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STD Report Shows Small Rise Overall, Higher Rates for People of Color, Young Gay Men

Reported cases of gonorrhea rose slightly and syphilis declined somewhat during 2010, but the syphilis rate among young black men has increased dramatically over the past 5 years, largely driven by increases among men who have sex with men (MSM), according to the latest sexually transmitted disease (STD) surveillance report from the Centers for Disease Control and Prevention (CDC).

The report notes that the observed rise in chlamydia cases is thought to be due to increased screening rather than a real increase in prevalence, but still fewer than half of sexually active young women receive the recommended annual screening.

"This new data shows a persistence of the same trends that we have been seeing for years -- that MSM and communities of color are continuing to bear a disproportionate share of the STDs in this country," said William Smith, Executive Director of the National Coalition of STD Directors (NCSD), in a press release issued by the group. "The 2010 STD data released today shows that we need to look closely at further investments in STD prevention as a means to prevent HIV as well."

Across all 3 diseases, people of color and young people are most affected, according to NCSD's summary. Although the 2010 figures show that overall syphilis rates declined compared with 2009, the rate among Hispanics rose by more than 9%. The rate among black men fell by 8.5% in 2010, but they continue to have the highest rate of any demographic group, with young black men -- primarily MSM -- showing a "shocking" increase of 134% between 2006 and 2010. Gay and bisexual men account for two-thirds of all syphilis cases in the U.S.

Below is the text of a CDC summary of the 2010 STD surveillance report. The full report is available at http://www.cdc.gov/std/stats10/default.htm.

STD Trends in the United States: 2010 National Data for Gonorrhea, Chlamydia, and Syphilis

This document summarizes 2010 national data on gonorrhea, chlamydia, and syphilis that are published in CDC’s report, Sexually Transmitted Disease Surveillance, 2010. The data are based on state and local STD case reports from a variety of private and public sources, the majority of which come from non-STD clinic settings, such as private physician offices and health maintenance organizations.

19 Million

STDs are one of the most critical health challenges facing the nation today. CDC estimates that there are 19 million new infections every year in the United States.

$17 Billion

STDs cost the U.S. health care system $17 billion every year -- and cost individuals even more in immediate and life-long health consequences.

CDC’s surveillance report includes data on the three STDs that physicians are required to report to local or state public health authorities -- gonorrhea, chlamydia, and syphilis -- which represent only a fraction of the true burden of STDs. Some common STDs, like human papillomavirus (HPV) and genital herpes, are not required to be reported.

The latest CDC data show troubling trends in three treatable STDs:

• Gonorrhea: While reported rates are at historically low levels, cases increased slightly from last year and more than 300,000 cases were reported in 2010. There are also signs from other CDC surveillance systems that the disease may become resistant to the only available treatment option.
• Chlamydia: Case reports have been increasing steadily over the past 20 years, and in 2010, 1.3 million chlamydia cases were reported. While the increase is due to expanded screening efforts, and not to an actual increase in the number of people with chlamydia, a majority of infections still go undiagnosed. Less than half of sexually active young women are screened annually as recommended by CDC.
• Syphilis: The overall syphilis rate decreased for the first time in a decade, and is down 1.6 percent since 2009. However, the rate among young black men has increased dramatically over the past five years (134 percent). Other CDC data also show a significant increase in syphilis among young black men who have sex with men (MSM), suggesting that new infections among MSM are driving the increase in young black men. The finding is particularly concerning as there has also been a sharp increase in HIV infections among this population.

For more detailed data on each disease, see the Snapshot and Table.

Less than half of people who should be screened receive recommended STD screening services

Undetected and untreated STDs can increase a person’s risk for HIV and cause other serious health consequences, such as infertility. STD 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 STDs to others.

STDs in the United States: A Look Beyond the Data

STDs primarily affect young people, but the health consequences can last a lifetime

Young people represent 25 percent of the sexually experienced population in the United States, but account for nearly half of new STDs. The long-lasting health effects are particularly serious for young people:

• Untreated gonorrhea and chlamydia can silently steal a young woman’s chance to have her own children later in life. Each year, untreated STDs cause at least 24,000 women in the U.S. to become infertile.
• Untreated syphilis can lead to serious long-term complications, including brain, cardiovascular, and organ damage. Syphilis in pregnant women can also result in congenital syphilis (syphilis among infants), which can cause stillbirth, death soon after birth, and physical deformity and neurological complications in children who survive. Untreated syphilis in pregnant women results in infant death in up to 40 percent of cases.
• Studies suggest that people with gonorrhea, chlamydia, or syphilis are at increased risk for HIV. Given the increase in both syphilis and HIV among young black gay and bisexual men, it is particularly urgent to diagnose and treat both diseases.

A range of factors place some populations at greater risk for STDs

STDs affect people of all races, ages, and sexual orientations, though some individuals experience greater challenges in protecting their health. When individual risk behaviors are combined with barriers to quality health information and STD prevention services, the risk of infection increases. While everyone should have the opportunity to make choices that allow them to live healthy lives regardless of their income, education, or racial/ethnic background, the reality is that if an individual lacks resources or has difficult living conditions, the journey to health and wellness can be harder. Even with similar levels of individual risk, African Americans and Latinos sometimes face barriers that contribute to increased rates of STDs and are more affected by these diseases than whites.

CDC and Partners Working to Expand STD Prevention Efforts

CDC closely tracks STDs to guide prevention programs and clinical recommendations for STD services. CDC also funds state and local health departments and community-based organizations to implement and support local prevention efforts to reduce risk behavior and increase STD and HIV testing among populations at greatest risk. Through the Get Yourself Tested multimedia campaign, CDC, MTV, and the Kaiser Family Foundation are raising STD awareness among young people.

• CDC assists health departments in local gonorrhea prevention efforts to best reach at-risk persons in areas where disease burden is greatest. CDC recently conducted a series of regional gonorrhea control discussions with STD program directors to help identify the most at-risk populations and develop action plans to reduce disparities.
• CDC supports the Infertility Prevention Project, which promotes chlamydia screening and treatment for low-income, sexually active women in family planning and STD clinics.
• CDC and public health partners are working to implement CDC’s Syphilis Elimination Plan, including using local data to create targeted action plans to reach those at greatest risk, particularly young black men and MSM.

11/18/11

Sources

Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2010. November 2011.

Centers for Disease Control and Prevention. STD Trends in the United States: 2010 National Data for Gonorrhea, Chlamydia, and Syphilis. November 17, 2011