The number of Americans newly infected with syphilis has fallen for the first time in a decade, but sexually transmitted diseases continue to take a staggering toll on the United States, with 19 million new infections each year at a cost of $17 billion annually.
The U.S. Centers for Disease Control and Prevention's annual report on sexually transmitted diseases, which tracks cases of the three reportable STDs, chlamydia, gonorrhea, and syphilis, shows widespread disparities.
Overall, blacks and Hispanics in the United States are far more affected by sexually transmitted diseases than whites, as are young people, according to the annual report, which looks at data from 2010.
"Despite everything we know about how to prevent and treat STDs, they remain one of the more critical challenges in the United States today," Dr. Kevin Fenton, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, said in a telephone interview.
While people aged 15 to 24 make up just a quarter of the sexually experienced population in the United States, they represent nearly half of all new infections.
"The data really confirms that STDs primarily affect young people, and we know that this is of major concern because the health consequences can and do last a lifetime if they are untreated," Fenton said.
The report also found a disproportionate burden of disease among African Americans and Hispanics, Fenton said.
For example, he said rates of chlamydia among African Americans are about 1,383 per 100,000, compared with 467 per 100,000 among Hispanics and 166 per 100,000 for whites.
There are similar patterns for gonorrhea and syphilis.
For gonorrhea, rates for whites are 26 per 100,000. Among Hispanics, rates are about three times that at 63 per 100,000, and among African Americans, the rates are 512 per 100,000.
And while overall rates of syphilis have fallen, there are still wide disparities across ethnic groups, with rates ranging from about 2.4 per 100,000 for whites, 5.9 per 100,000 Hispanics and 20 per 100,000 for African Americans.
"It's not because someone is black or Hispanic or white that results in the differences that we see in STDs. It's really what these represent in terms of differences in health insurance coverage, employment status, in ability to access preventive services or curative services. These are all factors which are going to have a huge impact on communities as well as individuals who are vulnerable to acquiring STDs or not getting them diagnosed early," Fenton said.
Here are some details on each disease:
Overall, rates of gonorrhea rose slightly in 2010 to more than 300,000 cases, but the disease remains at historically low levels.
Reported cases have risen over the past 20 years, but that is due to expanded screening efforts. In 2010, there were 1.3 million reported cases of chlamydia. CDC says fewer than half of sexually active young women are screened for chlamydia.
The overall rate fell for the first time in a decade, falling 1.6 percent in 2010 compared with a year ago. Rates of syphilis fell 20 percent in women, but rose 1.3 percent among men.
The CDC says it is too early to tell whether this is a blip, or the start of a new trend.
In the past five years, syphilis rates among young black men increased 134 percent, driven by sharp increases among young black men who have sex with men. This is especially worrisome because rates of HIV are also rising among this population.
If left untreated, gonorrhea and chlamydia cause infertility, and syphilis can lead to serious long-term complications, including brain, heart and organ damage.
People with any of these diseases are at greater risk for infection with human immunodeficiency virus or HIV, the virus that causes AIDS.