STDs

  		•  Chlamydia
  		• Gonorrhea
  		• Syphilis
  		• Trichomoniasis
  		• Herpes
  		• Human Immunodeficiency Virus
  		• Human Papilloma Virus
  		• Research on Adolescents and STDs
    SEXUALLY TRANSMITTED DISEASES (STDs)

    There are more than 25 diseases spread primarily by sexual activity. Together these infections — called sexually transmitted diseases (STDs) — have created a significant public health challenge in the United States. While many STDs are curable, others are not. Even those that are curable often have no symptoms and go unrecognized for long periods of time. If left untreated, even curable STDs can result in long-term health problems for both men and women.

    In the United States, there are an estimated 19 million new STD cases each year.[i]

    • Half of these cases occur among young people ages 15–24.
    • In addition, an estimated 65 million people live with an incurable STD.
    • Still, less than half of adults ages 18–44 have ever been tested for an STD other than HIV/AIDS.

    STDs are often divided into two categories—viral and bacterial— based on the type of microorganism that causes the specific disease. In general, bacterial infections can be cured with antibiotics and viral infections can be treated but not cured

    This page focuses on eight of the most common STDs and contains information on how they are spread, how prevalent they are, what signs and symptoms individuals should look for, and what treatment options are available.  Wherever possible it provides links to the original sources of data and information as well as additional websites that provide more information.  This page also provides additional information on research focused on adolescents and STDs.

    Note: Some professionals use the term sexually transmitted infection (STI) instead of sexually transmitted disease (STD).

    CHLAMYDIA

    Chlamydia, which is caused by the bacteria Chlamydia trachomatis, targets the cells of mucous membranes including the surfaces of the urethra (male and female), vagina, cervix, and endometrium (the lining of the uterus) as well as the anus and rectum. Although possible, it rarely targets the mouth or throat. If left untreated in women, it can spread to the fallopian tubes and lead to Pelvic Inflammatory Disease (PID), a serious medical condition that can cause infertility.

    Chlamydia is transmitted through vaginal or cervical secretions and semen during unprotected anal, oral, or vaginal sex with an infected person. It can also be transmitted from mother to newborn during childbirth.

    Chlamydia is not transmitted through such casual contact as hugging, shaking hands, sharing food, using the same eating utensils, drinking from the same glass, sitting on public toilets, or touching door knobs.

    Signs and Symptoms:

    • Signs of infection usually appear within one to three weeks after contact. In some cases, infection is obvious only after several weeks or months. Approximately 75 percent of women and 50 percent of men do not have symptoms.
    • Women may experience such symptoms as itching, vaginal discharge, and burning during urination.
    • Some women may experience pain of the lower abdomen or back, pain during intercourse, bleeding between menstrual periods, nausea, or fever if the infection has spread to the fallopian tubes. This may indicate that the infection has progressed to PID.
    • Men may experience heaviness and discomfort in their testicles and inflammation of their scrotal skin. They may also notice pus in the form of a thick white fluid or watery or milky discharge from the penis. Men may also experience pain or burning during urination.

    Testing:

    • Chlamydia is diagnosed through cultures of secretions collected from the urethra, anus, throat, or cervix. It is also diagnosed through urine tests.

    Treatment:

    • Chlamydia is curable with oral antibiotics prescribed by a health care provider. All partners should undergo treatment at the same time to avoid passing the infection back and forth. They should also be sure to finish the full course of antibiotics even if symptoms subside.

    For more information click here: www.ashastd.org/learn/learn_chlamydia_facts.cfm

    Prevalence:

    • National Data - CDC's STD Surveillance 2005 Report: www.cdc.gov/std/stats/chlamydia.htm
    • In 2005, 976,445 Chlamydia infections were reported to the CDC from 50 states and the District of Columbia for a rate of 332.5 cases per 100,000 people.
    • Nationally, cases of Chlamydia rose 5.1% between 2004 and 2005, from 316.5 cases per 100,000 people in 2004 to 332.5 cases per 100,000 people in 2005.

    Data by Sex:

    • In 2005, the overall rate of reported Chlamydia infection among women in the United States (496.5 cases per 100,000 females) was over three times higher than the rate among men (161.1 cases per 100,000 males), likely reflecting a greater number of women screened for this infection

    Data by Race/Ethnicity:

    • In 2005, Chlamydia rates increased for all race/ethnic groups.
    • The rate of Chlamydia among blacks was over eight times higher than that of whites (1,247.0 cases per 100,000 versus 152.1 cases per 100,000).
    • The rates among American Indian/Alaska Natives (748.7) and Hispanics (459.0) were also higher than that of whites (4.9 and 3.0 times higher, respectively).

