AUGUST 2006

THE NEW EPIDEMICS:
WHICH STDs AND INFECTIONS ARE ON THE RISE AND HOW TO PROTECT YOURSELF


By Adelaide G. Nardone, MD
Medical Advisor to the Vagisil Women’s Health Center^SM (VWHC)

While sexually transmitted diseases (STDs) can be contracted at any time in your life, they are much more prevalent among teenagers and young adults. The Centers for Disease Control (CDC) estimates that at least 15.3 million new STD cases are reported each year in the United States (in addition to the more than 67 million people who presently have some type of STD). A great many of these cases are among teenagers and young adults less than 25 years old. My personal clinical experiences reflect similar findings.

The alarming rise in STDs can be attributed to such factors as:

• Multiple sex partners
• Failure to use condoms
• Younger age of first sexual encounter (e.g. more teenagers are having sex at younger ages)
• Increase in oral and anal sex
• Failure to seek screening/treatment for STDs (allowing their spread)

It is difficult to know precisely how many people have had an STD since so many cases are asymptomatic, undiagnosed or underreported. The CDC typically does not keep track of specific STDs unless they are life threatening. While serious and contagious, highly prevalent viral infections, such as the human papillomavirus (HPV), genital herpes and trichomonas, are not reported to the CDC annually. Chlamydia, gonorrhea (GC), AIDS and syphilis must be reported because these infections are potentially fatal.

The most recent statistics available by the CDC (from 2004) show chlamydia as the most commonly reported STD in the United States: 929,462 cases of chlamydia were reported in 2004 compared with 877,478 in 2003 -- an increase of 51,984, or six percent, in just one year. However, it is estimated that close to three million new cases of chlamydia actually occur each year.

The second most commonly reported STD in the United States is gonorrhea (GC), which decreased by 76 percent from the 1970s through 2004, but recently has been rising again in several states. Since this STD is substantially underdiagnosed, there may be as many as twice as many new cases each year than reported. As for syphilis in men, statistics show the rate increased from 2000 to 2004, with an eight- percent increase between 2003 and 2004. An increase in syphilis rates from 2000 to 2004 was not observed in women. I often encourage my patients to take a blood test that screens for syphilis, and, as a result, I have recently treated many unknowing patients for this infection.

There is also good reason to mention the herpes simplex virus (HSV). While HSV is not reported to the CDC, we do know that it is among the most common STD occurring in women of all ages (with more than 910,000 new cases occurring each year and many more going undiagnosed). It is so common because HSV is a chronic infection with no cure and is easily passed from person to person through sexual contact. Once a woman contracts herpes, it lives dormant in her spinal cord and can resurface in the genital area at any given time in the form of herpetic blisters that are often painful. Women may experience outbreaks when they are stressed, ill or even over-tired. There are now wonderful treatments available to help suppress the outbreaks and/or alleviate them when they occur, so women should not be discouraged, even though it cannot be “cured.” (It is very difficult to pinpoint exactly when a woman contracted HSV, so she should not play the “blame game.”) However, women should be aware that oral herpes (fever sores) can be contracted as genital herpes during oral sexual activity.

Human papillomavirus, known as HPV, is also among the most prevalent STDs in the United States. In fact, up to 80 percent of women will be exposed to HPV at some point in their sexual lives. This is the virus associated with cervical cancer and there have been tremendous breakthroughs in the diagnosis and screening for this virus through liquid-based Pap smears. What is more, there is a brand-new vaccine that is intended for young girls (less than 13 years of age) with the anticipation that some day HPV and cervical cancer related to it can be eradicated.

To reduce the chances and spread of infections, I offer the following tips:

1. Abstinence from sexual activity (e.g., oral, vaginal or anal sex) is the only way to protect yourself 100 percent from getting an STD.
2. Long-term monogamous relationship: Both partners should get tested for STDs, including HIV, before having sex in a new relationship (which will hopefully be long-term). Women should be cautious and selective and relationships should be monogamous on both ends to prevent STD transmission.
3. Condoms: Male latex condoms are still one the best options for protecting yourself from STDs. However, because condoms do not cover all areas of the body, they may protect against infections transmitted through fluids, such as gonorrhea and chlamydia while not affording the same protection against STDs that are contracted from skin-to-skin contact, such as herpes, HPV and syphilis. Nonetheless, they are still one of the best barriers against STDs and pregnancy that we have available.
4. Consult with your physician if you have any concerns or symptoms, and get tested regularly, even if you don’t have symptoms, as many STDs can be asymptomatic.

It is important to remember that most STDs can be treated and, once cured, we can reduce their spread. Therefore, women of all ages, especially teenagers and young adults, need to be honest with their doctors about their sexual history and seek regular testing.