This is a companion article to the feature, “Sexually Transmitted Infections Present Diagnostic Challenges.”

The scope of the STI and STD epidemic in the United States is truly staggering. A compilation of statistics by the American Sexual Health Association bears this out.1 More than half of all people will have an STI or STD at some point in their lifetime, and recent estimates from the Centers for Disease Control and Prevention (CDC) show that there are 19.7 million new STIs every year in the United States. In 2008, there were an estimated 110 million prevalent STIs among women and men in the United States. Of these, more than 20% (22.1 million) were among women and men aged 15 to 24 years.

And the financial cost is also staggering: the total estimated direct cost of STIs annually in the United States is $15.6 billion (2010 US dollars).

Further, in a national survey of US physicians, fewer than one third routinely screened patients for STIs or STDs. Each year, one in four teens contracts an STI or STD; one in two sexually active persons will contract an STI or STD by age 25; and about half of all new STIs and STDs in 2000 occurred among youth ages 15 to 24. The total estimated costs of these nine million new cases was $6.5 billion, with HIV and human papillomavirus (HPV) accounting for 90% of the total burden.

In addition, of the STIs and STDs that are diagnosed, only some (chlamydia, gonorrhea, hepatitis A and B, and syphilis) are required to be reported to state health departments and the CDC.

One out of 20 people in the United States will become infected with hepatitis B (HBV) sometime during their lives. HBV is 100 times more infectious than HIV, and approximately half of HBV infections are transmitted sexually. HBV is linked to chronic liver disease, including cirrhosis and liver cancer.

It is estimated that as many as one in five Americans have genital herpes, a lifelong (but manageable) infection, yet up to 90% of those with herpes are unaware they have it. With more than 50 million adults in the United States with genital herpes and up to 776,000 new infections each year, some estimates suggest that by 2025 up to 40% of all men and half of all women could be infected. Over 14 million people acquire HPV each year, and by age 50 at least 80% of women will have acquired genital HPV infection. Most people with HPV do not develop symptoms.

Each year, there are almost 3 million new cases of chlamydia, many of which are in adolescents and young adults. About two-thirds of young females believe doctors routinely screen teens for chlamydia. However, in 2003 only 30% of women 25 and under with commercial healthcare plans and 45% in Medicaid plans were screened for chlamydia.

REFERENCE

  1. Statistics [online]. Research Triangle Park, NC: American Sexual Health Association, 2016. Available at: www.ashasexualhealth.org/stdsstis/statistics.