a high probability of dying within four years, is 5-11 months, and the median age at death for the second group is more than five years (Byers et al., 1993).

Human T-cell lymphotropic virus type 1, a retrovirus that is transmitted sexually among adults, is also transmitted perinatally or postnatally from mother to infant and may result in T-cell malignancies and a progressive form of paralysis known as HTLV-1-associated myelopathy later in life. Ophthalmia neonatorum, an eye infection in newborns, results when infants of women with vaginal gonorrhea or chlamydial infection are infected during delivery. Gonococcal ophthalmia neonatorum often produces severe initial inflammation of the tissues around the eye, which may result in corneal ulcers and eventual blindness. Chlamydial pneumonia is also a common illness among infants born to mothers with chlamydial cervical infection. Hepatitis B virus infection, when acquired during birth, becomes a chronic infection in as many as 90 percent of infected newborn infants and may lead to cirrhosis of the liver or liver cancer during midlife in a large proportion of those infected perinatally.

Health Consequences for Infected Pregnant Women

Pregnant women are at increased risk for complications of STDs. Vaginal and cervical infections with STD pathogens can lead to inflammation of the placenta or fetal membranes, resulting in maternal fever during or after delivery, to wound and pelvic infections after Cesarean section, and to postpartum infection of the uterus that may result in infertility (Brunham et al., 1990). As mentioned previously, ectopic pregnancy caused by previous pelvic inflammatory disease is one of the leading causes of maternal death during pregnancy.

Health Consequences for Men

In the United States, HIV infection is currently much more common among men than among women. Acute health consequences of some STDs (e.g., syphilis) are similar in both men and women. Human papillomavirus is associated with cancer of the penis and anus in men; these cancers, however, are less common than cervical cancer in women. Certain STDs, such as gonorrhea and chlamydial infection, produce complications that are unique or more severe in women than in men. However, both gonorrhea and chlamydial infection produce epididymitis in men and chlamydial infection is associated with Reiter's Syndrome, which seems to be more common among men than among women (Berger, 1990). Urethral stricture is a late manifestation of gonorrhea or chlamydial urethritis and is common in developing countries. Infertility seems to be a rare complication of STDs in men. The role of STDs in prostatitis (inflammation of the prostate gland) is uncertain (Colleen and Mårdh, 1990). Over and Piot (1993) compared the health impact of STDs in men and women and have reported that the health burden



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