But we don't want to talk about it, and because we don't talk about it, STIs have now become the leading cause of seven of the most common cancers in the United States. So simply by not talking about sex, we are killing ourselves.”
Terlinde said the health department's outreach education works to put people at ease about STI testing and treatment.
“At the health department, we strive to be a trusted health facility in the community, a health partner in the community. So when you come in for testing and treatment, you're treated with respect and privacy,” she said. “That's fairly important when you when you're coming in because however you contracted an STI is a private matter, and it can be very traumatizing. So being anonymous when you do come in and having that respect and trust with our health care workers is very important.”
Central Illinois Friends can provide treatment for some STIs, said Kimler, and referral services for those that they can't. But he said their counseling and outreach efforts are just as important.
“Most people go into a sexual health (clinic), they think, ‘Oh, I'm gonna to pee in a cup, they're gonna take my blood, they're gonna test me. They're gonna give me my results. If I’ve got something, I'm gonna be treated,’ et cetera,” said Kimler.
“At Central Illinois Friends, all those things happen, but we also have the talk and we meet you where you're at. We don't waste your time to learn every single thing; we listen to you, find out what types of sex you're having, and talk about how you can prevent STIs and how you can talk to partners about going forward.”