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Trends in Sexually Transmitted Diseases in the United States: 2009 National Data for Gonorrhea, Chlamydia and Syphilis

Page 2: Table


  Gonorrhea Chlamydia Syphilis (Primary and Secondary)
Current Burden
  • Cases reported in 2009: 301,174
  • Rate per 100,000 people: 99.1
  • Cases reported in 2009: 1,244,180
  • Rate per 100,000 people: 409.2

Primary and secondary (P&S) syphilis, the most infectious stages of the disease:

  • Cases reported in 2009: 13,997
  • Rate per 100,000 people: 4.6
Trends Over Time
  • Reported gonorrhea cases have declined steadily in recent years – 10% over the past year and 17% since 2006 – and are now at the lowest level since CDC began tracking the disease in 1941.
  • While gonorrhea is declining for all races and ethnicities, since 2006 the drop has been smaller for blacks (15%) than for Hispanics (21%) or whites (25%).
  • Chlamydia diagnoses increased 3% over the past year and are up 19% from 2006. This is actually good news: The increase is likely due to expanded screening and not an increase in disease.
  • From 2000 to 2009, the chlamydia screening rate among young women nearly doubled (from 25% to 47%).
  • However, data suggest that most young women are still not getting screened. CDC estimates that there are 2.8 million chlamydia cases annually – more than twice the number actually reported.
  • Reported syphilis cases overall continue to rise – 5% over the previous year and 39% since 2006. However, for the first time in five years, syphilis did not increase among women – there was a 7% decline among women overall over the past year. This follows an 88% increase in syphilis among women from 2004 to 2008.
  • In addition, for the first time in four years, cases of congenital syphilis did not increase in 2009 (427 total cases). Since 1991, when there were 4,424 cases, rates have dramatically declined.
Disparities

A range of factors contribute to STD disparities by race/ethnicity, including: a greater prevalence of STDs in minority communities, which places individuals living in those communities at increased risk of infection with each sexual act, compared to other populations; poverty; lack of access to quality healthcare; and stigma and homophobia, which can prevent individuals in need from seeking STD prevention, screening and treatment services.

  • Blacks accounted for 71% of all gonorrhea cases in 2009, though they represent only 14% of the U.S. population. The gonorrhea rate among blacks is 20 times higher than whites and almost 10 times higher than Hispanics (556.4 per 100,000 for blacks v. 27.2 for whites and 58.6 for Hispanics).
  • Young black women bear the heaviest gonorrhea burden (rate among those aged 15-19: 2,613.8 per 100,000; rate among those aged 20-24: 2,548.7 per 100,000).
  • Young Hispanic women and men aged 20-24 have the highest gonorrhea rates among Hispanics, which are twice as high as those among whites in the same age group (In the 20-24 age group: 274.9 per 100,000 for Hispanic women v. 186.4 for white women; 215.7 per 100,000 for Hispanic men v. 80.8 for white men).
  • Blacks represented almost half of all reported chlamydia cases (48%) in 2009. Based on case reports, the chlamydia rate among blacks is eight times higher than whites and three times higher than Hispanics (1,559.1 per 100,000 for blacks v. 178.8 for whites and 504.2 for Hispanics).
  • Young black women aged 15-24 are most affected. In 2009, there was one chlamydia case reported for every 10 black women in that age group (10,629.7 per 100,000).
  • Young Hispanic women and men aged 20-24 have the highest chlamydia rates among Hispanics, which are twice as high as those among whites in the same age group (In the 20-24 age group: 3,679.7 per 100,000 Hispanic women v. 1,727.8 for white women; 1,077.8 per 100,000 Hispanic men v. 491.9 for white men).
  • Since 2000, the largest increase in syphilis cases has been among men who have sex with men (MSM). In 2009, MSM accounted for nearly two-thirds of syphilis cases (62%), up from just 4% in 2000.
  • Blacks accounted for half of all P&S syphilis cases (52%) in 2009. The rate of P&S syphilis among blacks is nine times higher than whites and four times higher than Hispanics (19.2 per 100,000 for blacks v. 2.1 for whites and 4.5 for Hispanics).
  • P&S syphilis cases among young black men aged 15-24 continue to increase significantly – indicating a concerning new trend. Between 2005 and 2009, the P&S syphilis rate among young black men aged 15-24 tripled (from 19.3 per 100,000 in 2005 to 58.2 in 2009). This trend may also be contributing to disproportionately high rates of HIV among young black men.
CDC Recommendations

CDC supports the recommendations of the U.S. Preventive Services Task Force to screen highrisk sexually active women for gonorrhea.

CDC recommends annual chlamydia screening for young women under age 26.

CDC recommends that sexually active men who have sex with men be tested at least annually for syphilis (as well as gonorrhea, chlamydia and HIV).

CDC & Partner Activities

CDC assists health departments in expanding local gonorrhea prevention efforts. CDC recently conducted a series of regional gonorrhea control meetings throughout the nation to help identify new prevention strategies and develop local action plans to reduce disparities.

CDC, together with the Partnership for Prevention and a small group of other national organizations, established the National Chlamydia Coalition in 2008 to increase chlamydia screening among sexually active adolescents and young adults. The Coalition has expanded rapidly and today includes more than 40 organizations as members.

CDC and public health partners are working to implement CDC’s Syphilis Elimination Plan, including using local data to create targeted action plans to reach those at greatest risk, particularly young black men and MSM.

CDC closely tracks STDs to guide prevention programs and clinical recommendations for STD services. CDC also funds state and local health departments and community-based organizations to implement and support local prevention efforts to reduce risk behavior and increase STD and HIV testing among populations at greatest risk. Through the Get Yourself Tested campaign, CDC, MTV and the Kaiser Family Foundation are raising STD awareness among young people.


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