Sexually Transmitted Diseases: A Major Public Health Problem.

In the last century, infectious diseases in the United States have been largely conquered. Devastating diseases such as diphtheria, typhoid, measles and polio have been brought under control, if not virtually eradicated. (1,2) Yet, in stark contrast to these successes, the country has been unable to stem the spread of sexually transmitted diseases (STDs).

Twelve million sexually transmitted infections occur every year. (3) At current rates, it is estimated that at least one in four--and perhaps as many as one in two--Americans will contract an STD at some point in their lives. (4) No person who is sexually active--whether he or she is married or single, white or black, rich or poor, heterosexual or homosexual, young or old--is immune from the risk of infection.

The country's STD rates are among the highest in the industrialized world, and in some areas, rates approach those found in developing countries. (5) Inmost industrialized countries, syphilis and gonorrhea have virtually disappeared, (6) but in the United States, infectious syphilis is at its highest levels in 40 years, (7) and gonorrhea is the country's most commonly reported communicable disease. (2) Meanwhile, an estimated four million cases of chlamydia occur each year--nearly four times the number of cases of gonorrhea. (3) And AIDS, which burst on the scene just a dozen years ago, has already claimed the lives of more than 170,000 Americans (8) and has become a leading cause of death among persons aged 25-44. (9)

Young people are hit hardest by these infections. Two-thirds of persons who contract STDs are under age 25; (3) one-quarter are teenagers. (3) Many of these young people suffer long-term health problems as a consequence of their infection.

Refuting Misperceptions

The AIDS epidemic has increased public awareness of other STDs, but a widespread misperception persists that, with the exception of AIDS, STDs are easily cured and cause no serious or irreversible problems. (10) The facts tell a different story.

* At least 56 million people--more than one in five Americans--are believed to be infected with a viral STD other than AIDS. (3,11,12) These incurable diseases--such as genital herpes, human papillomavirus (HPV) and hepatitis B--have consequences ranging from recurrent painful outbreaks to chronic liver disease to cancer. In addition to enduring personal suffering, infected individuals can transmit these viruses to their sexual partners even when they have no current symptoms or have never had any symptoms. (12,13,14,15)