An annual report on sexually transmitted diseases released today by the US Centers for Disease Control (CDC) reports that in 2008 adolescent girls 15–19 years of age had the largest recorded number of
chlamydia and gonorrhea cases (409,531) when compared to any other age
group.

Women ages 20-24 were the next most affected group.

More than 1.5 million cases of chlamydia and gonorrhea were reported in 2008.

The
report – Sexually Transmitted Disease Surveillance, 2008, which tracks
reported cases of chlamydia, gonorrhea and syphilis in the United
States – also showed that African-Americans continue to be more
disproportionately affected by STDs than any other racial or ethnic
group.

Read the full report here.  See also this article by Amanda Marcotte and this one by Dr. Will Wong.

“While adolescent males have a similar prevalence of
STDs,” states the report, “biological differences place females at greater risk for STDs
than males.”

Additionally, the health consequences are more severe among
females than males for chlamydia and gonorrhea – the two most commonly
reported infectious diseases in the United States. These diseases may
have no symptoms and often go undetected. CDC estimates that half of
new gonorrhea cases and more than half of new chlamydia cases remain
undiagnosed and unreported.

Left untreated, it is estimated that 10-20
percent of chlamydia or gonorrhea infections in women can result in
pelvic inflammatory disease, which can lead to long-term complications,
such as chronic pelvic pain, ectopic pregnancy (a potentially
life-threatening form of pregnancy where implantation of the fertilized
egg occurs outside the uterus) and infertility.

Untreated STDs are
estimated to cause at least 24,000 women to become infertile each year
in the United States.

“When you take into account the severe
health consequences of STDs and the millions of Americans infected
every year, it is clear that much more work needs to be done to prevent unintended long-term health issues,” said Kevin Fenton, M.D., director
of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB
Prevention. “We know adolescent girls and minorities are most impacted
by STDs. So it is up to us as a nation, to reach out to them and ensure
we are providing the necessary prevention, testing and treatment
services. Taking these critical steps now could help reduce the number
of couples who may not be able have children in the future because of a
previously undiagnosed, yet treatable, STD.”

In
the United States overall, about 1.2 million cases of chlamydia were
reported in 2008; almost 337,000 cases of gonorrhea were reported in
the same year.

STDs are taking a disproportionate toll on racial minorities, especially among young African-American women.

Racial
minorities continue to face severe disparities in all reportable STDs,
but African-Americans are the group most impacted. Gonorrhea rates
among African-Americans are higher than any other racial or ethnic
group and 20 times higher than that of whites. Blacks represent 12
percent of the U.S. population, but accounted for about 71 percent of
reported gonorrhea cases and almost half of all chlamydia and syphilis
cases (48 percent and 49 percent, respectively) in 2008.

Among
women, black women 15 to 19 years of age had the highest rates of
chlamydia and gonorrhea (10,513 per 100,000 and 2,934 per 100,000,
respectively), followed by black women ages 20 to 24 (9,373 per 100,000
and 2,770 per 100,000, respectively).

“We cannot ignore the
glaring racial disparities in rates of STDs, particularly when we
consider the hard truth that gonorrhea rates among African-Americans
are 20 times those of whites,” said John M. Douglas, Jr., M.D.,
director of CDC’s Division of STD Prevention. “Research has shown that
socioeconomic barriers to quality health care and higher overall
prevalence of STDs within minority communities contribute to this
pervasive threat. It is imperative that we improve access to effective
STD prevention and treatment services in local communities for those
who need them most.”

Syphillis is on the rise

Syphilis,
once on the verge of elimination, began re-emerging as a threat in
2001, according to CDC.

In 2008, 13,500 cases of primary and secondary syphilis cases
were reported, an almost 18 percent increase from 2007. The majority of
these syphilis cases (63 percent) continues to be among men who have
sex with men (MSM). Increased syphilis transmission among MSM is
believed to be the primary driver of syphilis rate increases
nationally. For MSM, syphilis infection is of particular concern
because it can facilitate HIV transmission and lead to irreversible
complications such as strokes, especially in those who are HIV-infected.

While
occurring at substantially lower levels among women than men, syphilis
rates have been increasing among women since 2004. In 2008, the
syphilis rate among women increased 36 percent from the previous year
(1.1 cases per 100,000 women in 2007 vs. 1.5 in 2008). By comparison,
rates among men increased 15 percent from the previous year (6.6 cases
per 100,000 men in 2007 vs. 7.6 in 2008). Untreated syphilis can be
transmitted from pregnant women to infants and can result in
stillbirths, infant deaths, or severe complications in children who
survive.

Intensified efforts are needed to reduce the toll of STDs

To
reduce the toll of STDs and protect the health of millions of
Americans, expanded education and prevention efforts, including
increased screening, are urgently needed. Chlamydia, gonorrhea and
syphilis cases represent only a fraction of the true STD burden in the
United States. CDC estimates that a total of almost 19 million new
sexually transmitted infections occur each year, almost half of which
are among 15- to 24-year-olds. In addition, CDC estimates that STDs
cost the U.S. health care system as much as $15.9 billion annually.

Since
treatment of STDs is essential to prevent long-term health
consequences, early testing and diagnosis are crucial. STD screening
remains one of the most effective yet underutilized tools to protect
heath and prevent the further spread of these diseases. Recent data
show that less than half of sexually active women under 26 are screened
for chlamydia – the most commonly reported infectious disease. CDC
recommends annual chlamydia screening for sexually active women younger
than 26 years of age, and supports U.S. Preventive Services Task Force
recommendations to screen high-risk, sexually active women for
gonorrhea. CDC also recommends that all sexually active MSM be tested
for syphilis, chlamydia, gonorrhea and HIV at least annually.