Focus Area 25 Sexually Transmitted Diseases Progress Review July 21, 2004

STD’s: Magnitude of the Problem More than 65 million people currently living with an incurable sexually transmitted disease 18.9 million new STD infections (curable and incurable) each year; Half occur in persons under age 25 Direct medical cost in 2000: $9.3 - $15.5 billion Source: STD Surveillance System, NCHSTP,CDC; MMWR weekly, April 30, 2004 / 53(16);

Screening in youth detention facilities and jails Contracts to treat nonplan partners of STD patients Chlamydia Gonorrhea Primary and secondary syphilis Bacterial STD Illness and Disability Sexually Transmitted Diseases Personal Behaviors Genital herpes Human papillomavirus infection Viral STD Illness and Disability STD Complications Affecting Females, Fetus and Newborn Pelvic inflammatory diseases Fertility problems Heterosexually transmitted HIV in women Congenital syphilis Neonatal STDs Responsible adolescent sexual behavior Community Protection Infrastructure Hepatitis B vaccine in STD clinics Personal Health Services Annual screening for genital Chlamydia Screening of pregnant females Compliance with STD treatment standards Provider referral services for sex partners Responsible sexual messages on TV Improving Getting worseLittle or no change Cannot assess (limited data) Objective to be dropped

25-1. Chlamydia Gonorrhea Syphilis Genital Herpes Pelvic Inflammatory Disease Fertility Problems Responsible Adolescent Sexual Behavior Highlighted Objectives

Reported incidence per 100,000 population (log scale) Chlamydia Gonorrhea Syphilis Chlamydia, Gonorrhea, and Syphilis Infections Source: STD Surveillance System, NCHSTP,CDC. 0

Reported incidence per 100,000 population Chlamydia: Infections by Gender Male Female Source: STD Surveillance System, NCHSTP,CDC.

Reported incidence per 100,000 population Chlamydia: Infections by Race and Ethnicity Note: 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. Source: STD Surveillance System, NCHSTP,CDC White Black Hispanic American Indian Total Asian/Pacific Islander

Percent Positive Females attending family planning clinics Chlamydia: Infections among 15 to 24 Year Olds Females attending STD clinics Males attending STD clinics 2010 Target (3%) Obj Source: STD Surveillance System, NCHSTP,CDC.

Chlamydia: Infections among 15 to 24 Year Olds Attending STD Clinics, 2002 Note: 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. Source: STD Surveillance System, NCHSTP,CDC. Total Female Male Percent White Native Hawaiian Hispanic American Indian Asian Black 2010 Target Obj. 25-1c

Reported incidence per 100,000 population Gonorrhea: Infections by Gender Male Female Source: STD Surveillance System, NCHSTP,CDC Target (19 per 100,000) Obj. 25-2

Gonorrhea: Infections by Race and Ethnicity Source: STD Surveillance System, NCHSTP,CDC. Reported incidence per 100,000 population White Black Hispanic Asian/Pacific Islander American Indian 2010 Target ,000 1,500 2,000 2,

2002 Gonorrhea: Infections by Race and Ethnicity Total Reported incidence per 100,000 population White Black Hispanic American Indian Asian/ Pacific Islander Note: 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. Source: STD Surveillance System, NCHSTP,CDC. Obj Target 1997 Reported incidence per 100,000 population White Black Hispanic Asian/Pacific Islander American Indian 2010 Target ,000 1,500 2,000 2,

Reported incidence per 100,000 population Syphilis: Infections by Gender Male Female Note: Data are for primary and secondary syphilis. Source: STD Surveillance System, NCHSTP,CDC. Obj Target (0.2 per 100,000)

Syphilis: Infections by Race and Ethnicity Total Asian/ Pacific Islander Black American Indian HispanicWhite Reported incidence per 100,000 Obj Note: 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. Source: STD Surveillance System, NCHSTP,CDC Target

Syphilis: Infections by Age and Gender MalesReported incidence per 100,000 populationFemales Age Total 1.3 Note: Data are for primary and secondary syphilis. Source: STD Surveillance System, NCHSTP,CDC.

Syphilis: Infections by County, 2002 Rate per 100,000 population <= (n=421) (n=174) (n=2544) >4.0 Note: Data are for primary and secondary syphilis. Source: STD Surveillance System, NCHSTP,CDC.

Congenital Syphilis: Infections by Race and Ethnicity Total Black American Indian Hispanic White 2002 Reported incidence per 100,000 live births Asian/ Pacific Islander Note: Data represent the mother’s race and ethnicity. 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. Source: STD Surveillance System, NCHSTP,CDC. Obj Target

Obj Percent Genital Herpes: Infections by Gender and Age Group, Note: I = 95% confidence interval. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Total Female Male 2010 Target

Total Percent Obj Target Mexican Black White Genital Herpes Infection among Adults 20 to 29 Years by Race/Ethnicity Note: Black and white exclude persons of Hispanic origin. Persons of Mexican- American origin may be any race. I = 95% confidence interval. Source: National Health and Nutrition Examination Survey, NCHS, CDC.

Need for Treatment of PID by Race/Ethnicity and Education Level, 1995 Percent of women requiring treatment Total White Hispanic High School Black Less than HS At some least college Obj Note: PID refers to pelvic inflammatory disease. 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. I = 95% confidence interval. Source: National Survey for Family Growth, NCHS, CDC Target

Pelvic Inflammatory Diseases Initial Visits to Physicians’ Offices PID Hospitalizations – Acute PID Hospitalizations - Chronic Note: Data are for women ages 15 to 44 years. Source: National Disease and Therapeutic Index,IMS America, Ltd.; National Hospital Discharge Survey, NCHS, CDC. Number (in thousands)

Fertility Problems among Childless Females with an STD or PID, 1995 Black years years White Less than high school Hispanic Total High school years At least college Note: Data are for females ages 15 to 44 years. Fertility problems refer to the standard medical definition of infertility or impaired fecundity. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. I = 95% confidence interval. Source: National Survey for Family Growth, NCHS, CDC. Obj Target Percent

Obj Responsible Adolescent Sexual Behavior Note: Data are for students grades 9 through 12. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Youth Risk Behavior Surveillance System, NCHSTP, CDC. Never had sex Had sex, but not in the past 3 months Had sex in the past 3 months, used a condom Total Female Male WhiteBlackHispanic Target

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