The U.S. Is far From Free of Sexually Transmitted Disease

From the WebMD Archives

Dec. 5, 2000 -- For the most part, rates of sexually transmitted disease have been declining around the U.S., according to a report released today. While this news is certainly welcome, the report also indicates that some areas of the country still have a lot of work to do in eliminating the spread of diseases such as gonorrhea and syphilis.


"For the first time in two decades, we're seeing increases in gonorrhea rates in the United States," says Ronald O. Valdiserri, MD, MPH. He says that while some of the increases may be due to more aggressive screening for sexually transmitted diseases and better tests to detect them, there are very real increases that need to be addressed in certain areas of the country and in certain groups of people.


The 12 cities with the highest rates in the nation of both gonorrhea and syphilis are, in alphabetical order: Atlanta; Baltimore; Chicago; Detroit; Indianapolis; Memphis; New Orleans; Newark, N.J.; Norfolk, Va.; Richmond, Va.; St. Louis; and Washington.


Gonorrhea and syphilis are two common sexually transmitted diseases. Symptoms of gonorrhea include discharge from the vagina or penis and pain or difficulty urinating. Gonorrhea is readily curable with antibiotics if detected early. Left untreated, it can affect the joints, tendons, the lining of the heart, and lead to pelvic disease and infertility among women. Syphilis also is highly curable in most cases, but left untreated, it can lead to diseases of the heart and brain, as well as cause blindness.


Speaking at a sexually transmitted disease meeting in Milwaukee, Valdiserri, who is with the CDC, says infection with gonorrhea also increases the risk of getting HIV by two to five times. He adds that the high rate of infections in mostly southern states is directly related to poverty and inadequate access to prevention and treatment.


The CDC, which released the new report, says about 65 million Americans are currently living with a sexually transmitted disease and millions more will become infected each year. The majority of these infections occur among people under age 25.

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Researchers say some of the increase of such diseases are in gay and bisexual men. They believe safe sex is not being as widely practiced as it was a few years ago, possibly because of less fear of

the consequences of getting infected with HIV, the virus that causes AIDS.


In Baltimore, where the rate of syphilis is one of the highest in the country, the local health department recently began aggressively fighting the spread of the infection. A spokesperson for the Baltimore City Health Department tells WebMD the city created a training program for health professionals to teach them how to diagnose and treat sexually transmitted diseases. They also have a mobile medical van that goes into communities at highest risk to address treatment and prevention. The efforts seem to be working. The new report says Baltimore's rate of syphilis dropped by more than 63% between 1997 and 1999.


"The good news is we do know what works if we have the resources and commitment to implement those programs," Valdiserri says. Additional good news is that rates of babies being born with syphilis have gone down by about half nationally.


One city that may need to take some pointers from Baltimore is Indianapolis. The home of one of the most famous car races in the world is also home to an incredibly high rate of syphilis, according to the new report. Syphilis cases in Indy jumped by nearly 475% between 1997 and 1999. However, health officials there provided WebMD with materials stating that syphilis cases are now half of what they were at the same time last year. Indianapolis attributes this success to galvanizing community groups, clergy, health centers, jails, and minority organizations to educate people about the signs and symptoms of syphilis and convince people to be tested.


In addition to syphilis and gonorrhea, another disease that is worrisome to experts is chlamydia. Among women, untreated chlamydia infections can cause pelvic inflammatory disease, a common cause of fertility problems. Chlamydia, which is easily treated and cured, is increasing at a rate of about three million new cases each year. The states with the highest rate of chlamydia infections in young women are Alabama, Arkansas, California, Georgia, Illinois, Louisiana, Mississippi, North Carolina, Rhode Island, South Carolina, Texas, and Wisconsin.

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Experts at the conference say young people account for a large percentage of the 15 million sexually transmitted diseases that occur each year. They say teens must be made aware of the dangers of getting such diseases and giving them to others. That also includes human papilloma virus -- or HPV -- and venereal warts.


Research indicates that one in five teenagers have had four or more sexual partners, says Judith Wasserheit, MD, MPH, another CDC official. And by grade 12, about 65% of high-school students are sexually active. Moreover, "the highest rates of chlamydia and gonorrhea among women occur among adolescents," she says.

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