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Current Epidemiology of Selected STDs

2. Topics. Chlamydia Gonorrhea SyphilisHIV/AIDS Herpes type 2HPV and cervical cancerOther STDs. 3. Chlamydia. . 4. Epidemiology of Chlamydia. Incidence: Approximately 4 million estimated cases in U.S. per annumMost frequently reported STD in U.S.Rates 4x higher in femalesDecreasing prevalence in selected areas with control programs that include clinic-based screeningHigh prevalence of co infection in partners (>50%)Perinatal transmission results in neonatal conjunctivitis in 30-50% of exposed babies.

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Current Epidemiology of Selected STDs

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    1. 1 Current Epidemiology of Selected STDs Division of STD Prevention Centers for Disease Control and Prevention

    2. 2 Topics Chlamydia Gonorrhea Syphilis HIV/AIDS Herpes type 2 HPV and cervical cancer Other STDs

    3. 3 Chlamydia

    4. 4 Epidemiology of Chlamydia Incidence: Approximately 4 million estimated cases in U.S. per annum Most frequently reported STD in U.S. Rates 4x higher in females Decreasing prevalence in selected areas with control programs that include clinic-based screening High prevalence of co infection in partners (>50%) Perinatal transmission results in neonatal conjunctivitis in 30-50% of exposed babies

    5. 5 Chlamydia — Rates by gender: United States, 1984–2003

    6. 6 Chlamydia — Age- and sex-specific rates: United States, 2003

    7. 7 Chlamydia — Rates by state: United States and outlying areas, 2003

    8. 8 Chlamydia Case Rates by County, 2003

    9. 9 Chlamydia — Positivity among 15- to 24-year-old women tested in family planning clinics by state: United States and outlying areas, 2003

    10. 10 Chlamydia — Trends in positivity among 15- to 24-year-old women tested in family planning clinics by HHS regions, 1988–2003

    11. 11 Gonorrhea

    12. 12 Epidemiology of Gonorrhea Proportion of gonococcal infections caused by resistant organisms is increasing Incidence remains high in some groups defined by geography, age and race/ethnicity, or sexual orientation Gonorrhea associated with increased susceptibility to HIV infection

    13. 13 Gonorrhea — Reported rates: United States, 1970–2003 and the Healthy People year 2010 objective

    14. 14 Gonorrhea — Rates by state: United States and outlying areas, 2003

    15. 15 Gonorrhea — Rates by gender: United States, 1981–2003 and the Healthy People year 2010 objective

    16. 16 Gonorrhea — Rates by race and ethnicity: United States, 1981–2003 and the Healthy People year 2010 objective

    17. 17 Gonorrhea — Age- and gender-specific rates: United States, 2003

    18. 18 Gonorrhea — Positivity among 15-24 year old women tested in family planning clinics by state: United States and outlying areas, 2003

    19. 19 Gonococcal Isolate Surveillance Project (GISP) — Percent of Neisseria gonorrhoeae isolates with resistance or intermediate resistance to ciprofloxacin, 1990–2003

    20. 20 MSM Prevalence Monitoring Project — Gonorrhea Positivity Among Men Who Have Sex With Men, STD Clinics, 1999–2003

    21. 21 MSM Prevalence Monitoring Project — Test Positivity For Gonorrhea And Chlamydia Among Men Who Have Sex With Men, By HIV Status, STD Clinics, 2003

    22. 22 Gonococcal Isolate Surveillance Project (GISP) — Percent Of Gonorrhea Cases That Occurred Among MSM, 1988–2003

    23. 23 Syphilis Treponema pallidum

    24. 24 Epidemiology of Syphilis In the 1940s: Syphilis was distributed widely throughout the U.S. 1986-90: 85% increase in the incidence of primary and secondary syphilis Since 1990, reported cases of syphilis have decreased approximately 15% per year to an all-time low in 2000

    25. 25 Epidemiology of Syphilis (continued) Late 1990s: syphilis elimination a feasible goal Rates remain high in: Some urban areas throughout the U.S.; Rural areas in the South; Some minority populations who suffer from poverty, lack of access to health care, and breakdown of stable community and personal relationships. Recent outbreaks have been associated in men who have sex with men (MSM)

