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Young black American women are disproportionately affected by chlamydia and other sexually transmitted infections

Sexually Transmitted Infections (STI) remain rampant in the United States

The newly released annual report by the US Centers for Disease Control and Prevention (CDC) for sexually transmitted infections for the year 2007 makes grim reading. It clearly shows that risky sexual behavior continues unabated despite all the very visible public information efforts.

The most reported sexually transmitted infections (STI) were, as expected, Chlamydia and gonorrhoea. The total number of these exceeded 1.4 million. Also standing out starkly was the continuing increase of a once almost fully eliminated infection syphilis. There was a more than 15% rise of this infection compared to the previous year 2006.

Chlamydia continues to increase; women more affected

There were 1.1 million cases of chlamydia in 2007, a 10% increase from the previous year. That number was also the highest ever reported. Also standing out were the statistics showing a three-fold rate among women as compared to men. The rates stood at 543 cases per 100,000 women  as compared to  190 cases per 100,000 men. The long-term consequences of this (discussed below) regarding fertility is a serious concern. The rates for gonorrhoea between the sexes was more even but still higher for women  (124 per 100,000 women compared to 114 per 100,000 men)

Sexually transmitted infections racial disparities

Racial disparities in the prevalence of sexually transmitted infections (STIs) in the United States continues to be quite pronounced. Dr John M. Douglas, Jr, MD; director of CDC's Division of STD Prevention was quoted as saying that  “the racial disparities in rates of sexually transmitted infections is among the worst health disparities in the nation for any  health condition”. Statistics bear this out:  In 2007, blacks represented 12% of the US population but accounted for 70% of reported gonorrhoea cases, 48% of all chlamydia cases, and 46% of all syphilis cases.

A comparative analysis reveals why there is a great cause for concern. As quoted above, the rate of chlamydia infection among all women for 2007 was 543 per 100,000. If you take a sub-group of teenage black  girls (15 - 19 years), the rate for them was an eye-watering 9646 per 100,000. That is almost 20 times the national average. In other words, nearly 10% of 15 -19 year old black women contracted chlamydia in that year alone. The picture with gonorrhoea is the same.

There is little doubt that socioeconomic status, which is an important predictor of sexual health, is partly responsible for increased prevalence in this population, with higher poverty rates reported among blacks compared to whites.

Gay and bisexual men and STIs

Syphilis is the one STI where men significantly outnumber women. The rate among men in 2007 was 6.6 per 100,000 which is six times higher that seen in women. The disparity is explained by figures showing that, of all the cases reported, a good 65% was among men who have sex with men (MSM).

Long term STI health consequences

There are nearly 19 million new cases of STIs every year. Young people are particularly affected, with 15 - 24 year olds accounting for almost half of all these cases.

Chlamydia, especially when unrecognized (it can be symptom-less) can lead to fertility problems through damaged fallopian tubes. The same applies to gonorrhoea. In the United States, these two infections are estimated to be responsible for 50,000 cases of infertility every year.

Damage to pelvic organs increase the risk of ectopic pregnancy, a potentially life-threatening condition.

Away from fertility issues, pelvic inflammation from these infections can lead to chronic pelvic pain and persistent painful sexual intercourse.

All these STIs increase the risk of acquiring HIV infection and syphilis can lead to irreversible neurological complications including stroke.

Points to remember: