S.C. Department of Health and Environmental Control Columbia headquarters (Photo by Bee Brawley)
Richland County has the third-highest rate of sexually transmitted disease in the nation, and a local expert said the reason might be complex.
Bernard Gilliard, an expert with the S.C. Department of Health and Environmental Control, said many factors ultimately contribute to the county’s high STD rate. The state, too, has a high rate of confirmed cases.
“You’ve really got to peel the onion to kind of figure out why certain states, or in this case, certain counties rise to the top as worse,” said Gilliard, who works with DHEC’s Partner Services & Disease Intervention Program.
Some populations are more empowered to get tested or have better access to testing locations. That, combined with people’s reluctance to talk about diseases with a partner, drive up the numbers.
South Carolina has large rural areas, and that can affect how often people get tested, because of a lack of healthcare providers or a lack of public transportation in those areas, Gilliard said.
“STDs are not something that can be (handled) through telemedicine or telehealth,” Gilliard said. “With virtual exams and virtual questions and stuff like that you can ask the history — the questions virtually. But you really have to do an exam or collect specimens to then send off to the lab.”
With telemedicine, specimens would have to be self-collected or a patient would have to go to a clinician to have a sample collected to even be treated in South Carolina, Gilliard said.
South Carolina is a test and treat state, which means that every case counted in the state must first be confirmed with lab testing before treatment is offered.
Gilliard also noted that South Carolina saw a dip in cases during the start of the COVID-19 pandemic, but those numbers have risen since 2020.
“Since COVID has relaxed a little bit, and healthcare providers have opened up and folk have gone back out in the community more, there is that rebound — or bounce back — (toward) pre-pandemic levels,” Gilliard said.
It’s not just Richland County’s problem. The state itself also ranks third in the nation, according to a report from NYRequirements.com.
The report calculates rankings per 100,000 residents, using data collected from the Centers for Disease Control and Prevention.
Gilliard expects the state’s STD rates will fall in due time.
“I see South Carolina moving down and national rankings and the counties moving down in the county rankings,” Gilliard said.
South Carolina now allows healthcare providers to give medication to the patient to then pass on to any partners that might have been infected as well. Now, those people don’t have to see a doctor themselves. This means that states treating patients this way are not really counting all of their cases, Gilliard said.
“So now … South Carolina, South Carolina will probably drop further down as a state, and the counties may drop further down,” said Gilliard.
Right now, STD rates could be high because of the stigma of talking with a partner about possible infection.
“People don’t want to talk about sex,” said Shannon Shields, the HIV program manager at CAN Community Health, a nonprofit that helps those affected by sexually transmitted diseases. “They know it’s happening, and it happens all the time, everywhere, and they don’t want to talk about it.”
Shields said having an open dialogue about STDs would be a good first step toward lowering the state’s high rate.
“If we start talking about this more, and the importance of signs and symptoms and screenings … that can make a big difference,” she said. “It’s hard to do that in the state of South Carolina.”