The latest annual report on the burden of sexually transmitted diseases in the United States, produced by the US Centers for Disease Control and Prevention (CDC), shows that STDs are still widespread, in some cases on the rise, and remain a serious threat to American public health, especially that of women and racial and ethnic minorities, said a senior CDC official on Tuesday.

The CDC’s report, Sexually Transmitted Disease Surveillance 2007, found there were over 1.4 million reported cases of chlamydia and gonorrhea in the United States that year, the latest year for which complete figures are available. These diseases are still the most commonly reported infectious diseases in the US, where they “pose persistent and preventable threats to fertility” said the federal agency in a press release.

The report also shows persistent racial disparities across STD figures, and the burden among women is also particularly heavy.

Director of the CDC’s Division of STD Prevention, Dr John M. Douglas, Jr, said:

“The widespread occurrence of these diseases should serve as a stark reminder that STDs remain a serious health threat in the United States, especially for women and racial and ethnic minorities.”

If chlamydia and gonorrhea aren’t treated, they can result in infertility, and infected women may find themselves unable to have children afterwards. As Douglas explained, this is a completely avoidable situation, if everyone worked together to “increase the use of proven prevention tools and make them widely available to those who need them”.

The report highlights that:

  • About 19 million new sexually transmitted infections occur in the US every year, with almost half of them among 15- to 24-year-olds.

  • There were more than 1.1 million reported cases of chlamydia in 2007, compared with 1 million in 2006, making it the largest number of cases reported to the CDC for any condition.

  • The rate of chlamydia among women was three times that of men (543.6 cases per 100,000 women versus 190 per 100,000 men).

  • There were more than 350,000 reported cases of gonorrhea in 2007, making it the second most commonly reported infectious disease.

  • The rate of gonorrhea was also higher among women (123.5 versus 113.7 per 100,000 for women and men respectively).

  • Racial disparities in the three most commonly reported STDs persist, with African-Americans bearing the greatest burden.

  • Although only 12 per cent of Americans are African-American, about 70 per cent of reported cases of gonorrhea, 48 per cent of chlamydia, and 46 per cent of syphilis in 2007 were from this group.

  • Black women aged between 15 and 19 bear a very high proportion of the burden of STDs. This is a particular worry because these diseases can make women infertile.

  • This group has the highest rate of both chlamydia and gonorrhea of any group (9,646.7 and 2,955.7 per 100,000 population respectively).

  • Syphilis, which was on the verge of being wiped out in the US, is now resurging, emerging as a threat in 2001 and showing a 15 per cent rise in reported cases between 2006 and 2007.

  • Syphilis is a growing threat especially to gay and bisexual men, who accounted for 65 per cent of the 11,466 reported cases of both primary and secondary syphilis.

  • Increased spread among men who have sex with men is thought to be the main driver of syphilis spreading in the US as a whole.

  • This is very worrying because the disease spreading in this way can accelerate HIV spread as well as resulting in irreversible conditions such as strokes.

  • Although primary and secondary syphilis is still lower among women (1.1 cases per 100,000 for women versus 6.6 for men), in more recent years the rate has been going up in women and young children, reversing years of decline in these groups.

  • Since 2004 syphilis among women has risen steadily, and the rate of babies born with the disease went up for the second consecutive year in 2007.

More prevention programs are needed to reduce the spread of STDs, said the CDC. As well as the threat to fertility, increasing risk of spreading HIV, and other health problems, STDs affect the economic health of the country, costing the health care system as much as 15.3 billion dollars a year, said the CDC.

“Sexually Transmitted Disease Surveillance 2007.”
US Centers for Disease Control and Prevention (CDC), Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, December 2008.

Click here for the full report.

Sources: CD.

Written by: Catharine Paddock, PhD