The number of reported cases of sexually transmitted diseases reached a record high in the US last year, figures show, as officials warned that stretched services meant people were slipping through the "public health safety net".
In its latest report, the Centres for Disease Control and Prevention said the sharp rise in syphilis was of particular concern.
"We have reached a decisive moment for the nation," Dr Jonathan Mermin, a director at the CDC, said.
"STD rates are rising, and many of the country's systems for preventing STDs have eroded. We must mobilise, rebuild and expand services - or the human and economic burden will continue to grow.”
More than 1.5 million chlamydia cases were reported in 2015, according to the report, while there were nearly 400,000 cases of gonorrhea, and nearly 24,000 cases of primary and secondary syphilis.
Cases of primary and secondary syphilis soared the most, rising by 19 per cent, while reports of gonorrhea increased by 12.8 per cent.
The CDC said that more than half of state and local STD programmes had experienced budget cuts in recent years, leading to the closure of more than 20 STD clinics in one year alone.
"STD prevention resources across the nation are stretched thin, and we’re beginning to see people slip through the public health safety net,” Dr Mermin said.
"Turning the STD epidemics around requires bolstering prevention efforts and addressing new challenges – but the payoff is substantial in terms of improving health, reducing disparities and saving billions of dollars."
Those most at risk were gay and bisexual men, while pregnant women were also advised to be tested.
“The health outcomes of syphilis – miscarriage, stillbirth, blindness or stroke – can be devastating,” Dr. Gail Bolan, Director of CDC’s Division of STD Prevention, said.
“The resurgence of congenital syphilis and the increasing impact of syphilis among gay and bisexual men makes it clear that many Americans are not getting the preventive services they need. Every pregnant woman should be tested for syphilis, and sexually active gay and bisexual men should be tested for syphilis at least once a year.”
In November, a leading sexual health consultant in the UK warned last year that the use of dating apps had contributed to a rise in sexually transmitted diseases.
Dr Peter Greenhouse, from the British Association for Sexual Health, said such smartphone apps facilitated casual sexual encounters. "That must increase the rate of which you change partners or find new partners and that in itself has got to increase the risk of sexually transmitted infections," he told Radio 1's Newsbeat.
Figures released by Public Health England last year show a 33 per cent rise in cases of syphilis and a 19 per cent increase in gonorrhoea diagnoses.
Why did humans become monogamous, apparently rejecting the promiscuity that is natural to most animals?
Was it morality? Religion? Maybe love?
The answer is germs, researchers said on Tuesday, arguing that the havoc caused by sexually transmitted diseases (STIs) convinced our ancestors it would be better to mate for life.
A research duo from Canada and Germany observed that STIs flourished among large groups of people living in the villages, towns and cities that arose after prehistoric hunter-gatherers settled down to farm.
Left unchecked, spreading diseases can affect individual fertility and a group's overall reproduction rate.
Falling population numbers would force a rethink of sexual behaviour - which in turn gives rise to social mores.
The researchers developed a mathematical model of hunter-gatherer demographics and likely STI spread among them.
They used it "to show how growing STI disease burden in larger residential group sizes can foster the emergence of socially imposed monogamy in human mating."
In small groups of no more than 30 individuals, with no chance for epidemic spread, STI outbreaks are generally short-lived, the team said.
The reduced risk may explain why small groups, both among early humans and today, are often polygynous (when men have more than one partner).
Socially-imposed human monogamy has long been considered an "evolutionary puzzle", according to the research duo.
It requires societies to put in place checks and structures - a police and court system, for example - to uphold societal mores.
"Yet, many larger human societies transitioned from polygyny to socially imposed monogamy beginning with the advent of agriculture and larger residential groups," said the paper.
That riddle may now be solved.
The research showed that our natural environment, with factors such as disease spread, "can strongly influence the development of social norms, and in particular our group-oriented judgements," study author Chris Bauch of the University of Waterloo in Canada told AFP.
But this did not necessarily mean that humans would become wildly promiscuous if drugs were to make STIs a thing of the past, he added.
"Modern societies are more complicated... and there is probably more than one reason that explains socially imposed monogamy," Bauch said by email.
"I think it is premature to speculate that marriage will disappear, or that polygyny will return, if we solve the problem of STIs."
The research was published in the journal Nature Communications.
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