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Chlamydia, STD Rates Soar in U.S.

Teenage Girls, Young Women Have Top Rates of Fertility-Robbing Infection
WebMD Health News
Reviewed by Louise Chang, MD

Nov. 13, 2007 -- With nearly 3 million new chlamydia infections a year and drug-resistant gonorrhea on the rise, a new CDC report offers a grim view of sexually transmitted diseases (STDs) in America.

The report shows that STDs are on the rise across the U.S. Southern states are particularly affected, although sharp increases in Western states also raise eyebrows.

Overall, 19 million Americans catch an STD every year. Half of these infections are in people aged 15 to 24. At particular risk are teenage girls and young women, African-Americans, and men who have sex with men.

"STDs represent a substantial threat to Americans," John M. Douglas Jr., MD, director of the CDC's Division of Sexually Transmitted Disease Prevention, said at a news conference held to announce the findings.

The CDC report focused on three very troubling STDs: chlamydia, gonorrhea, and syphilis. All of these infections can be cured -- if they're detected. But most people carrying and spreading these infections don't even know they have them.

In the case of HIV, that could be fatal. But all of these diseases can cause permanent damage if left untreated. For example, untreated chlamydia -- the most common reportable infection in the U.S. -- can rob a woman of her fertility.

"Very few young, sexually active women are actually aware that annual chlamydia screening is recommended, and that the disease is linked to compromises in fertility," Stuart Berman, MD, chief of epidemiology and surveillance for the CDC's STD branch, said at the news conference.

America's No. 1 STD: Chlamydia

The CDC received reports of more than 1 million chlamydia infections in 2006, up from 2005. CDC experts believe that the actual infection rate is closer to 3 million.

The increase in the chlamydia rate may represent more actual infections, but CDC researchers aren't sure. Douglas says most of the increase in reported infections is probably due to increased screening for the disease.

What makes chlamydia particularly frustrating is that many women who are treated for the infection quickly get reinfected by their male partners.

"Up to 25% of women treated for chlamydia get reinfected within three to six months," Douglas says. "There is a sense among doctors that once they report the disease to the local health department, they will follow up with the partners. This is absolutely not true for chlamydia and gonorrhea."

The situation is so bad the CDC has started urging doctors to give young women a dose of antibiotics to take home to their sex partners. They're calling this "expedited partner therapy."

"With expedited partner therapy, which is the partner receiving antibiotic treatment without a formal medical evaluation, we have shown we can reduce rates of reinfection if women deliver the therapy to their partners," Douglas said. "We have completed a legal analysis, and now there are 11 states where we have formally determined it is legal. In other states, laws are not in support or are ambiguous. This is a relatively important prevention approach."

But the biggest problem with chlamydia is people who don't think they're at risk.

"The finding that chlamydia rates are highest in young women is almost universal," Berman said. "If health care providers think the young women in their practice don't have chlamydia, they should think again."

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