Progress Seen in Cutting STDs
By Nancy Walsh, Staff Writer, MedPage Today
Published: November 22, 2010
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
Action Points
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Explain that rates and reported cases of gonorrhea are at an all-time low in the U.S.
Explain that syphilis cases did not increase among women for the first time in five years, and that rates of chlamydia increased only minimally in 2009.
Public health efforts to cut rates of s*xually transmitted diseases (STDs) appear to be making some headway, according to a new report from the CDC.
One noteworthy example: 301,174 cases of gonorrhea were reported during 2009, for an incidence rate of 99.1 per 100,000 -- the lowest level recorded since CDC's surveillance for the disease began in 1941.
CDC estimates that there are 19 million new cases of STDs each year, carrying a price tag of $16.4 billion.
But notable disparities exist in STD rates according to age and race, the CDC report said.
For instance, while there was an overall 10% decline in cases of gonorrhea over the past year, the CDC noted that the biggest drop occurred among whites at 25% -- compared with a 21% decline for Hispanics, and 15% among African Americans.
A total of 71% of cases of gonorrhea in 2009 were reported in blacks -- particularly in young black women ages 15 to 19, who had a rate of 2,613.8 per 100,000.
Among Hispanics, gonorrhea rates for those ages 20 to 24 were much higher than for whites in the same age group -- 274.9 per 100,000 versus 186.4 for women and 215.7 per 100,000 versus 80.8 for men -- and the highest gonorrhea rates among all Hispanics.
For chlamydia, there was a 3% increase in diagnoses in 2009 and an increase of almost 20% since 2006.
"This is actually good news," the CDC report commented. "The increase is likely due to expanded screening and not an increase in disease."
Indeed, since 2000, the rate of screening for chlamydia among young women has risen from 25% to 47%.
With 1,244,180 cases of chlamydia reported in 2009, the infection rate was 409.2 per 100,000.
However, CDC investigators believe that many cases aren't detected or reported, and that there are actually 2.8 million cases of chlamydia each year.
The highest burden of chlamydia in 2009 was among black women ages 15 to 24, who had a rate of 10,629.7 per 100,000, according to the report.
And Hispanics in their early twenties had twice the rate of chlamydia compared with whites, the CDC said.
For the third reportable STD -- syphilis -- there were 13,997 cases of primary and secondary disease in 2009, for a rate of 4.6 per 100,000.
The overall number of cases of syphilis has increased almost 40% since 2006, with 62% of cases occurring in men who have s*x with men.
Among women, there was an 88% increase in cases of syphilis between 2004 and 2008, but 2009 saw a 7% decrease, the agency found.
There also has been a decline in cases of congenital syphilis from 1991 -- when 4,424 infants were infected -- to 427 cases in 2009.
The rate of syphilis among blacks in 2009 was 19.2 per 100,000, compared with 4.5 in Hispanics, and 2.1 in whites.
A "concerning new trend" was a tripling of cases of primary and secondary syphilis from 19.3 per 100,000 among young black men in 2005 to 58.2 in 2009, the authors of the CDC report observed.
The CDC report offered these recommendations to help curtail the spread of STDs:
For gonorrhea, high-risk s*xually active women should be screened
For chlamydia, women younger than 26 should undergo screening annually
For syphilis, men who have s*x with men should be tested annually, and should also be screened each year for gonorrhea, chlamydia, and HIV
"Screening can help detect disease early and, when combined with treatment, is one of the most effective tools available to protect one's health and prevent the spread of [s*xually transmitted diseases] to others," a fact sheet accompanying the report concluded.
The authors of the report are CDC employees.
Primary source: Centers for Disease Control and Prevention
Source reference:
Centers for Disease Control and Prevention "Trends in s*xually transmitted diseases in the United States: 2009 national data for gonorrhea, chlamydia and syphilis" 2010.
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Wednesday, November 24th 2010 at 11:01AM
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