    Data by Age:

    • Among women, the highest rates of reported Chlamydia in 2005 were among young women ages 15-19 and ages 20-24 (2,796.6 and 2,691.1 cases per 100,000 females, respectively). These increased rates in women may be, in part, due to increased screening in this group.
    • Chlamydia rates among men were highest in young men ages 20-24 (804.7 cases per 100,000 males).

    State, County, and City Data:

    Research:

    Condoms and Chlamydia Prevention
    Gabriela Paz-Bailey, et al., "The Effect of Correct and Consistent Condom Use on Chlamydial and Gonococcal Infection Among Urban Adolescents," Archives of Pediatric and Adolescent Medicine, 159.6 (June 2005): 536-542.
    Both correct and consistent condom use was reported by only 80 patients (16%).
    Correct and consistent use was associated with a significant reduction in Chlamydia.

    The full text of this article may be obtained online for a fee. For more information:
    See the abstract at the, Archives of Pediatric and Adolescent Medicine www.archpedi.ama-assn.org/cgi/content/abstract/159/6/536), or contact your local librarian.

    If you have difficulty finding this article, you may contact SIECUS www.siecus.org/feedback.html.

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    GONORRHEA

    Gonorrhea, once known as “the clap,” is caused by bacteria called Neisseria gonorrhoea that grow in the warm, moist areas of the reproductive tract, including the cervix, uterus, and fallopian tubes in women and the urethra in both women and men. The bacteria can also grow in the mouth, throat, and anus.

    Gonorrhea is transmitted through vaginal or cervical secretions and semen during unprotected anal, oral, or vaginal sex with an infected person. It can also be transmitted from mother to newborn during childbirth.

    Gonorrhea is not transmitted through such casual contact as hugging, shaking hands, sharing food, using the same eating utensils, drinking from the same glass, sitting on public toilets, or touching door knobs.

    Signs and Symptoms:

    • Most men and women will experience no symptoms.
    • Men may show signs of infection within two to five days after exposure. Women may show signs within 10 days. The signs are similar to those of Chlamydia. Individuals should, therefore, receive tests for both STDs.
    • Men may experience such symptoms as a yellowish discharge from the penis, burning or pain during urination, frequent urination, and pain or swelling of the testicles.
    • Women may experience such symptoms as a yellow or bloody discharge from the vagina and burning or pain during urination.
    • Some women may experience pain of the lower abdomen or back, pain during intercourse, bleeding between menstrual periods, and nausea or fever if the disease has spread to the fallopian tubes. This is often an indication that the infection has progressed to PID.
    • Men and women may have a sore or red throat if that part of the body has become infected.

    Testing:

    • Gonorrhea is diagnosed through cultures of secretions collected from the throat, urethra, anus, or cervix. It is also diagnosed through urine tests.

    Treatment:

    • Gonorrhea is curable with oral antibiotics prescribed by a health care provider. All partners should undergo treatment at the same time to prevent passing the infection back and forth. They should also be sure to finish the full course of antibiotics even if symptoms subside.

    For more information click here: www.ashastd.org/learn/learn_gonorrhea_fact.cfm

    Prevalence:

    • National Data - CDC's STD Surveillance 2005 Report: www.cdc.gov/std/stats/gonorrhea.htm
    • In 2005, gonorrhea cases reported in the United States increased slightly from 330,132 in 2004 to 339,593.
    • * The rate of reported gonorrhea in the United States was 115.6 cases per 100,000 people in 2005, the first increase in gonorrhea since 1999.

    Data by Sex:

    • Prior to 1996, rates of gonorrhea among men were higher than rates among women. 2005, however, was the fifth straight year in which gonorrhea rates in women were slightly higher than in men.
      In 2005 the gonorrhea rate among women was 119.1 cases per 100,000 people and the rate among men was 111.5 cases per 100,000 people.

    Data by Race/Ethnicity:

    • Gonorrhea rates decreased by 17.8% between 2001 and 2005 for African Americans from 762.0 to 626.4 cases per 100,000 people.
    • In contrast, rates in other racial/ethnic groups have increased. Since 2001, the gonorrhea rate among American Indian/Alaska Natives increased 28.4% (131.7 per 100,000 in 2005), the rate among whites increased 19.7% (35.2 per 100,000 in 2005), the rate among Hispanics increased 6.4% (74.8 per 100,000 in 2005), and the rate among Asian/Pacific Islanders increased 5.3% (25.9 per 100,000 in 2005).

