Previous Conferences - 2004 (Philadelphia, PA)
New U.S. data show fewer Americans have herpes but rates of other sexually transmitted diseases still high
Philadelphia (March 8) - New data presented at the 2004 National STD Prevention Conference in Philadelphia show both important gains and lost ground in preventing sexually transmitted diseases (STDs) in the United States. National surveillance data and studies of groups at risk for STD infection show striking declines in herpes infection, continued increases in U.S. syphilis rates, and high levels of STDs among youth. Other studies highlight the positive impact of innovative prevention strategies.
Significant Decrease in Genital Herpes Nationwide
A Centers for Disease Control and Prevention (CDC) analysis of two national surveys found that the prevalence of herpes simplex virus type 2 (HSV-2) infection declined significantly in the United States in the late 1990s. Between the periods 1988-1994 and 1999-2000, the prevalence of HSV-2, the most common cause of genital herpes, declined 17 percent overall - from 21.3 percent infected with the virus to 17.6 percent. Prevalence in men declined even more dramatically, from 17.3 percent to 11.2 percent - a 35 percent decrease (Abstract 1131).
U.S. Syphilis Rates Continue to Climb
Preliminary surveillance data from the CDC indicate a likely increase in 2003 syphilis rates - which would be the third consecutive year of increases. From 2002 to 2003, cases of primary and secondary (P&S) syphilis increased slightly from 6,862 to 7,082. Rates also increased from 2.4 to 2.5 cases per 100,000. Since the first reported increases in P&S syphilis, the number of reported cases has jumped 18 percent, from 5,979 cases in 2000 to 7,082 cases in 2003. The overall rate also increased 19 percent during that time, from 2.1 to 2.5 cases per 100,000 people. Syphilis cases increased 65 percent among men (from 3,532 to 5,844 cases) between 2000 and 2003 but decreased 50 percent among women (from 2,445 to 1,229 cases).
Although CDC does not collect syphilis data by sexual orientation, CDC researchers estimate that more than 60 percent of syphilis cases in 2003 occurred among men who have sex with men (MSM), compared to 5 percent in 1999. This estimate is based in part on the ratio of male to female cases (Abstracts 1195 and 1222)."STDs can cause serious medical consequences, including infertility, transmission to newborns, neurologic damage and increased risk of HIV transmission," said Dr. Ronald O. Valdiserri, deputy director of HIV, STD and TB prevention programs at CDC, one of the conference's sponsors. "While we acknowledge the successful declines in herpes, overall STD rates in the U.S. remain alarmingly high."
Risky Strains of Human Papillomavirus (HPV) High but Threat Diminished Over Time
Researchers at the University of Colorado Health Sciences Center found that of 1,595 study participants, 30.2 percent of women and 18.7 percent of men had been infected with HPV-16, one of 10 high-risk strains of genital HPV associated with cervical cancer. In contrast with previous research, they also found that sexual risk behavior in the past three months was a stronger predictor of HPV infection than the number of lifetime sexual partners (Abstract 1135).
A separate study by CDC researchers of nearly 300 female adolescents attending a public clinic found that 72 percent were infected with a high-risk strain of HPV. Although HPV is often naturally cleared by an infected individual's immune system, 10 percent of these women still had evidence of infection after 12 months (Abstract 1290).
STDs and Youth: Herpes Down, Chlamydia Rates and Risk Behavior High
Additional research on youth included age breakdowns of the national genital herpes data, which showed considerable declines among young people - 74 percent in 14- to 19-year-olds and 48 percent in 20- to 29-year-olds. According to study authors, declines are likely due in part to reported decreases in sexual risk behavior among U.S. adolescents (Abstract 1131).
Other study results, however, indicate troubling levels of other STDs among young adults. Researchers at the Minnesota Department of Public Health found that nearly one in 10 of more than 1,300 adolescent males in a statewide study had chlamydia. This rate was nearly as high as prevalence among young women, who suffer disproportionately from the disease's effects (e.g. pelvic inflammatory disease, infertility) (Abstract 1054). In another study, led by Yale University researchers, female adolescent sexual behavior and perception of their STD risk did not change even after they were diagnosed with an STD (Abstract 1127)."The best time to educate young men and women about how to avoid STDs is long before there is a diagnosis," said Dr. John Douglas, director of CDC's STD prevention programs. "Studies at the conference examine several approaches for reaching young people with information and STD screening to help them stay healthy."
STD Prevention Programs Offer Solutions
In spite of ongoing challenges, STD prevention programs in many cities are demonstrating promising results. One study examined a school-based chlamydia screening program in Philadelphia that identified almost 800 chlamydia infections among female students in city schools. The intervention prevented an estimated 238 cases of pelvic inflammatory disease, a dangerous complication of chlamydia infection (Abstract 1349). Another program in Oakland County, Michigan, tested more than 3,400 youth for chlamydia infection in a variety of non-traditional settings, including high school clinics. Among the 18 percent of students who tested positive for chlamydia, most infections - 83 percent among males and 59 percent among females - were asymptomatic and would have otherwise gone undiscovered (Abstract 1386).
Other research examined the potential of "patient-delivered partner therapy," in which individuals diagnosed with an STD bring appropriate medication to their partners. Tulane University researchers compared the patient-delivered approach to standard partner referral strategies and found that men provided with medication for their partners were more likely to have seen and spoken with those individuals, and were less likely to test positive for gonorrhea or chlamydia a month later (Abstract 1189).
Since 2001, California has allowed health care providers to prescribe STD medications for their patients' sexual partners without an examination. A 2002 California Department of Health Services survey of nearly 4,000 medical personnel found that 50 percent of physicians and 48 percent of nurse practitioners usually or always provide medication for partners since the law went into effect (Abstract 1151).
About the Conference
The 2004 National STD Prevention Conference is the leading U.S. conference focusing on sexually transmitted diseases. The conference presents the latest data on national and local STD trends and highlights new STD prevention strategies, research and treatment options. Participants include more than 1,000 delegates from academic, public health, nongovernmental and policy organizations.
This year's conference is sponsored by the Centers for Disease Control and Prevention (CDC), the American STD Association (ASTDA), the National Coalition of STD Directors (NCSD) and the American Social Health Association (ASHA).