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Sexually Transmitted Infections

Narrative

Sexually transmitted infections (STIs) are considered a hidden epidemic because symptoms are often absent and the causes are not openly discussed. Yet there are approximately 19 million new STI cases in the United States each year at an annual health care cost of nearly 16 billion dollars.1 Active infections can increase the likelihood of contracting another STI, such as HIV, and untreated STIs can lead to pelvic inflammatory disease, infertility, and adverse pregnancy outcomes. Safer sex practices, screening, and treatment can help reduce the burden of STIs.

The Centers for Disease Control and Prevention requires state and local reporting of new chlamydia, gonorrhea, syphilis, and HIV cases (see page on HIV/AIDS). Reported STI rates among females of all ages vary by age and race and ethnicity. Rates are highest among adolescents and young adults; over 70 percent of all chlamydia and gonorrhea cases in females occurred among those under 25 years of age in 2009. With the exception of Asian/Pacific Islanders, minority females had higher STI rates than non-Hispanic White females. For example, compared with non-Hispanic White females, the chlamydia rate was 7.8 times higher for non-Hispanic Black females, 4.5 times higher for American Indian/Alaska Native females, and 2.9 times higher for Hispanic females. The syphilis rate was also highest among non-Hispanic Black females (8.2 versus 1.4 per 100,000 females overall).

Although chlamydia, gonorrhea, and syphilis can be cured with appropriate antibiotics, viral STIs, such as herpes, HIV, and human papillomavirus (HPV) cannot be cured but can be monitored and managed to prevent symptoms and disease progression.2 HPV is the most common STI with over 40 different types, some of which can cause genital warts and cervical cancer among women. Overall, 41.3 percent of women aged 18–59 tested positive for one or more HPV types in 2005–2008. While HPV cannot be treated, it may clear on its own over time. HPV was detected in over 50 percent of 18- to 24-year-olds compared to about 40 percent of women aged 25–59. Non-Hispanic Black women also had a higher prevalence of HPV infection than non-Hispanic White and Mexican American women (57.7 versus 38.5 and 45.1 percent, respectively). A vaccine for high-risk HPV types is available and recommended for girls and young adult women. Pap smears can also detect early disease signs that can be treated to prevent cervical cancer.2

1 Centers for Disease Control and Prevention. Trends in Sexually Transmitted Disease in the United States: 2009 National Data for Gonorrhea, Chlamydia, Syphilis. November 2010. Accessed 04/27/11.
2 Centers for Disease Control and Prevention. Sexually Transmitted Diseases & Related Conditions. August 2010. Accessed 04/27/11.

Graphs

Data

Rates of Chlamydia and Gonorrhea Among Females (All Ages), by Race/Ethnicity, 2009
Race/Ethnicity Rate per 100,000 Females
Chlamydia Gonorrhea
*May include Hispanics.
Source: Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2009. Atlanta: U.S. Department of Health and Human Services; 2010.
Non-Hispanic White 270.2 32.8
Non-Hispanic Black 2,095.5 557.5
Hispanic 788.8 63.0
Asian/Pacific Islander* 221.9 18.5
American Indian/Alaska Native* 1,214.9 147.3
Total 593.4 105.7

HPV Infection* Among Women Aged 18–59, by Age, 2005–2008

Percent of Women:

  • Total: 41.3
  • 18-24 Years: 51.3
  • 25-44 Years: 40.5
  • 45-59 Years: 38.1

*Based on lab results from a vaginal swab.

Source: Centers for Disease Control and Prevention, National Health and Nutrition Examination Survey, 2005-2008. Analysis conducted by the Maternal and Child Health Information Resource Center.

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