    Data by Age:

    • The overall gonorrhea rate for young people ages 20-24 (506.8 cases per 100,000) was over 4 times higher than the national gonorrhea rate.
    • Among females in 2005, young women ages 15-19 and ages 20-24 had the highest rates of gonorrhea (624.7 and 581.2 cases per 100,000 respectively); among males, young men ages 20-24 highest rate (436.8 cases per 100,000). The gonorrhea rate among all of these groups increased slightly in 2005.

    Regional, State, County, and City Data:

    Research:

    Condoms and Gonorrhea Prevention
    Gabriela Paz-Bailey, et al., "The Effect of Correct and Consistent Condom Use on Chlamydial and Gonococcal Infection Among Urban Adolescents," Archives of Pediatric and Adolescent Medicine, 159.6 (June 2005): 536-542.
    Both correct and consistent condom use was reported by only 80 patients (16%).
    Correct and consistent use was associated with a significant reduction in gonorrhea.
    No adolescent girls were infected with gonorrhea if they and their partner(s) used condoms consistently and correctly.

    The full text of this article may be obtained online for a fee. For more information:

    See the abstract at the, Archives of Pediatric and Adolescent Medicine www.archpedi.ama-assn.org/cgi/content/abstract/159/6/536, or contact your local librarian.

    If you have difficulty finding this article, you may contact SIECUS www.siecus.org/feedback.html.

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    SYPHILIS

    Syphilis, which is caused by bacteria called spirochetes, causes sores (chancres) to appear mainly on the external genitals, vagina, anus, or in the rectum. They can also appear on the lips and in the mouth.

    There are three stages of syphilis. During the primary stage, which usually occurs within 10 to 90 days after exposure, a sore may appear. During the secondary phase, which usually occurs within 17 days to six-and-a-half months after exposure, a rash may appear on various parts of the body. If left untreated, Syphilis can proceed to the latent stage during which it may have no visible symptoms but can cause irreversible damage to internal organs.

    Syphilis is transmitted through direct contact with sores during unprotected anal, oral, or vaginal sex with an infected person. Syphilis can also be transmitted from mother to newborn during childbirth.

    Syphilis is not transmitted through such casual contact as hugging, shaking hands, sharing food, using the same eating utensils, drinking from the same glass, sitting on public toilets, or touching door knobs.

    Signs and Symptoms:

    • Women and men may experience the same signs of Syphilis.
    • During the primary stage, a sore may appear on the genitals at or near the place where the bacteria entered the body. Usually firm, round, small, and painless, the sore will develop within 10 to 90 days after contact with the bacteria and will usually last from one to five weeks. A person can easily spread the disease during this stage. If adequate treatment is not received, the infection will progress to the secondary stage.
    • During the secondary stage, a rash may appear over the entire body or on the hands and soles of the feet. Other symptoms may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and tiredness. Symptoms may appear from 17 days to six-and-a-half months after infection has occurred. They can last up to six months. A person can easily spread the disease during this stage. If adequate treatment is not received, the infection will progress to the latent stage.
    • During the latent stage, the untreated bacteria will begin to damage internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Latent signs may include uncoordinated muscle movements, paralysis, numbness, gradual blindness, and dementia. A person is not usually contagious during this stage.

    Testing:

    • Syphilis is diagnosed through cultures of secretions from the sore or through blood tests.

    Treatment:

    • Syphilis is curable with antibiotics prescribed by a health care provider. Damage to internal organs during the latent stage is irreversible. All partners should undergo treatment at the same time to prevent passing the infection back and forth. They should also be sure to finish the full course of antibiotics even if symptoms subside.

    For more information click here: www.ashastd.org/learn/learn_syphilis_facts.cfm

    Prevalence:

    • National Data - CDC's STD Surveillance 2005 Report: www.cdc.gov/std/stats/syphilis.htm
    • In 2005, the reported cases of primary and secondary (P&S) syphilis increased 9.3% to 8,724 from 7,980 in 2004.
    • The rate of P&S syphilis in the United States in 2005 (3.0 cases per 100,000) was 11.1% higher than the rate in 2004 (2.7 cases per 100,000).

    Data by Sex:

    • The rate of P&S syphilis increased 8.5% among men (from 4.7 to 5.1 cases per 100,000 men) between 2004 and 2005. During this time, the rate increased among women from 0.8 to 0.9 cases per 100,000 women.
    • The male-to-female rate ratio for P&S syphilis has risen steadily since 1996 when it was 1.2, suggesting an increase in syphilis among men who have sex with men during this time. The male-to-female rate ratio in 2005 was 5.7.

