America: Awash in STDs
Hsu, Gracie S., The World and I
A "hidden epidemic" is stalking America, according to the Institute of Medicine, a branch of the National Academy of Sciences.
More than 25 infectious diseases transmitted by unprecedented rates of promiscuous extramarital sexual activity are infecting at least 12 million Americans annually.
At current rates of infection, at least one in four Americans will contract a sexually transmitted disease (STD) at some point in life.
The United States bears the dubious distinction of leading the industrialized world in overall rates of STDs.
Two-thirds of the 12 million new cases a year are among men and women under age 25. Indeed, about 3 million teenagers--one in four sexually experienced adolescents--acquire an STD each year.
STDs should concern Americans because they can cause such serious consequences as cervical cancer, infertility, infection of offspring, and death. Most people are unaware that
* an estimated 100,000 to 150,000 women become infertile each year as a result of an STD;
* half of the 88,000 ectopic pregnancies that occur each year are due to a preexisting STD infection;
* 4,500 American women die each year from cervical cancer, which is almost always caused by an STD called the human papilloma virus (HPV).
"I don't think people understand [how common some of these serious consequences are, particularly infertility," says Patricia Donovan, senior associate at the Alan Guttmacher Institute (AGI), a nonprofit research corporation specializing in reproductive health.
"Seventy-five percent of women with chlamydia don't have any symptoms. They don't know until 5 years later, when they have serious pelvic pain, or 10 years later, when they can't get pregnant, that they had this STD that would have been easily curable."
STDs such as chlamydia, gonorrhea, syphilis, and trichomoniasis are nonviral and therefore curable if detected early enough. Other STDs, however, are viral and have no cure. These include HPV, genital herpes, sexually transmitted hepatitis B, and the human immunodeficiency virus, or HIV, which is responsible for 90,000 cases of AIDS annually, a figure that was dramatically expanded in 1993 over previous years due to an official redefinition of AIDS.
As many as 56 million individuals--more than one in five Americans--may be infected with an incurable viral STD other than AIDS.
STDs are "a tremendous problem," says W. David Hager, president of the Infectious Diseases Society for Obstetrics and Gynecology.
"Last fall, a New England Journal of Medicine article found that slightly over 21 percent of Americans over age 12 are herpes simplex virus positive," Hager says. "That equals 45 million people.
"Furthermore, huge numbers of coeds on college campuses have HPV. Ninety-five percent of all cervical cancer and dysplasia [abnormal growth of organs or cells] are caused by HPV. And this may only be the tip of the iceberg."
The Institute of Medicine (IOM) estimates that the annual direct and indirect costs of selected major STDs, in addition to the human suffering associated with them, are approximately $10 billion. If sexually transmitted HIV infections are included, the total rises to $17 billion.
Medically, experts agree that the main risk factor for contracting an STD is promiscuity.
"Having more than one lifetime sexual partner connotes risk," says Shepherd Smith, president of the Institute for Youth Development (IYD). "The more partners, the more risk. It's that simple."
Compared with men and women who have had only 1 partner, those who report 2-3 partners are 5 times as likely to have had an STD; those with 4-6 lifetime partners are 10 times as likely; and the odds are 31 times greater for those who report 16 or more partners.
But Americans today are far more promiscuous than in the past. …