Sexually Transmitted Diseases—

Five Key Points:

Sexually transmitted diseases (STDs), once called venereal diseases, are among the most common infectious diseases in the United States today. More than 20 STDs have now been identified, and they affect more than 13 million men and women in this country each year. The annual comprehensive cost of STDs in the United States is estimated to be well in excess of $5 billion.

Understanding the basic facts about STDs--the ways in which they are spread, their common symptoms, and how they can be treated--is the first step toward prevention.

What are some of these basic facts?

It is important to understand at least five key points about all STDs in this country today:

1.STDs affect men and women of all backgrounds and economic levels. They are most prevalent among teenagers and young adults. Nearly two thirds of all STDs occur in people younger than 25 years of age.

2.The incidence of STDs is rising, in part because in the last few decades, young people have become sexually active earlier yet are marrying later. In addition, divorce is more common. The net result is that sexually active people today are more likely to have multiple sex partners during their lives and are potentially at risk for developing STDs.

3.Many STDs initially cause no symptoms, particularly in women. When symptoms develop, they may be confused with those of other diseases not transmitted through sexual contact. However, even when an STD causes no symptoms, a person who is infected may be able to pass the disease on to a sex partner. That is why many doctors recommend periodic testing for people who have more than one sex partner.

4.Health problems caused by STDs tend to be more severe and more frequent for women than for men, in part because the frequency of asymptomatic infection means that many women do not seek care until serious problems have developed. Some STDs can spread into the uterus (womb) and fallopian tubes to cause pelvic inflammatory disease (PID), which in turn is a major cause of both infertility and ectopic (tubal) pregnancy. The latter can be fatal. STDs in women may also be associated with cervical cancer. One STD, human papillomavirus infection (HPV), can result in genital warts, but can also lead to cervical and other genital cancers; the relationship between other STDs and cervical cancer is not yet clear. STDs can be passed from a mother to her baby before or during birth; some of these infections of the newborn can be cured easily, but others may cause a baby to be permanently disabled or even die.

5.When diagnosed and treated early, almost all STDs can be treated effectively. Some organisms, such as certain forms of gonococci, have become resistant to the drugs used to treat them and now require newer types of antibiotics. The most serious STD for which no cure now exists is acquired immunodeficiency syndrome (AIDS), a fatal viral infection of the immune system. Experts believe that having STDs other than AIDS increases one's risk for becoming infected with the AIDS virus.

There are very active research programs focused on finding better methods of diagnosis and more effective treatments, as well as producing vaccines that could one day ensure that STDs, like many other infectious diseases, no longer pose serious threats to health.

Sexually Transmitted Diseases Statistics

*In the United States, more than 12 million new cases of sexually transmitted diseases (STDs) occur each year, at least 3 million of them among teenagers.1

*Of the top 10 reportable diseases in the United States in 1995, five are STDs (chlamydial infection, gonorrhea, AIDS, primary and secondary syphilis, and hepatitis B virus infection).2

*Approximately two-thirds of people who acquire STDs in the United States are younger than 25.1

*Each year in the United States, approximately $10 billion is spent on major STDs (other than HIV/AIDS) and their preventable complications. This figure rises to approximately $17 billion if sexually transmitted human immunodeficiency virus (HIV) infections are included.1

* Worldwide, an estimated 333 million new cases of four curable STDs (gonorrhea, chlamydial infection, syphilis and trichomoniasis) occurred among adults 15 to 49 years of age in 1995.3

The World Bank has estimated that STDs, excluding AIDS, are the second leading cause of healthy life lost among women between ages 15 to 44 in the developing world.4


*Through 1996, an estimated 29.4 people worldwide had been infected with HIV, of whom approximately 8.4 million have developed AIDS. Cumulative AIDS-related deaths worldwide as of December 1996 numbered approximately 6.4 million.5

*In 1996 alone, HIV/AIDS-associated illnesses caused the deaths of approximately 1.5 million people worldwide.5

*In the United States, 581,429 cases of AIDS had been reported to the Centers for Disease Control and Prevention (CDC) as of Dec. 30, 1996. Of these people, 362,004 had died by the end of 1996.6

*In 1994, the total cost of sexually transmitted HIV infection in the United States was approximately $6.7 billion.1

Chlamydial Infection *Infection with Chlamydia trachomatis is the most common bacterial STD in the United States. More than 4 million new cases are estimated to occur annually, including 2.6 million cases among women.1