    Data by Race/Ethnicity:

    • From 2004 to 2005, the rate among whites increased 12.5% (from 1.6 to 1.8 per 100,000); rates among white men increased 10% (from 3.0 to 3.3 per 100,000) but stayed the same among white women (0.3).
    • The rate among African Americans increased 11.4% (from 8.8 to 9.8); rates among African-American men increased 12.9% (from 13.9 to 15.7 cases per 100,000) and rates among African-American women increased 4.8% (from 4.2 to 4.4 cases per 100,000).
    • The rate among Hispanics increased 6.5% (from 3.1 to 3.3 case per 100,000); rates among Hispanic men increased 1.9% (from 5.4 to 5.5 cases per 100,000 men) and rates among Hispanic women increased 28.6% (from 0.7 to 0.9 cases per 100,000 women).
    • The rate among Asian/Pacific Islanders stayed the same (1.2 cases per 100,000); rates among Asian/Pacific Islanders men increased 4.5% (from 2.2 to 2.3 cases per 100,000 men) but stayed the same among women (0.2 cases per 100,000 women).
    • The rate among American Indian/Alaska Natives decreased 22.6% (from 3.1 to 2.4 cases per 100,000); rates among American Indian/Alaska Native men decreased 5.7% (from 3.5 to 3.3 cases per 100,000 men) and rates among American Indian/Alaska Natives women decreased 42.9% (from 2.8 to 1.6 cases per 100,000 women).

    Data by Age:

    • In 2005, the rate of P&S syphilis among African Americans was highest among women ages 20-24 (13.5 cases per 100,000) and among men ages 25-29 (38.2 cases per 100,000).
    • For whites, the rate was highest among women ages 20-24 years (0.8 cases per 100,000) and among men ages 35-39 years (10.3 cases per 100,000).
    • For Hispanics, the rate was highest among women ages 20-24 (2.9 cases per 100,000) and among men ages 35-39 (14.0 cases per 100,000)
    • For Asian/Pacific Islanders, the rate was highest among women ages 20-24 (0.8 per 100,000) and among men ages 30-34 years (6.6 cases per 100,000).
    • For American Indian/Alaska Natives, the rate was highest among women ages 35-39 years (4.7 cases per 100,000) and among men ages 30-34 years (11.4).

    Regional, State, County, and City Data:

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    TRICHOMONIASIS

    Trichomoniasis, or “trich,” is a genital inflammation caused by the protozoa trichomonas vaginalis.

    Trichomoniasis is transmitted through skin-to-skin contact during unprotected anal, oral, or vaginal sex with an infected person.

    Signs and Symptoms:

    • Signs of infection in women usually appear within five to 28 days after exposure. Men usually show no signs of infection.
    • Women may have a frothy, yellow-green vaginal discharge with a strong odor. They may also experience burning during intercourse and urination as well as irritation and itching of the female genital area.
    • Pregnant women may experience a premature rupture of the membranes and a preterm delivery.
    • Men may experience irritation inside the penis, a mild discharge, or a slight burning after urination or ejaculation.

    Testing:

    • Trichomoniasis is diagnosed through cultures of vaginal and penile discharge.

    Treatment:

    • Trichomoniasis is curable with antibiotics prescribed by a health care provider. All partners must undergo treatment at the same time to prevent passing the infection back and forth. They should also be sure to finish the full course of antibiotics even if symptoms subside

    For more information click here: www.ashastd.org/learn/learn_vag_trich_tri.cfm

    Prevalence:

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    HERPES

    Herpes is a recurrent skin condition characterized by sores on the mouth or genitals. It is caused by the herpes simplex viruses called HSV-1 and HSV-2. Although HSV-1 most commonly causes cold sores or fever blisters on the mouth or face and HSV-2 most commonly causes sores on the penis or vulva, the viruses are identical under a microscope and either type can infect the mouth or genitals.

    Herpes is transmitted through skin-to-skin contact during unprotected anal, oral, or vaginal sex with an infected person or through kissing. This is possible even when no sores are present.

    Herpes is not transmitted through such casual contact as hugging, shaking hands, sharing food, using the same eating utensils, drinking from the same glass, sitting on public toilets, or touching door knobs.

    Signs and Symptoms:

    • Individuals are often not aware they are infected with Herpes because there are either no symptoms, mild symptoms that are not noticed, or symptoms that are mistaken for other health problems such as yeast infections, insect bites, and hemorrhoids.
    • Signs of Herpes may first appear within days. They may, however, not appear for weeks, months, or years. Symptoms can last for three or four weeks though they usually heal within two to 12 days.
    • Symptoms may include one or more sores, blisters, cuts, pimples, bumps, or a rash. Other symptoms include an itching, burning, or tingling in either the genital area or the mouth, a fever, or swollen glands.
    • Individuals usually have an average of four to five Herpes outbreaks a year. The recurrences tend to lessen in severity and frequency with time.

