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The Hidden Epidemic: Confronting Sexually Transmitted Diseases (1997)
Institute of Medicine (IOM)

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. "THE NEGLECTED HEALTH AND ECONOMIC IMPACT OF STDs." The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press, 1997.

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Table 2-1 Estimated Annual Incidence and Prevalence of Selected Sexually Transmitted Diseases (STDs) in the United States, 1994

STD

Incidence

Prevalence

Chlamydial infection

4,000,000a

Not available

Gonorrhea

800,000a

Not available

Syphilis

101,000

Not available

Congenital syphilis

3,400

Not available

Human papillomavirus infection

500,000-1,000,000

24,000,000

Genital herpes infection

200,000-500,000

31,000,000b

Hepatitis B virus infection (sexually transmitted)

53,000a

Not available

AIDS

79,897c

185,000d

HIV infection

Not available

630,000-897,000e

Chancroid

3,500

Not available

Trichomoniasis

3,000,000

Not available

Pelvic inflammatory disease

>1,000,000f

Not available

NOTE: The Division of STD Prevention, CDC, is currently developing a process for systematically generating and updating incidence and prevalence estimates for specific STDs.

a Number reflects reported cases to the CDC plus estimated unreported cases.

b Based on Johnson RE, Nahmias AJ, Magder LS, Lee FK, Brooks CA, Snowden CB. A seroepidemiologic survey of the prevalence of herpes simplex virus type 2 infection in the United States. N Engl J Med 1989;321:7-12. However, recent data indicate a substantial recent increase in prevalence in the United States (Johnson R, Lee F, Hadgu A, McQuillan G, Aral S, Keesling S, et al. U.S. genital herpes trends during the first decade of AIDS—prevalences increased in young whites and elevated in blacks. Proceedings of the Tenth Meeting of the International Society for STD Research, August 29-September 1, 1993, Helsinki [abstract no. 22]).

c Reported cases to the CDC. Source: CDC. HIV/AIDS Surveillance Report. Atlanta: Centers for Disease Control and Prevention, 1995;7(2).

d Estimated prevalence of persons diagnosed with AIDS at the end of 1993. All AIDS cases including unreported cases.

e Prevalence as of January 1993. Source: Rosenberg PS. Scope of the AIDS epidemic in the United States. Science 1995;270:1372-5.

f Based on estimate for 1993 by Siegel (Appendix D of present report), Washington and Katz also estimated more than one million cases per year using older data (Washington AE, Katz P. Cost of and payment source for pelvic inflammatory disease. Trends and projections, 1983 through 2000 [see comments]. JAMA 1991;266:2565-9.).

PRIMARY SOURCE: CDC, DSTD/HIVP. Annual Report 1994. U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for Disease Control and Prevention, 1995.

caused by gonorrhea or chlamydia but can also result from infection with ureaplasma, mycoplasma, and other organisms. Genital ulcers can result from herpes, chancroid, syphilis, or other infections. Vaginal discharge can be caused by trichomonas, bacterial vaginosis, or other infections. Syphilis and HIV infection have myriad clinical manifestations and can mimic many health conditions. In addition, common infections once considered trivial are now known to cause

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