Top Sexually Transmitted Diseases

Overview

STDs refer to more than 35 infectious organisms that are transmitted primarily through sexual activity. STD prevention is an essential primary care strategy for improving reproductive health.1

Despite their burdens, costs, and complications, and the fact that they are largely preventable, STDs remain a significant public health problem in the United States. This problem is largely unrecognized by the public, policymakers, and health care professionals. STDs cause many harmful, often irreversible, and costly clinical complications, such as:

Why Is Sexually Transmitted Disease Prevention Important?

The Centers for Disease Control and Prevention (CDC) estimates that there are approximately 20 million new STD infections each year—almost half of them among young people ages 15 to 24.3 The cost of STDs to the U.S. health care system is estimated to be as much as $16 billion annually.4 Because many cases of STDs go undiagnosed—and some common viral infections, such as human papillomavirus (HPV) and genital herpes, are not reported to CDC at all—the reported cases of chlamydia, gonorrhea, and syphilis represent only a fraction of the true burden of STDs in the United States.

Untreated STDs can lead to serious long-term health consequences, especially for adolescent girls and young women. CDC estimates that undiagnosed and untreated STDs cause at least 24,000 women in the United States each year to become infertile.5

Understanding Sexually Transmitted Diseases

Several factors contribute to the spread of STDs.

Biological Factors

STDs are acquired during unprotected sex with an infected partner.6 Biological factors that affect the spread and complications of STDs include:

Social, Economic, and Behavioral Factors

The spread of STDs is directly affected by social, economic, and behavioral factors. Such factors may cause serious obstacles to STD prevention due to their influence on social and sexual networks, access to and provision of care, willingness to seek care, and social norms regarding sex and sexuality. Among certain vulnerable populations, historical experience with segregation and discrimination exacerbates the influence of these factors.

Social, economic, and behavioral factors that affect the spread of STDs include:

Emerging Issues in Sexually Transmitted Diseases

There are several emerging issues in STD prevention:

References

1King K, et al. Sexually Transmitted Diseases. 4th Edition. 2007. The McGraw-Hill Companies: New York.

2St. Louis ME, Wasserheit JN, Gayle HD, editors. Janus considers the HIV pandemic: Harnessing recent advances to enhance AIDS prevention. Am J Public Health. 1997;87:10-12.

3Satterwhite CL, et al. Sexually transmitted infections among U.S. women and men: Prevalence and incidence estimates, 2008. Sex Transm Dis 2013; 40(3): pp. 187-193.

4Owusu-Edusei K, et al. The estimated direct medical cost of selected sexually transmitted infections in the United States, 2008. Sex Transm Dis 2013; 40(3): pp. 197-201.

5Centers for Disease Control and Prevention. Unpublished estimate.

6Institute of Medicine. The hidden epidemic: Confronting sexually transmitted diseases. Eng TR, Butler, WT, editors. Washington: National Academies Press; 1997.

7Chandra A, Stephen EH. Impaired fecundity in the United States: 1982–1995. Fam Plann Perspect. 1998 Jan–Feb;30(1):34-42.

8Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2014. Atlanta: U.S. Department of Health and Human Services; 2015.

9Krieger N, Waterman PD, Chen JT, et al. Monitoring socioeconomic inequalities in sexually transmitted infections, tuberculosis and violence: Geocoding and choice of area-based socioeconomic measures. Public Health Rep. 2003 May–Jun;118(3):240-60.

10Geisler WM, Chyu L, Kusunoki Y, et al. Health insurance coverage, health-care-seeking behaviors, and genital chlamydia infection prevalence in sexually active young adults. Sex Transm Dis. 2006 Jun;33(6):389-96.

11Institute of Medicine. Unequal treatment: Confronting racial and ethnic disparities in health care. Washington: National Academies Press; 2002.

12Beltrami J, Wright-DeAguero L, Fullilove M, et al. Substance abuse and the spread of sexually transmitted diseases. [Commissioned paper for the IOM Committee on Prevention and Control of STDs]. Washington: Institute of Medicine; 1997.

13Marx R, Aral SO, Rolfs RT, et al. Crack, sex, and STDs. Sex Transm Dis. 1991 Apr–Jun;18(2):92-101. [Review].

14Brandt, A. No magic bullet: A social history of venereal disease in the United States since 1880. New York: Oxford University Press; 1985.

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