    Testing:

    • Herpes is diagnosed through a visual examination of sores, an analysis of cultures from the sore(s), or blood tests.

    Treatment:

    • There is no cure for Herpes. Antiviral medications can reduce the frequency of outbreaks and speed the healing of the outbreaks.

    For more information click here: www.ashastd.org/herpes/herpes_learn.cfm

    Prevalence:

    • National Data - CDC's Tracking the Hidden Epidemics: Trends in STDs in the United States 2000 Report: www.cdc.gov/std/Trends2000/herpes.htm
    • More than one in five Americans - 45 million people - are infected with genital herpes.
    • From the late 1970s to the early 1990s, herpes prevalence increased 30 percent.
    • Preliminary 1999 data from the National Health and Nutrition Examination Survey (NHANES) suggest that the prevalence of HSV-2 has remained relatively stable over the 1990s. In 1999, the estimated prevalence was 19% among the people ages 14-49.

    Data by Sex:

    • Herpes is more common in women than men, infecting approximately one out of four women, versus one out of five men. This difference in gender may be because transmission from males to females is more efficient than transmission from females to males.

    Data by Race/Ethnicity:

    • Although genital herpes is increasing among young whites, the infection is more common among African Americans. The prevalence among African Americans tested for herpes is 45%, as compared to whites, who have a prevalence of approximately 17%.
    • To view a table showing Herpes prevalence by race/ethnicity and sex: www.cdc.gov/std/Trends2000/herpes-close.htm

    Data by Age:

    • The percent of people infected with herpes increases with age because, once infected, people remain infected with this incurable disease throughout their lives. Herpes infection is believed to be acquired most commonly during adolescence and young adulthood, as individuals become sexually active and may have multiple partners.
    • Herpes prevalence among white teens ages 12-19 in the 1990s was five times greater than the prevalence in the 1970s. Among young white adults ages 20-29, herpes prevalence increased two-fold during that period.

    Regional, State, County, and City Data:

    • Herpes is common in all regions of the country and in both urban and rural areas. There are no significant differences in prevalence by geographic location.

    Research:

    Condoms and Herpes Prevention
     Anna Wald, et al., "Effect of Condoms on Reducing the Transmission of Herpes Simplex Virus Type 2 From Men to Women," Journal of the American Medical Association, 285.24 (June 27, 2001): 3100-3106.
    Condom use offers significant protection against HSV-2 infection in susceptible women.
    Changes in sexual behavior, correlated with counseling about avoiding sex when a partner has lesions, were associated with reduction in HSV-2 acquisition over time.

    The full text of this article may be obtained online for a fee. For more information:
    See the abstract at the Journal of the American Medical Association http://jama.ama-assn.org/cgi/content/abstract/285/24/3100, or contact your local librarian.

    If you have difficulty finding this article, you may contact SIECUS www.siecus.org/feedback.html.

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    HUMAN IMMUNODEFICIENCY VIRUS

    The Human Immunodeficiency Virus (HIV) causes an individual’s immune system to weaken and lose its ability to fight off infections and cancers. After developing a number of these infections or reaching a certain blood count level, an HIV-positive person is diagnosed with Acquired Immunodeficiency Syndrome (AIDS).

    HIV is present in blood, semen, vaginal secretions, and breast milk. It is transmitted through unprotected anal, vaginal, and oral sex with an infected person; through contaminated needles or syringes used to inject drugs; or from an infected mother to her newborn during childbirth or breast-feeding.

    HIV is not transmitted through such casual contact as hugging, shaking hands, sharing food, using the same eating utensils, drinking from the same glass, sitting on public toilets, or touching door knobs.

    Signs and Symptoms:

    • There are no symptoms of HIV infection.
    • The average time between HIV infection and AIDS is eight to 11 years.
    • Over time, HIV causes the body to develop opportunistic infections or cancers normally controlled by a healthy immune system.
    • AIDS symptoms are usually those of the opportunistic infection or cancer. These include fever, chills and sweats, chronic fatigue, appetite or weight loss, muscle and joint pain, long-lasting sore throat, swollen lymph nodes, diarrhea, yeast infections, and skin sores.
    • Opportunistic infections that most frequently affect individuals with AIDS include Kaposi's sarcoma, Pneumocystis carinii pneumonia (PCP), tuberculosis, meningitis, and Herpes simplex infections.

