The impact of STDs on women's health is substantial. STDs disproportionately impact women because women are more susceptible to infection, they are more likely to have undetected infections, and they are more likely to have STD-related complications compared to men. Adolescents and young adults are at greatest risk for acquiring STDs. Female adolescents appear to be particularly susceptible to several STDs. As described in Chapter 3, adolescents and young adults are also likely to lack information regarding STDs, lack health insurance, and use intoxicating drugs; these factors significantly increase risk for STDs.
Many STDs increase an individual's risk for acquiring and transmitting HIV infection. Therefore, reducing STDs would decrease the incidence of HIV infection in the population. Given the strong association between certain STDs and cervical, liver, and other cancers, cancer prevention programs need to incorporate STD prevention strategies as means for preventing such cancers. As emerging and reemerging infections, new sexually transmitted infections appear on a regular basis and are likely to continue to do so as long as rates of risky sexual behaviors remain high and global economic and demographic factors continue to promote emergence of new STDs. STDs are major international health problems, and all nations will have to contribute to prevention efforts on a global scale.
ACS (American Cancer Society). Cancer facts and figures—1996. Atlanta: American Cancer Society, 1996.
AGI (Alan Guttmacher Institute). Sex and America's teenagers. New York: AGI, 1994.
Alter MJ. Heterosexual transmission of hepatitis B and implications for vaccine prevention strategies. Can J Infect Dis 1991;2(suppl A):13A-17A.
Alter MJ, Mast EE. The epidemiology of viral hepatitis in the United States. Gastroenterol Clin of North Am 1994;23:437-55.
AMA (American Medical Association), Council on Scientific Affairs. Health care needs of gay men and lesbians in the United States. JAMA 1996;275:1354-9.
Anderson JE, Brackhill R, Mosher WD. Condom use for disease prevention among unmarried U.S. women. Fam Plann Perspect 1996;28:25-28, 39.
Anderson RM, May RM. Infectious diseases of humans: dynamics and control. Oxford, England: Oxford University Press, Inc., 1991.
Andrus JK, Fleming DW, Harger DR, Chin MY, Bennet DV, Horan JM, et al. Partner notification: can it control epidemic syphilis [see comments]? Ann Intern Med 1990;112:539-43.
Aral SO, Guinan ME. Women and sexually transmitted diseases. In: Holmes KK, Mårdh P-A, Sparling PF, Wiesner PJ, eds. Sexually transmitted diseases. 1st ed. New York: McGraw-Hill, Inc., 1984:85-9.
Aral SO, Holmes KK. Sexually transmitted diseases in the AIDS era. Sci Am 1991;264:62-9.
Aral SO, Holmes KK, Padian NS, Cates W Jr. Overview: individual and population approaches to the epidemiology and prevention of sexually transmitted diseases and human immunodeficiency virus infection. J Inf Dis 1996;174(Suppl 2):S127-33.
Aral SO, Schaffer JE, Mosher WD, Cates W Jr. Gonorrhea rates: what denominator is most appropriate [see comments]? Am J Public Health 1988;78:702-3.
Bauer HM, Ting Y, Greer CE, Chambers JC, Tashiro CJ, Chimera J, et al. Genital human papillomavirus infection in female university students as determined by a PCR-based method. JAMA 1991;265:472-7.