Genital Herpes Prevalence Down Among Teens, Adults; Number of Syphilis, Other STD Cases Rising, Studies Say
Genital herpes prevalence in the United States has decreased "significantly" in recent years, federal health officials said on Monday at the 2004 National STD Prevention Conference in Philadelphia, the New York Times reports. Dr. Fujie Xu and colleagues from CDC tested blood samples for evidence of herpes simplex virus type 2 antibodies. Although the tests cannot determine when a person was infected, rates among young people are considered to be a "measure of more recent risky sexual behavior," according to the Times. According to two national surveys -- one conducted from 1988 to 1994 and the second in 1999 and 2000 -- the prevalence of type 2 herpes, the most common cause of genital herpes, declined 17% over the 12-year period among people ages 14 to 49. Herpes prevalence among people ages 14 to 19 fell 74%, from 5.8% to 1.5%, and among young adults ages 20 to 29, the rate fell 48%, from 17.2% to 8.9% (Altman, New York Times, 3/9). Officials said that the reason for the decline was unclear but that it was consistent with national surveys indicating a decline in risky sexual behavior among U.S. teens, the Philadelphia Inquirer reports (Uhlman, Philadelphia Inquirer, 3/9).
Early reports indicate that the number of new cases of syphilis, which CDC had hoped to eliminate by 2005, increased in 2003 for the third year in a row (New York Times, 3/9). The number of confirmed primary and secondary syphilis cases increased from 6,862 in 2002 to 7,082 in 2003 (Washington Post, 3/9). Syphilis prevalence rose from 2.4 cases per 100,000 people in 2002 to 2.5 cases per 100,000 people in 2003. CDC researchers said that an estimated 60% of the cases occurred among men who have sex with men, compared with 5% in 1999. The increase is of "particular concern" because syphilis infection can increase the risk of contracting or transmitting HIV, according to Reuters. About 70% of MSM infected in recent syphilis outbreaks are HIV-positive (Simao, Reuters, 3/8). Dr. John Douglas, director of CDC's Division of STD Prevention, said that the increase in the number of syphilis cases among MSM may be fueled by the use of the Internet to meet sex partners and by an increase in methamphetamine use, the Atlanta Journal-Constitution reports. In addition, "AIDS fatigue" and the success of HIV treatments have led to an increase in risky sexual behavior, researchers said (Wahlberg, Atlanta Journal-Constitution, 3/9).
Researchers also reported high rates of chlamydia, human papillomavirus and other sexually transmitted diseases (Washington Post, 3/9). Researchers on Monday presented several studies showing that chlamydia is "widespread" and that prevalence among young people has not changed in recent years, the Inquirer reports. Researchers from the Minnesota Department of Health found that nearly 10% of 1,300 adolescent males tested positive for chlamydia in the state between 1999 and 2001. The researchers said that the percentage was "unexpectedly high." Another study of 3,400 young people in Oakland County, Mich., found that 18% tested positive for chlamydia. In addition, a study conducted by the Philadelphia Department of Public Health found that almost 40% of reported chlamydia cases in 2002 were among teens ages 15 to 19 (Philadelphia Inquirer, 3/9). Researchers on Monday also presented two studies on HPV prevalence. More than 30% of women and 18.7% of men in a recent study conducted by the University of Colorado Health Sciences Center were infected with a strain of HPV that is linked to cervical and anal cancers (Reuters, 3/8).
CDC on Monday issued a "Dear Colleague" letter calling on public health programs and private health care providers to offer "comprehensive STD prevention services" for MSM. The letter, signed by Douglas, Division of Viral Hepatitis Director Harold Margolis, Division of Immunization Services Director Lance Rodewald and Divisions of HIV/AIDS Prevention Director Robert Janssen, calls for "integrated services" to prevent all STDs. The letter calls attention to CDC's 2002 STD Treatment Guidelines, which call for all sexually active MSM each year to undergo HIV, syphilis, gonorrhea and chlamydia testing and recieve vaccinations against hepatitis A and B. In addition, the letter says that HIV and STD prevention workers should try to structure programs to address all STDs. MSM seeking preventive or clinical services related to STDs should receive or be referred to all CDC recommended STD prevention services, the letter says (CDC letter, 3/8). "The ... letter comes at a critical time for state and local public health officials battling increases in HIV and STD infections among gay men," Julie Scofield, executive director of the National Alliance of State & Territorial AIDS Directors, said in a statement, adding, "Leadership from CDC is essential now to promote integrated preventive and clinical STD services" (NASTAD/National Coalition of STD Directors release, 3/8).