    Testing:

    • HIV infection is diagnosed through blood tests. It can also be diagnosed through urine tests and an oral fluid test taken from the inside of the mouth.
    • Tests that determine HIV infection look for antibodies produced by the body to fight the virus. Most people will develop such antibodies between 25 days and three months after infection (though in rare cases it can take up to six months). Although it is possible to test earlier, the CDC recommends testing three months after the last possible exposure.
    • Testing sites may provide pre- and post-test counseling for those who want it. They may also provide either anonymous (no name given) or confidential (name given only to doctor) testing. Some states require that doctors report positive results to state health departments. Individuals should check to determine procedures at individual sites.
    • For more information about HIV tests and test sites, individuals should contact the CDC National AIDS Hotline at 1-800/342-2437 (English), 1-800/344-7432, (Spanish), or 1-800/243-7889 (TTY) or the CDC’s National HIV Testing Resources webpage at www.hivtest.org

    Treatment:

    • There is no cure or vaccine for HIV or AIDS. There are, however, new combinations of drugs (called “cocktails”) that allow people to live with the infection or HIV/AIDS for longer periods of time.

    For more information click here: www.ashastd.org/learn/learn_hiv_aids_overview.cfm

    Prevalence:

    • National Data - CDC's "A Glance at the HIV/AIDS Epidemic" fact sheet: www.cdc.gov/hiv/resources/factsheets/At-A-Glance.htm
    • At the end of 2003, it was estimated that between 1,039,000 and 1,185,000 persons in the United States were living with HIV/AIDS.
    • In 2005, 38,096 cases of HIV/AIDS in adults, adolescents, and children were diagnosed in the 33 states with updated reporting systems.
    • The CDC estimates that approximately 40,000 people in the United States become infected with HIV each year.
    • In 2005, the largest portion of HIV/AIDS diagnoses were for men who have sex with men (MSM), followed by adults and adolescents infected through heterosexual contact.

    Data by Sex:

    • CDC's HIV/AIDS Among Women fact sheet: www.cdc.gov/hiv/topics/women/resources/factsheets/women.htm
    • In 2005, almost three quarters of HIV/AIDS diagnoses were for male adolescents and adults.
    • In 2002, HIV infection was the 5th leading cause of death among all women ages 35-44 and the 6th leading cause of death among all women ages 25-34.
    • In 2004, heterosexual contact was the source of 78% of new infections in women.

    Data by Race/Ethnicity:

    • CDC's HIV/AIDS Among African Americans, HIV/AIDS Among Hispanics, HIV/AIDS Among Asian/Pacific Islanders, and HIV/AIDS Among American Indians and Alaskan Natives fact sheets: www.cdc.gov/hiv/resources/factsheets/index.htm#Surveillance
    • In 2005, African Americans, who make up approximately 12% of the U.S. population, accounted for almost half of the estimated number of HIV/AIDS cases diagnosed.
    • Most African-American men living with HIV/AIDS were through sexual contact with other men, followed by injection drug use and high-risk heterosexual contact.
    • Most African-American women living with HIV/AIDS were exposed through high-risk heterosexual contact, followed by injection drug use.
    • In 2004, Hispanics accounted for 18% of new diagnoses reported in the 35 states and territories (includes the U.S. Virgin Islands and Guam) with updated reporting systems.
    • Most Hispanic living with HIV/AIDS men were exposed through sexual contact with other men, followed by injection drug use and heterosexual contact. Most Hispanic women living with HIV/AIDS were exposed through heterosexual contact, followed by injection drug use.
    • At the end of 2004, less than 1% of the estimated 462,792 persons living with HIV infection or AIDS in the 35 states and territories with updated reporting systems were Asians and Pacific Islanders.
    • At the end of 2004, 77% of Asians and Pacific Islanders living with HIV/AIDS were men, 22% were women, and 1% were children.
    • The numbers of HIV and AIDS diagnoses for American Indians and Alaska Natives represent less than 1% of the total number of HIV/AIDS cases reported to the CDC. However, when population size is taken into account, this population in 2004 was ranked 3rd in rates of AIDS diagnoses, after African Americans and Hispanics.
    • In the 33 states with updated reporting systems, women accounted for 29% of the HIV/AIDS diagnoses among American Indians and Alaska Natives between 2001 and 2004.

    Data by Age:

    • CDC's HIV/AIDS and Youth fact sheet: www.cdc.gov/hiv/resources/factsheets/youth.htm
    • In 2004, 13% of new infections occurred in young people ages 13-24.
    • In 2004, 55% of new infections among young people occurred in African- American youth.
    • In the 7 cities that participated in CDC's Young Men's Survey during 1994-1998, 14% of African American young men who have sex with men (MSM) and 7% of Hispanic MSM ages 15-22 were infected with HIV.
    • The number of young people living with AIDS increased by 42% to 5,457 in 2004 from 7,761 in 2000.
    • During 2001-2004, in the 33 states with updated reporting systems, 62% of the 17,824 young people ages 13-24 diagnosed with HIV/AIDS were males and 38% were females.

