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An overview of the prevalence, impact, and prevention of sexually transmitted diseases (STDs), including statistics, treatment options, and annual screening recommendations.
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Focus Area 25Sexually Transmitted DiseasesProgress Review Richard J. Klein National Center for Health Statistics August 8, 2008
Sexually Transmitted Diseases • More than 65 million people currently living with an incurable sexually transmitted disease • 19 million new STD infections (curable and incurable) occur each year; • Almost half occur in persons aged 15 to 24 years • Estimated annual direct medical cost up to $15.3 billion* Note: *Estimates are in 2007 dollars. Source: Weinstock H, Berman S, Cates W. Sexually transmitted infections in American youth: incidence and prevalence estimates, 2000. Perspectives on Sexual and Reproductive Health 2004;36(1):6-10.; Kaiser Family Foundation.
Highlighted Objectives 25-1. Chlamydia 25-2. Gonorrhea 25-6. Pelvic Inflammatory Disease 25-16. Annual Screening for Genital Chlamydia Improving Little or no change* Getting worse *Percent of targeted change achieved is between -10% and 10%, and/or change not statistically significant.
Chlamydia Infections: Persons 15 to 24 Years Attending STD Clinics, 2006 Decreasedesired 2010 Target: 3.0 Male Percent Female * American Indian Asian Black Hispanic White Total Note: Data reported are unpublished. American Indian includes Alaska Native. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons were asked to select only one race category; selection of more than one race was not an option. * Data for Asian male do not meet the criteria for statistical reliability. Source: STD Surveillance System, NCHHSTP, CDC. Obj. 25-1b,c
Decreasedesired Chlamydia Infections Among Persons 15 to 24 Years Percent 25 Males attending STD clinics 20 Females attending STD clinics 15 10 Females attending family planning clinics 5 2010 Target: 3.0 0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Obj. 25-1 Source: STD Surveillance System, NCHHSTP, CDC. Obj. 25-1a-c
Gonorrhea Infections Decreasedesired Reported incidence per 100,000 population 500 400 Male 300 Female 200 100 2010 Target: 19.0 0 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 Source: STD Surveillance System, NCHHSTP,CDC. Obj. 25-2a
Gonorrhea Infections Reported incidence per 100,000 population 1000 Black 800 600 400 American Indian 200 Total Hispanic White Asian 0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Note: American Indian includes Alaska Native. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Asian includes Pacific Islander. Persons were asked to select only one race category; selection of more than one race was not an option. Source: STD Surveillance System, NCHHSTP, CDC Obj. 25-2a
Gonorrhea Infections Decreasedesired Reported incidence per 100,000 population 1997 2006 2010 Target: 19.0 White American Indian Asian Black Hispanic Total Note: American Indian includes Alaska Native. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Asian includes Pacific Islander. Persons were asked to select only one race category; selection of more than one race was not an option. Source: STD Surveillance System, NCHHSTP,CDC. Obj. 25-2a
Gonorrhea Infections, 2006 2010 Target: 19.0 Rates per 100,000 population 33.7 - 78.7 78.8 - 163.3 163.4 - 508.7 13.5 - 33.6 0.0 - 13.4 Note: Legend represents quintiles of the rates. Rates are calculated by health service area.Rates are per 100,000 population Source: STD Surveillance System, NCHSTP, CDC Obj. 25-2a
Treatment for Pelvic Inflammatory Diseases (PID) Decreasedesired Percent of women ever treated 1995 2002 2010 Target: 5.0 Less than High School At least College High School White Hispanic Black Total Note: Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Data are for females aged 15 to 44 years who reported ever being treated for PID in their lives. I = 95% confidence interval. Source: National Survey for Family Growth, NCHS, CDC. Obj. 25-6
Treatment for Pelvic Inflammatory Diseases (PID) Decreasedesired Percent of women ever treated 1995 2002 2010 Target: 5.0 30-34 years 35-39 years 40-44 years 20-24 years 25-29 years 15-19 Total Note: Data are for females aged 15 to 44 years who reported ever being treated for PID in their lives. I = 95% confidence interval. Source: National Survey for Family Growth, NCHS, CDC. Obj. 25-6
Treatment for Pelvic Inflammatory Diseases (PID), 2002 Decreasedesired White Percent of women ever treated Black Hispanic 2010 Target: 5.0 30-34 years 35-39 years 40-44 years 20-24 years 25-29 years 15-19 years Total Note: Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Data are for females aged 15 to 44 years who reported ever being treated for PID in their lives. I = 95% confidence interval. Source: National Survey for Family Growth, NCHS, CDC. Obj. 25-6
Annual Screening for Chlamydia: Females in Managed Care Organizations (MCO) Increasedesired Percent 70 2010 Target: 62 60 Medicaid MCO 50 Commercial MCO 40 30 20 10 0 2000 2001 2002 2003 2004 2005 2006 Obj. 25-1 Source: National Committee for Quality Assurance, NCQA. Obj. 25-16 a,b
Progress Towards 2010 Targets Personal Behaviors Bacterial STD Illness and Disability 25-11a-c. Responsible adolescent sexual behavior 25-12. Responsible sexual messages on TV 25-1 a-d. Chlamydia 25-2 a,b. Gonorrhea 25-3. Primary and secondary syphilis Community Protection Infrastructure 25-13. Hepatitis B vaccine in STD clinics Viral STD Illness and Disability 25-14. Screening in youth detention facilities and jails 25-15. Contracts to treat nonplan partners of STD patients 25-4. Genital herpes 25-5. Human papillomavirus infection STD Complications Affecting Females, Fetus and Newborn Personal Health Services 25-16. Annual screening for genital Chlamydia 25-17. Screening of pregnant females 25-18. Compliance with STD treatment standards 25-19. Provider referral services for sex partners 25-6. Pelvic inflammatory diseases 25-7. Fertility problems 25-8. Heterosexually transmitted HIV in women^ 25-9. Congenital syphilis 25-10. Neonatal STDs Target met Improving Little or no change* Getting worse Baseline only Deleted Note: *Percent of targeted change achieved is between -10% and 10%, and/or change not statistically significant. ^ Objective 25-8 has been realigned to Healthy People 2010 HIV focus area. It is currently objective 13-18
Summary • Chlamydia infections among men and women aged 15-24 years attending STD clinics, and women attending family planning clinics has increased slightly in the past 10 years. • Annual screening for Chlamydia among females 25 years and under enrolled in commercial and medicaid managed care organizations increased by 48% and 27% respectively. • Significant disparities in gonorrhea persist across racial/ethnic groups and geographic locales. • From 1995 to 2002, the proportion of females requiring treatment for pelvic inflammatory diseases decreased by 37%.
Acknowledgements • Leda Gurley • Epidemiologist • CDC/National Center for Health Statistics • Lug1@cdc.gov • Contributors: • Tamyra Carroll, CDC\NCHS • Rachel Wynn, CDC/NCHHSTP • Amy Pulver, CDC/NCHHSTP • Jill Wasserman, CDC/NCHHSTP • Catherine L Satterwhite, CDC/NCHHSTP • Samuel Groseclose CDC/NCHHSTP • Elizabeth Jackson, CDC/NCHS • Geraldine McQuillan, CDC\NCHS • Anjani Chandra, CDC\NCHS • Ellis Davis, HHS/ODPHP
Progress review data and slides can be found on the web at: http://www.cdc.gov/nchs/hphome.htm