National Academies Press: OpenBook
« Previous: APPENDIX A
Suggested Citation:"APPENDIX B." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
×

Appendix B Characteristics of Major STDs in the United States

Suggested Citation:"APPENDIX B." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
×

STD (etiologic agent)

Estimated Annual Incidence, 1994a

Estimated Prevalence, 1994b

Estimated Annual Total Costs (millions of 1994$)c

Routes of Transmissiond

Frequency of Asymptomatic Infectionse

Major Long-Term Health Consequences.f

Increases Risk for Acquisition or Transmission of HIV Infection?g

Effective Curative Treatment Available/ Vaccine Available?h

 

 

 

 

 

 

Adults

Pregnant Women and Infants

 

 

Chlamydial infection (Chlamydial trachomatis)

4,000,000

NA

2,013

Vaginal, anal, and oral sex. Mother-to-infant transmission.

Women: very common. Men: common.

Women: pelvic inflammatory disease, infertility, ectopic pregnancy, chronic pelvic pain. Men: epididymitis, urethral stricture. Women and men: Reiter's syndrome (arthritis), complications of septicemia.

Infants: neonatal eye disease, pneumonia. Pregnant women: prematurity and other complications.

Yes

Yes/No

Gonorrhea (Neisseria gonorrhoeae)

800,000

NA

1,051

Vaginal, anal, and oral sex. Mother-to-infant transmission.

Women: common. Men: uncommon.

Women: pelvic inflammatory disease, infertility, ectopic pregnancy, chronic pelvic pain. Men: epididymitis, urethral stricture. Women and men: complications of septicemia.

Infants: eye infections (conjunctivitis), blindness. Pregnant women: prematurity and other complications.

Yes

Yes (but antibioticresistant strains exist)/No

Syphilis (all stages) (Treponema pallidum)

101,000

NA

106

Vaginal, anal, and oral sex. Mother-to-infant transmission. Very rarely by direct nonsexual contact with infectious lesions. Rarely through blood transfusion if donor is in early stages of disease.

Women: common. Men: common or less common.

Women and men: cardiovascular problems, neurological disorders, damage to other organ systems, often years after the initial infection.

Infants: congenital syphilis. Pregnant women: stillborn fetus, premature delivery.

Yes

Yes/No

Human papillomavirus infection (human papillomavirus)

500,000-1,000,000

24,000,000

3,827

Vaginal, anal, and probably oral sex. Occasional mother-to-infant transmission.

Women and men: very common.

Women: genital cancer (vulvar, cervical, vaginal). Men: penile cancer. Women and men: anal cancer.

Infants: wart-like tumors of larynx.

No evidence

Yes/No

Genital herpes (herpes simplex virus types 1 and 2)

200,000-500,000

31,000,000

237

Vaginal, anal, and oral sex. Direct nonsexual contact with infectious lesions. Mother-to-infant transmission.

Women and men: common.

Women and men: recurrent lesions.

Infants: fetal malformations, severe mental retardation, brain damage. Pregnant women: spontaneous abortion, premature delivery.

Possible

No/No

Suggested Citation:"APPENDIX B." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
×
Complete Table on previous page.
Suggested Citation:"APPENDIX B." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
×

STD (etiologic agent)

Estimated Annual Incidence, 1994a

Estimated Prevalence, 1994b

Estimated Annual Total Costs (millions of 1994$)c

Routes of Transmissiond

Frequency of Asymptomatic Infectionse

Major Long-Term Health Consequences.f

Increases Risk for Acquisition or Transmission of HIV Infection?g

Effective Curative Treatment Available/Vaccine Available?h

 

 

 

 

 

 

Adults

Pregnant Women and Infants

 

 

Hepatitis B virus infection (hepatitis B virus)

53,000 (sexually transmitted cases)

NA

156 (sexually transmitted cases)

Vaginal, anal, and oral sex. Parenterally, through exposure to infectious blood, especially intravenous drug use. Mother-to-infant transmission. Close direct contact with infectious body fluids, especially in health care settings, including blood, saliva, semen, and vaginal fluids.

Women and men common.

Women and men: chronic liver disease, cirrhosis, liver cancer, death.

Infants: same as adults, chronic infection more likely.

No evidence

No/Yes

Chancroid (Haemophilus ducreyi)

3,500

NA

1

Vaginal and anal sex.

Women: common. Men: uncommon.

Long-term consequences uncommon.

Unknown.

Yes

Yes/No

Trichomoniasis (Trichomonas vaginalis)

3,000,000

NA

NA

Vaginal sex.