    State Data:

    Research:

    Epidemiology of HIV/AIDS Among Young Adults
    Maria C Rangel, et al., "Epidemiology of HIV and AIDS among Adolescents and Young Adults in the United States," Journal of Adolescent Health, 39.2 (August 2006), 156-163.

    At the end of 2003, 7074 adolescents and young adults, ages 13-24 years at the time of diagnosis, were living with AIDS in the United States.

    National case surveillance data for young people ages 13-24 revealed that the burden of HIV and AIDS falls most heavily upon the Southern region of the United States and disproportionately upon black and Hispanic youth.

    Findings highlight the need for intensified HIV-prevention efforts within minority communities and among men who have sex with men as well as strengthened efforts to encourage at-risk youth to get tested for HIV.

    The full text of this article may be obtained online for free through the Journal of Adolescent Health www.jahonline.org/article/PIIS1054139X06000772/fulltext.

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    HUMAN PAPILLOMA VIRUS

    There are over 100 strains of the human papillomavirus (HPV). Approximately a third of these strains are sexually transmitted and cause genital HPV. Some types of genital HPV cause warts that infect the genital tract. These warts can grow on the cervix, vagina, vulva, penis, scrotum, urethra, and anus. HPV can also cause other abnormal cells to grow on the cervix. Some strains of HPV can lead to cervical cancer.

    HPV is transmitted by direct skin-to-skin contact with an infected individual. It can also be transmitted when warts are not present. It is sometimes transmitted from mother to infant during childbirth.

    Certain strains of HPV are considered the primary risk factor for cervical cancer. The majority of such cancers develop through a series of gradual precancerous lesions that are easily detected by a Pap smear, and can be removed.

    A Pap smear is a routine gynecological test in which a health care provider uses a cotton swab or similar instrument to collect cells from the cervix. The test looks for abnormal or precancerous cells. These cells may be signs of cervical cancer.

    Regular Pap smears reduce the risk of invasive cervical cancer by early detection of abnormal cells.

    Researchers at the pharmaceutical companies Merck and GlaxoSmithKline have developed vaccines that target particular strains of HPV. Merck’s vaccine, Gardasil, targets HPV types 16 and 18, which are associated with 70% of all cervical cancer and types 6 and 11 which are associated with 90% of all genital warts. GlaxoSmithKline’s vaccine only targets HPV types 16 and 18. Both vaccines have been shown to be nearly 100% effective in preventing infection with the HPV strains they target. Merck’s vaccine, Gardasil, was approved by the Food and Drug Administration (FDA) for females ages 9–26 and was recommended for routine use with females ages 11–12.

    It is important to note that not every HPV infection will become cervical cancer. The National Cancer Institute points out that while HPV infection is common, cervical cancer is not.

    Signs and Symptoms:

    • People with HPV may experience no visible signs or symptoms or may have warts in places they cannot see (such as the cervix).
    • Genital warts are raised or flat growths that are usually flesh colored or whitish in appearance.
    • Genital warts usually do not cause itching or burning.
    • If left untreated, genital warts may disappear. However, HPV infection remains and warts can reappear.

    Testing:

    • HPV is often diagnosed through a visual examination of genital warts. In some cases, a biopsy is necessary. The presence of HPV on the cervix is detected through a Pap smear.

    Treatment:

    • There is no cure for HPV. There are, however, a number of methods to remove warts.

    For more information click here: www.ashastd.org/hpv/hpv_learn.cfm

    Prevalence:

    • National Data - CDC's Tracking the Hidden Epidemics, Trends in STDs in the United States, 2000: www.cdc.gov/std/Trends2000/HPV.htm
    • Every year, about 5.5 million people acquire a genital HPV infection.
    • An estimated 75% of the reproductive-age population has been infected with sexually transmitted HPV.
    • Research indicates that approximately 1% of sexually active adults in the United States have genital warts.

    Data by Sex and Age:

