www.hivandhepatitis.com

CDC STD Report Shows Rise in Gonorhea, Syphilis

The U.S. Centers for Disease Control and Prevention (CDC) this week released its annual sexually transmitted disease (STD) surveillance report on chlamydia, gonorrhea, and syphilis, showing that the latter two infections have increased by 4% and 11%, respectively, with the rise in syphilis occurring primarily among gay and bisexual men.

"STDs are a significant health challenge facing the United States," according to a CDC fact sheet summarizing the findings. "CDC estimates that nearly 20 million new sexually transmitted infections occur every year in this country, half among young people ages 15-24."

"Each of these infections is a potential threat to an individual’s immediate and long-term health and well-being. In addition to increasing a person’s risk for HIV infection, STDs can lead to severe reproductive health complications, such as infertility and ectopic pregnancy," according to the CDC. "STDs are also a serious drain on the U.S. health care system, costing the nation almost $16 billion in health care costs every year."

Data summarized in the annual report are based on state and local STD case reports from a variety of private and public sources.

Summary

Chlamydia

• 1,422,976 cases reported in 2012
• 456.7 cases per 100,000 people
• Increase of 0.7% -- essentially stable -- since 2011.

Gonorrhea

• 334,826 cases reported in 2012
• 107.5 cases per 100,000 people
• 4.1% increase since 2011.

Syphilis (primary and secondary)

• 15,667 cases reported in 2012
• 5.0 cases per 100,000 people
• 11.1% increase since 2011.

Syphilis (congenital)

• 322 cases reported in 2012
• 7.8 cases per 100,000 live births
• 10% decrease since 2011.

Many cases of chlamydia, gonorrhea, and syphilis -- which can be asymptomatic at early stages -- continue to go undiagnosed and unreported. Other common STDs, including human papillomavirus (HPV) and genital herpes, are not routinely reported to the CDC. "As a result, the annual surveillance report captures only a fraction of the true burden of STDs in America."

Young people bear the greatest burden of all 3 reportable STDs. Youth age 15-24 have the highest rates of chlamydia and gonorrhea, while those age 20-24 have the highest rates of syphilis. Men who have sex with men account for 75% of primary and secondary syphilis cases, which are the most infectious stages of the disease, according to the CDC. Syphilis can increase the risk of acquiring or transmitting HIV, and surveillance data from several cities indicate that an average of 4 in 10 gay men with syphilis also have HIV.

"Simply put, STD public health programs do not have enough resources to address all the serious problems that face them," said William Smith, executive director of the National Coalition of STD Directors. "As a result, thousands, if not millions, of Americans at risk for STDs are not able to be reached, with long-term human and economic costs. STD programs desperately need additional funding to address these rising rates and meet our STD epidemics effectively."

CDC STD Screening Recommendations

Annual chlamydia screening for all sexually active women age 25 and under, as well as older women with risk factors such as new or multiple sex partners.

Yearly gonorrhea screening for at-risk sexually active women (e.g., those with new or multiple sex partners, and women who live in communities with a high burden of disease).

Syphilis, HIV, chlamydia, and hepatitis B screening for all pregnant women, and gonorrhea screening for at-risk pregnant women starting early in pregnancy, with repeat testing as needed.

Screening at least once a year for syphilis, chlamydia, gonorrhea, and HIV for all sexually active gay, bisexual, and other men who have sex with men (MSM).

Gay/bisexual who have multiple or anonymous partners should be screened more frequently for STDs (i.e., at 3-to-6 month intervals). Men who have sex in conjunction with illicit drug use (particularly methamphetamine) or whose sex partners do so should also be screened more frequently.

The full 2012 STD surveillance report is available online.

1/10/14

Reference

CDC Division of STD Prevention. Sexually Transmitted Disease Surveillance 2012. Department of Health and Human Services. 2103.

Other Sources

CDC. Reported STDs in the United States: 2012 National Data for Chlamydia, Gonorrhea, and Syphilis. Fact Sheet. January 2014.

National Coalition of STD Directors. NCSD Responds to Release of 2012 STD Surveillance Data. Press release. January 8, 2014.