14 January 2009

STI rates soar

US syphilis rates rose for a seventh year in 2007 while chlamydia reached record numbers and gonorrhea remained at alarming levels, health officials said on Tuesday.

US syphilis rates rose for a seventh year in 2007 while chlamydia reached record numbers and gonorrhea remained at alarming levels, health officials said on Tuesday.

No detailed data exists for sexually transmitted infections (STI) in South Africa, but the Department of Health admits that STIs are a major public health concern in the country. The South African Demographic and Health Survey for 2003 (which are the latest statistics available), 2.9% of women and 2.1% of men reported an STI in the last year (prior to the survey). However, 7.7% of women and 3.8% of men showed symptoms of STIs during the same time period.

"Many STIs are asymptomatic and therefore self reported symptoms are an underestimate of the total burden of STIs in a population," reads the report.

Rates unacceptably high in US
Dr John Douglas, who heads the Centres for Disease Control's (CDC) division of sexually transmitted disease, or STD, prevention, said overall syphilis, chlamydia and gonorrhea rates are unacceptably high in the US. Cases of these three STDs are reported by US states to the CDC.

In 2007, 1.1 million US cases of chlamydia were reported, up from about 1 million in 2006 and the most ever, and the rate rose by 7.5% from the prior year, the CDC said in a report. Douglas said the figures may reflect that more people are being diagnosed rather than a rise in infections.

In addition, more than 350 000 cases of gonorrhea were reported in 2007, essentially unchanged from 2006, the CDC said. Gonorrhea rates fell dramatically from the mid-1970s through the mid-1990s, with little progress since.

Some STIs treatable
Chlamydia and gonorrhea are easily diagnosed and treated, but frequently have no symptoms and remain undetected.

Untreated, chlamydia and gonorrhea - both bacterial infections - can cause pelvic inflammatory disease and infertility in women. The two infections also can cause ectopic pregnancy, chronic pelvic pain and other health problems.

"Of all the causes of infertility, this is probably the most preventable - since these infections can be prevented, diagnosed and treated," Douglas said in a telephone interview.

In men, gonorrhea can cause a painful condition of the ducts attached to the testicles that cause infertility. Gonorrhea also can spread to the blood or joints and can be life threatening. Chlamydia complications among men are rare.

Limit the risk
Douglas said to avoid STDs, teens can delay the beginning of sexual activity, people can limit the number of sexual partners and use condoms. "Condoms have risk-reduction value for every sexually transmitted condition," Douglas said.

Syphilis is less common than the others, with 11 466 cases reported in 2007. Rates rose 15% from 2006. Syphilis rates dropped by 90% in the 1990s to a record low level in 2000, and officials thought it might disappear as a public health threat before its resurgence this decade.

Syphilis has increased each year since 2000 - its rate is up 81% - with gay and bisexual men representing 65 percent of cases, the CDC said.

Douglas said many cases are occurring in HIV-positive men who are choosing other HIV-positive men as sexual partners.

"Within that relationship, they are less concerned about the transmission of other conditions. They're not using condoms. They believe that their partner already has got the worst they can get - they've got an HIV infection," he said.

When all STDs are considered, including human papillomavirus (HPV or genital wart virus) and herpes simplex viruses, almost 19 million new infections occur each year, with nearly half among those ages 15 to 24, the CDC said. – (Will Dunham/Reuters Health)

Read more:
STI Factsheet

January 2009




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