Rates of chlamydia, gonorrhea, and syphilis increased in the United States during the past year and continued recent upward trends, according to a report from the Centers for Disease Control and Prevention.
"Young women, racial and ethnic populations, and men who have sex with men are particularly hard hit by these diseases," said Dr. John M. Douglas Jr., director of the CDC's Division of Sexually Transmitted Disease Prevention.
The direct medical costs associated with STDs in the United States were estimated at nearly $15 billion in 2006, the researchers stated in the report, "Sexually Transmitted Disease Surveillance 2006," which was presented in a telebriefing.
In 2006, the national rate of reported cases of chlamydia increased by 5.6% from 2005 to 2006. Specifically, the reported rate was 347.8 cases per 100,000 persons in 2006, compared with 329.4 cases per 100,000 persons in 2005.
Chlamydia hits hardest among adolescent girls and young womenthe highest chlamydia rate was reported in young women aged 15-19 years followed by women aged 20-24 years. And racial disparity is high: The chlamydia rate was highest among black women, whose rate was more than seven times higher than that of white women and more than twice as high as that of Hispanic women.
Because of the high rate of chlamydia in young women, the CDC recommends screening sexually active women younger than 26 years for the disease. Chlamydia screening also is recommended for older women with new or multiple sex partners, because these women are also at increased risk. Based on recent studies showing that chlamydia reinfection can occur in women whose partners remain untreated, the CDC's treatment guidelines include retesting patients 3 months after treatment.
"If there are providers who don't think the young women in their practice don't have chlamydia, they should think again," noted Dr. Stuart Berman, chief epidemiologist at the Division of Sexually Transmitted Disease Prevention.
Gonorrhea rates increased for the second consecutive year, following a plateau in reported disease rates from 1997 to 2005. "The racial disparities are stark," in reported gonorrhea cases, Dr. Douglas said. Overall, the rate among blacks is 18 times higher than in whites, he said.
Gonorrhea rates also continue to vary by region. As in previous years, the southern region of the United States had the highest overall gonorrhea rate in 2006, at 159 cases per 100,000 persons.
"We are also concerned about increases in the West," Dr. Douglas said. Gonorrhea cases in the West increased by 2.9% between 2005 and 2006, contributing to a 32% increase between 2002 and 2006.
Untreated gonorrhea can, among other complications, increase a person's risk for HIV if he or she is exposed. But gonorrhea treatment has become more challenging, because evidence of fluoroquinolone resistanceespecially among men who have sex with menprompted the CDC in April 2007 to stop recommending fluoroquinolones as treatment for any gonorrhea cases. As an alternative, the CDC recommends cephalosporins to treat gonorrhea.
Rates of primary and secondary syphilis in the United States increased by nearly 14% from 2005 to 2006, but the most notable increase has occurred among men who have sex with men. Syphilis rates among that group increased by 54% from 2002 to 2006, Dr. Douglas said.
The report's data provide an incomplete picture of sexually transmitted diseases in the United States, the researchers cautioned, because many cases are not reported. To view the complete report, visit www.cdc.gov/std/stats