*As many as 85 percent of women with chlamydial infections are asymptomatic; 40 percent of infected men report no symptoms.1

*In 1995, 477,638 chlamydial infections were reported to the CDC, a case rate of 182 per 100,000 population.8

*From 1987 to 1995, the annual reported rate of chlamydial infections in the United States increased 261 percent (from 48 to 182 cases per 100,000).8

*In 1994, the total cost of chlamydial infections in the United States was estimated to be $2.0 billion.1

*Worldwide, an estimated 89 million new chlamydial infections occurred in 1996.9

*If not adequately treated, 20 to 40 percent of women with genital chlamydial infections develop pelvic inflammatory disease (PID), which in turn causes problems such as infertility, ectopic pregnancy and chronic pelvic pain.1

Gonorrhea *An estimated 800,000 cases of gonorrhea, caused by Neisseria gonorrhea, occur annually in the United States.1

*In 1995, 392,848 cases of gonorrhea in the United States were reported to the CDC, a case rate of 150/100,000.10

*In 1994, costs associated with gonorrhea in the United States totaled an estimated $1.1 billion.1

*Worldwide, an estimated 62 million new cases of gonorrhea occurred in 1996.9

*If not adequately treated, 10 to 40 percent of women infected with gonorrhea develop PID.1

Pelvic Inflammatory Disease *At least 1 million cases of PID, an important complication of both gonorrhea and chlamydial infection, occur annually in the United States.1

*Of all infertile women, at least 15 percent are infertile because of tubal damage caused by PID.1

*Total costs associated with PID in the United States were estimated to be $6 billion in 1996.14

*Following PID, scarring will cause approximately 20 percent of women to become infertile, 18 percent to develop chronic pelvic pain, and 9 percent to have ectopic pregnancies.11

Genital Herpes *Approximately 200,000 to 500,000 new cases of genital herpes occur each year in the United States; at least 31 million individuals are already infected.1

*Costs associated with genital herpes totaled approximately $237 million in 1994.1

Hepatitis B *An estimated 53,000 cases of sexually transmitted hepatitis B infection occurred in the United States in 1994.1

*Costs associated with sexually transmitted hepatitis B in the United States totaled $156 million in 1994.1

Human Papillomavirus (HPV) Infection *An estimated 24 million people in the United states are infected with HPV, and as many as 1 million new infections occur each year.1

*Cervical infection with oncogenic types of HPV is associated with more than 80 percent of cases of invasive cervical cancer.12

*An estimated 14,500 cases of invasive cervical cancer will be diagnosed in the United States in 1997.13

*In 1997, an estimated 4,800 American women will die of cervical cancer.13

*Worldwide, cervical cancer is the second most common cancer among women. More than 525,000 new cases and 247,000 deaths occurred in 1996.9

*In the United States, total costs associated with HPV (excluding HPV-related cervical cancer) were an estimated $3.8 billion in 1994 in the United States.1

*Total costs associated with HPV-related cervical cancer totaled approximately $737 million in 1994.1

Syphilis *An estimated 101,000 sexually transmitted infections with Treponema pallidum, the cause of syphilis, occur each year in the United States; in addition, approximately 3,400 newborns acquire the infection from their mothers before or during birth.1

*Globally, an estimated 12 million new cases of sexually acquired syphilis occurred in 1996.9

*In 1995, 16,500 cases of primary and secondary syphilis in the United States were reported to the CDC, a case rate of 6.3/100,000. The rate of reported syphilis cases among African Americans was nearly 60 times greater than that among whites.10

*Costs associated with syphilis in the United states totaled an estimated $106 million in 1994.1

Trichomoniasis *Globally, an estimated 170 million people acquired Trichomonas vaginalis, a sexually transmitted parasite, in 1996 (WHO).9

*Approximately 3 million cases of trichomoniasis occurred in the United States in 1994.1

Chancroid *An estimated 2 million new cases of chancroid, caused by Haemophilus ducreyi, occurred globally in 1996.9

*Approximately 3,500 new cases of chancroid occurred in the United States in 1994.1

*Costs associated with chancroid in the United States totaled an estimated $1 million in 1994.1

This information is adapted from official reports of the National Institutes of Arthritis and Infectious Diseases.

St. Louis, Missouri

Private Clinic for Sexually Transmitted Diseases—

Z.A. Dalu M.D.
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