Women: common. Men: very common.

Women: chronic vaginal discharge.

Infants: possible low birth weight. Pregnant women: possible preterm delivery.

Possible

Yes/No

HIV-1 infection (human immunodeficiency virus)

NA

630,000-897,000 (estimate for January 1993)

6,683 (sexually transmitted cases)

Vaginal, anal, and oral sex. Parenterally, through exposure to infectious blood, especially through intravenous drug use. Mother-to-infant transmission.

Women and men: common.

Women and men: AIDS.

Infants: pediatric AIDS.

 

No/No

NOTE: NA = not available.

a CDC, DSTD/HIVP (Division of STD/HIV Prevention). Annual report, 1994. U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for Disease Control and Prevention, 1995. CDC, DSTDP (Division of STD Prevention). Sexually transmitted disease surveillance, 1994. U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for Disease Control and Prevention, 1995.

b CDC, DSTD/HIVP, 1995 (see above). Rosenberg PS. Scope of the AIDS epidemic in the United States. Science 1995;270:1372-5.

c IOM Committee on Prevention and Control of STDs, Chapter 2 of this volume.

d Benenson AS, ed. Control of communicable disease manual. 16th ed. Washington, D.C.: American Public Health Association, 1995. Wasserheit JN, Aral SO, Holmes KK, Hitchcock PJ, eds. Research issues in human behavior and sexually transmitted diseases in the AIDS era. Washington, D.C.: American Society for Microbiology, 1991. Donovan P. Testing positive: sexually transmitted disease and the public health response. New York: Alan Guttmacher Institute, 1993.

e Categories are (a) very common: > 75 percent of infections; (b) common: > 25 to 75 percent of infections; (c) less common: 5 to 25 percent of infections; and (d) uncommon: < 5 percent of infections are asymptomatic. SOURCE: Wasserheit et al., 1991 (see above).

f Wasserheit et al., 1991 (see above). Donovan, 1993 (see above).

g Wasserheit et al., 1991 (see above).

h CDC. 1993 Sexually transmitted diseases treatment guidelines. MMWR 1993;42(No. RR-14).

Suggested Citation:"APPENDIX B." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
×
Complete Table on previous page.
Suggested Citation:"APPENDIX B." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
×
Page 311
Suggested Citation:"APPENDIX B." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
×
Page 312
Suggested Citation:"APPENDIX B." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
×
Page 313
Suggested Citation:"APPENDIX B." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
×
Page 314
Suggested Citation:"APPENDIX B." Institute of Medicine. 1997. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press. doi: 10.17226/5284.
×
Page 315
Next: APPENDIX C »
The Hidden Epidemic: Confronting Sexually Transmitted Diseases Get This Book
×
Buy Hardback | $59.95 Buy Ebook | $47.99
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

The United States has the dubious distinction of leading the industrialized world in overall rates of sexually transmitted diseases (STDs), with 12 million new cases annually. About 3 million teenagers contract an STD each year, and many will have long-term health problems as a result. Women and adolescents are particularly vulnerable to these diseases and their health consequences. In addition, STDs increase the risk of HIV transmission.

The Hidden Epidemic examines the scope of sexually transmitted infections in the United States and provides a critical assessment of the nation's response to this public health crisis. The book identifies the components of an effective national STD prevention and control strategy and provides direction for an appropriate response to the epidemic. Recommendations for improving public awareness and education, reaching women and adolescents, integrating public health programs, training health care professionals, modifying messages from the mass media, and supporting future research are included.

The book documents the epidemiological dimensions and the economic and social costs of STDs, describing them as "a secret epidemic" with tremendous consequences. The committee frankly discusses the confusing and often hypocritical nature of how Americans deal with issues regarding sexuality—the conflicting messages conveyed in the mass media, the reluctance to promote condom use, the controversy over sex education for teenagers, and the issue of personal blame.

The Hidden Epidemic identifies key elements of effective, culturally appropriate programs to promote healthy behavior by adolescents and adults. It examines the problem of fragmentation in STD services and provides examples of communities that have formed partnerships between stakeholders to develop integrated approaches.

The committee's recommendations provide a practical foundation on which to build an integrated national program to help young people and adults develop habits of healthy sexuality.

The Hidden Epidemic was written for both health care professionals and people without a medical background and will be indispensable to anyone concerned about preventing and controlling STDs.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    Switch between the Original Pages, where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

    « Back Next »
  6. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  7. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  8. ×

    View our suggested citation for this chapter.

    « Back Next »
  9. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!