    26. 26

    27. 27 Syphilis — Reported cases by stage of illness: United States, 1941–2003

    28. 28 Primary and Secondary Syphilis — Reported rates: United States, 1970–2003 and the Healthy People year 2010 objective

    29. 29 Primary and Secondary Syphilis — Rates by race and ethnicity: United States, 1981–2003 and the Healthy People year 2010 objective

    30. 30 Congenital syphilis — Reported cases for infants <1 year of age and rates of primary and secondary syphilis among women: United States, 1970–2003

    31. 31 Primary and Secondary Syphilis — Age- and gender-specific rates: United States, 2003

    32. 32 Primary and secondary syphilis — Rates by state: United States and outlying areas, 2003

    33. 33 Primary and secondary syphilis — Counties with rates above and counties with rates below the Healthy People year 2010 objective: United States, 2003

    34. 34 MSM Prevalence Monitoring Project — Syphilis Serologic Reactivity Among Men Who Have Sex With Men, STD Clinics, 1999–2003

    35. 35 HIV/AIDS

    36. 36 Epidemiology of HIV/AIDS The peak in 1993 is due to the expansion of the AIDS surveillance case definition implemented in January 1993. In recent years, both AIDS incidence and deaths among persons with AIDS have declined. Declines in new AIDS diagnoses and deaths among persons with AIDS are primarily due to the success of highly active antiretroviral therapies introduced in 1996.

    37. 37 Estimated Incidence of AIDS and Death of Adults with AIDS*, United States, January 1985 – June 2003

    38. 38 Proportion of Adult/Adolescent AIDS Cases by Transmission Category and Year Diagnosis, United States, 1985-2003

    39. 39 Estimated AIDS Incidence* among Adults/ Adolescents, Diagnosed by Sex and Exposure Category, United States, 2003

    40. 40 Proportion of AIDS Cases by Race/Ethnicity and Year of Report, United States, 1985-2003

    41. 41 Reported AIDS Cases in Children <13 Years of Age at Diagnosis, 2003, United States N=152*

    42. 42 AIDS in 13- to 19- Years-Old Cumulative through 2003, United States, N = 2,390

    43. 43 Reported AIDS Cases, by Age and Sex Cumulative through 2003—United States

    44. 44

    45. 45 Estimated Number of AIDS Cases and Rates For Female Adults and Adolescents, by Race/Ethnicity 2003—50 States and DC

    46. 46 Herpes type 2

    47. 47 Epidemiology of Herpes-2 The majority of genital and perirectal herpetic outbreaks in the U.S. are caused by HSV-2 Approximately one million new cases occur each year Seropositivity increases with age 22% of adults over age 12 years have HSV-2 antibodies HSV-2 seroprevalence rates show a correlation with level of sexual activity Seropositivity to HSV-2 is higher in HIV-infected persons and adults of lower socioeconomic status

    48. 48 Genital herpes — Initial visits to physicians’ offices: United States, 1966–2003

    49. 49 Genital Herpes Simplex Virus Type 2 Infections — Percent seroprevalence according to age in NHANES* II (1976-1980) and NHANES III (1988-1994)

    50. 50 HPV and Cervical Cancer

    51. 51 Epidemiology of HPV and Cervical Cancer Genital warts incidence estimated to be approximately 0.3% per year overall Annual incidence of all types of genital HPV infection estimated to be 5.5 million in U.S. overall Estimated that 75% of sexually active adults are infected with genital HPV over their lifetime Over 99% of cervical cancers have HPV DNA detected within the tumor

    52. 52 Genital warts — Initial visits to physicians’ offices: United States, 1966–2003

    53. 53 Age-Adjusted* Incidence of Cervical Cancer by Year of Diagnosis and Race: U.S. 1973-2002

    54. 54

    55. 55

    56. 56 Other STDs

    57. 57 Pelvic Inflammatory Disease Initial visits to physicians’ offices by women 15-44 years of age United States, 1980–2003

    58. 58 Pelvic Inflammatory Disease — Hospitalizations of Women 15-44 Years of Age: United States, 1980–2002

    59. 59 Ectopic Pregnancy – Hospitalizations of Women 15-44 Years of Age: United States, 1980-2002

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