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STDs
in the South
Public Health Impact
The southern region of the United States consists of the District
of Columbia and 16 states: Alabama, Arkansas, Delaware, Florida,
Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina,
Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West
Virginia. This region has consistently had higher reported rates
of chlamydia, gonorrhea and primary and secondary (P&S) syphilis
than the other regions of the country (Northeast, Midwest, and
West). The reasons for these higher rates in the South are not
well understood, but may include differences in the racial and
ethnic distribution of the population, poverty, and availability
and quality of health care services. Regional differences in STD
rates are particularly disturbing in light of the fact that STDs
can increase the risk of HIV transmission. The high HIV prevalence
among childbearing women living in the South is consistent with
the high rates of these other STDs in the region.1
Observations
- The South has consistently
had higher rates of gonorrhea and P&S syphilis compared with
other regions throughout the 1980s and 1990s (Figures 11 and 24, Tables
13 and 25).
From 1996 through 2000, the South also had a higher reported rate
of chlamydia than the other regions of the country (Figure 4, Table 4).
- In 2000, six of
the 10 states with the highest chlamydia rates were in the South
(Figure 3, Table 3).
Similarly, nine of the 10 states with the highest rates of gonorrhea
were located in the South (Figure 10, Table 12).
Fifteen of the southern states had 2000 reported rates of P&S
syphilis that were greater than the Healthy People Year 2010 (HP2010)
objective of 0.2 case per 100,000 persons (Figure 22, Table
23). All of these southern states had reported P&S syphilis
rates in 2000 that were at least six times greater than the HP2010
objective (Figure
22, Table
23).
- In 2000, 412 (69.2%)
of 595 counties with P&S syphilis rates above the HP2010 objective
were located in the South (Figures 23 and KK).
- Of the 412 counties
in the South that had reported P&S syphilis rates in 2000 above
the HP2010 objective, 226 (55.9%) had an increase in the rate from
1999 to 2000 (Figures
KK and LL).
- County-specific
rates of chlamydia and gonorrhea in 2000 were calculated for
those southern states submitting county level data (Figures MM and NN).
These county level data were reported through the National Electronic
Telecommunications System for Surveillance (NETSS), and are
provisional for all states shown except Alabama, Arkansas, Delaware,
Florida, Kentucky, Mississippi, Oklahoma, South Carolina, Texas,
and Virginia where hardcopy reports have been discontinued
based on consistent, high quality, and timely submissions of
NETSS data (Figures A1 and A2 in Appendix).
1Koumans EH,
Sternberg M, Gwinn M, Swint E, Zaidi A, St. Louis M. Geographic variation
of HIV infection in childbearing women with syphilis in the United
States. AIDS 2000;14:279-87.
Figure
KK. South — Primary and secondary syphilis case rates by
county, 2000
STDs in the South figures
continue on page 2
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