Valentine's Day brings the markedly unsexy news from the Centers for Disease Control (CDC) that the U.S. is in the throes of an "ongoing, severe" STI epidemic. According to the report, the high rate of STIs, which disproportionately affect young adults aged 15-24, costs the country billions of dollars a year. In 2008 alone, the United States spent nearly $16 billion on direct medical costs and treatment.
The study focuses on infection data for the eight most prevalent sexually transmitted infections: chlamydia, gonorrhea, syphilis, herpes, human papillomavirus (HPV), hepatitis B, HIV and trichomoniasis. The 'epidemic,' however, is driven mostly by two infections: HPV and chlamydia. And, especially in the case of HPV, the high rate of infection is entirely preventable.
“STIs take a big health and economic toll on men and women in the United States, especially our youth,” CDC epidemiologist Catherine Lindsey Satterwhite, who led the study of incidence and prevalence, told NBC News. […]
The story could have been different, insisted Matthew Golden, the director of Public Health Seattle and King County HIV/STD Program and a professor of medicine at the University of Washington Center for AIDS and STD. The good news, he said, is that rates for most viral and bacterial infections, including HIV, have stabilized or even dropped.
The “epidemic” Satterwhite speaks of, he said, is driven almost entirely by two bugs: HPV, and chlamydia. Chlamydia, a bacterial infection, is easily curable if it’s diagnosed. And there’s a very effective vaccine for the most dangerous forms of HPV that can trigger cervical, oral, anal, and penile cancers, and cause genital warts.
But, Golden argued, “we have snatched defeat from the jaws of victory” by not pursuing effective strategies, such as school-based universal access to the HPV vaccine.
HPV vaccination programs have been frequently accused of somehow promoting sexual promiscuity by conservative lawmakers, and in many cases face an uphill battle in Republican-dominated state legislatures, despite the fact that studies show no causal relation between vaccination rates and sexual promiscuity.
Another troubling reality is that certain strains of gonorrhea are no longer responding to oral antibiotic treatment. Last month, a study in the Journal of the American Medical Association found that 6.7 percent of patients with gonorrhea at a Toronto clinic still had the disease after a round of cephalosporins, the last effective oral antibiotic used to treat the disease.
From U.S. News:
Less than a year ago, Gail Bolan, director of the CDC's sexually transmitted disease prevention program, wrote that the "threat of untreatable gonorrhea is emerging rapidly." At the time, just 1.7 percent of gonorrhea isolated in the lab were considered resistant to cephalosporins. Allen says her study shows just how fast antibiotic resistance is evolving in the organisms.
"Our results aren't generalizable to the overall population because they all came from one clinic," she says. "But basically, the problem appears worse than we originally thought."
Although each of the nine patients in Canada were cured with the injectable antibiotic known as ceftriaxone, Allen warns that there's been "a parallel increase" in resistance to that antibiotic.
"I think without a doubt this will become a bigger problem," Allen says. "The next threat is when, not if, the same thing happens with ceftriaxone. And then what?"
Condoms offer protection against HPV, chlamydia and other STDs, and just might turn out to be the best Valentine's Day gift that money can buy.