    • Eileen F. Dunne, et al., "Prevalence of HPV Infection Among Females in the United States," Journal of the American Medical Association, 297.8 (February 28, 2007): 813-819. The full text of this article may be obtained online for free through the Journal of the American Medical Association (www.jama.ama-assn.org/cgi/content/full/297/8/813)
    • National Data – CDC’s National Health and Nutrition Examination Survey, 2003-2004: www.cdc.gov/nchs/about/major/nhanes/nhanes2003-2004/nhanes03_04.htm
    • For females the percent of the population infected is listed by age group:
      • 25% for young women 14-19,
      • 45% for women 20-24,
      • 27% for women 25-29,
      • 28% for women 30-39,
      • 25% for women 40-49,
      • 20% for women 50-Y.
    • In the U.S., about 1 in 4 females (27%) ages 14-59 are infected with HPV. This is equivalent to 25 million American women.
    • 57% of females aged 14-19 and 97% of females aged 20-59 years are sexually active. The prevalence of HPV infection is highest in these groups, affecting approximately 40% of sexually active 14-19 year old girls and 50% of sexually active 20-24 year old women. HPV prevalence is substantially lower in sexually active women aged 24-59 years.
    • For females 15-49, about 2% have HPV strains 16 and 18, which together cause about 70% of cervical cancer cases. These two strains are the target of the two vaccines in development or on the market.
    • Although less data are available on HPV among men, levels of current infection in men appear to be similar to those in women.

    Research:

    Condoms and HPV Prevention
     Rachel L. Winer, et al., "Condom Use and the Risk of Genital Human Papillomavirus Infection in Young Women," New England Journal of Medicine, 354.25 (June 22, 2006): 2645-2654.

    Among newly sexually active women, consistent condom use reduced the risk of HPV infection by 70%.

    Even women whose partners used condoms more than half the time had a 50 percent risk reduction, as compared with those whose partners used condoms less than 5% of the time.

    The full text of this article may be obtained online for free through the New England Journal of Medicine ( www.content.nejm.org/cgi/content/full/354/25/2645).

    National Institutes of Health, Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention (June 12-13, 2000).
    This comprehensive review found that of ten studies of condoms and precancerous or cancerous changes in the cervix, six found statistically significant reductions in risk, ranging from 39% to 80%.

    The full text of this article may be obtained online for free through the National Institutes of Health (www.niaid.nih.gov/research/topics/STI/pdf/condomreport.pdf).

    U.S. Centers for Disease Control and Prevention, Report to Congress: Prevention of Genital Human Papillomavirus Infection (Jan. 2004)

    The CDC panel found that "available studies suggest that condoms reduce the risk of the clinically important outcomes of genital warts and cervical cancer."

    The full text of this article may be obtained online for free through the Centers for Disease Control (www.cdc.gov/std/HPV/2004HPV%20Report.pdf).

    HPV and Sexual Active Young Women
     Gloria Ho, et al., "Natural History of Cervicovaginal Papillomavirus Infection in Young Women," New England Journal of Medicine, 338.7 (February 12, 1998), 423-428.

    The incidence of HPV infection among sexually active young women in college was 43%.

    The median duration of new infections was 8 months.

    In 91% of young women with new HPV infections, HPV became undetectable within two years.

    The full text of this article may be obtained online for a fee. For more information:

    See the abstract at the New England Journal of Medicine (www.content.nejm.org/cgi/content/abstract/338/7/423), or Contact your local librarian.

    If you have difficulty finding this article, you may contact SIECUS (www.siecus.org/feedback.html).

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    RESEARCH ON ADOLESCENTS AND STDS

    Factors Associated with STDs in Young Adults:

    • SCarol A. Ford, et al., “Predicting Adolescents’ Longitudinal Risk for Sexually Transmitted Infection,” Archives of Pediatric and Adolescent Medicine 159.7 (July 2005): 657–664.
    • Adolescents who perceived that their parents more strongly disapproved of their having sex during adolescence were less likely to have STIs 6 years later.
    • Feelings of connection to family or school, reported importance of religion, attending a parochial school, and pledges of virginity during adolescence did not predict STI status 6 years later.
    • Most factors associated with increased duration of virginity in adolescence do not influence the trajectory of STI risk.

    The full text of this article may be obtained online for a fee.  For more information:

    See the abstract at the Archives of Pediatric and Adolescent Medicine www.archpedi.ama-assn.org/cgi/content/abstract/159/7/657,
    or contact your local librarian.
    If you have difficulty finding this article, you may contact SIECUS www.siecus.org/feedback.html.

    Adolescent Knowledge, Attitudes, and Experience with STDs:

    • Tina Hoff, et al., National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences (Menlo Park, CA: Henry J. Kaiser Family Foundation, 2003).
    • One in five young people believe that they would simply “know” if someone they were dating had an STD and almost one in six mistakenly believe that STDs can only be spread when symptoms are present.
    • About one in 10 young people either doesn’t know you can get an STD through oral sex or thinks that oral sex poses no risk.
    • About one in four sexually active adolescents, and half of sexually active young adults, report having been tested for HIV, the virus that causes AIDS, and about the same percentage report having been tested for other STDs.

    The full text of this article may be obtained online for free through the Henry J. Kaiser Family Foundation www.kff.org/youthhivstds/3218-index.cfm

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