1. Focus Area 25 Sexually Transmitted Diseases Progress Review July 21, 2004

2. STD’s: Magnitude of the Problem More than 65 million people currently living with an incurable sexually transmitted disease 18.9 million new STD infections (curable and incurable) each year; Half occur in persons under age 25 Direct medical cost in 2000: $9.3 - $15.5 billion Source: STD Surveillance System, NCHSTP,CDC; MMWR weekly, April 30, 2004 / 53(16); 346-347.

3. 25-14. Screening in youth detention facilities and jails 25-15. Contracts to treat nonplan partners of STD patients 25-1. Chlamydia 25-2. Gonorrhea 25-3. Primary and secondary syphilis Bacterial STD Illness and Disability Sexually Transmitted Diseases Personal Behaviors 25-4. Genital herpes 25-5. Human papillomavirus infection Viral STD Illness and Disability STD Complications Affecting Females, Fetus and Newborn 25-6. Pelvic inflammatory diseases 25-7. Fertility problems 25-8. Heterosexually transmitted HIV in women 25-9. Congenital syphilis 25-10. Neonatal STDs 25-11. Responsible adolescent sexual behavior Community Protection Infrastructure 25-13. Hepatitis B vaccine in STD clinics Personal Health Services 25-16. Annual screening for genital Chlamydia 25-17. Screening of pregnant females 25-18. Compliance with STD treatment standards 25-19. Provider referral services for sex partners 25-12. Responsible sexual messages on TV Improving Getting worseLittle or no change Cannot assess (limited data) Objective to be dropped

4. 25-1. Chlamydia 25-2. Gonorrhea 25-3. Syphilis 25-4. Genital Herpes 25-6. Pelvic Inflammatory Disease 25-7. Fertility Problems 25-11. Responsible Adolescent Sexual Behavior Highlighted Objectives

5. Reported incidence per 100,000 population (log scale) Chlamydia Gonorrhea Syphilis Chlamydia, Gonorrhea, and Syphilis Infections Source: STD Surveillance System, NCHSTP,CDC. 0

6. Reported incidence per 100,000 population Chlamydia: Infections by Gender Male Female Source: STD Surveillance System, NCHSTP,CDC.

7. Reported incidence per 100,000 population Chlamydia: Infections by Race and Ethnicity Note: American Indian includes Alaska Native. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons were asked to select only one race category; selection of more than one race was not an option. Source: STD Surveillance System, NCHSTP,CDC White Black Hispanic American Indian Total Asian/Pacific Islander

8. Percent Positive Females attending family planning clinics Chlamydia: Infections among 15 to 24 Year Olds Females attending STD clinics Males attending STD clinics 2010 Target (3%) Obj. 25-1 Source: STD Surveillance System, NCHSTP,CDC.

9. Chlamydia: Infections among 15 to 24 Year Olds Attending STD Clinics, 2002 Note: American Indian includes Alaska Native. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons were asked to select only one race category; selection of more than one race was not an option. Source: STD Surveillance System, NCHSTP,CDC. Total Female Male Percent White Native Hawaiian Hispanic American Indian Asian Black 2010 Target Obj. 25-1c

10. Reported incidence per 100,000 population Gonorrhea: Infections by Gender Male Female Source: STD Surveillance System, NCHSTP,CDC. 2010 Target (19 per 100,000) Obj. 25-2

11. Gonorrhea: Infections by Race and Ethnicity Source: STD Surveillance System, NCHSTP,CDC. Reported incidence per 100,000 population White Black Hispanic Asian/Pacific Islander American Indian 2010 Target 0 500 1,000 1,500 2,000 2,500 1981 19851989199319972001

12. 2002 Gonorrhea: Infections by Race and Ethnicity Total Reported incidence per 100,000 population White Black Hispanic American Indian Asian/ Pacific Islander Note: American Indian includes Alaska Native. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons were asked to select only one race category; selection of more than one race was not an option. Source: STD Surveillance System, NCHSTP,CDC. Obj. 25-2 2010 Target 1997 Reported incidence per 100,000 population White Black Hispanic Asian/Pacific Islander American Indian 2010 Target 0 500 1,000 1,500 2,000 2,500 1981 1985198919931997 2001

13. Reported incidence per 100,000 population Syphilis: Infections by Gender Male Female Note: Data are for primary and secondary syphilis. Source: STD Surveillance System, NCHSTP,CDC. Obj. 25-3 2010 Target (0.2 per 100,000)

14. Syphilis: Infections by Race and Ethnicity Total Asian/ Pacific Islander Black American Indian HispanicWhite Reported incidence per 100,000 Obj. 25-3 Note: American Indian includes Alaska Native. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons were asked to select only one race category; selection of more than one race was not an option. Source: STD Surveillance System, NCHSTP,CDC. 2002 1997 2010 Target

15. Syphilis: Infections by Age and Gender 2002 65+ 55-64 45-54 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5.5 6.8 8.5 9.9 7.6 4.5 1.7 0.4 3.8 0.1 2.2 3.3 2.4 2.2 1.6 0.8 0.2 0.0 1.1 MalesReported incidence per 100,000 populationFemales Age 10.08.06.04.02.00.0 2.04.06.08.010.0 0.0 Total 1.3 Note: Data are for primary and secondary syphilis. Source: STD Surveillance System, NCHSTP,CDC.

16. Syphilis: Infections by County, 2002 Rate per 100,000 population <=0.2 0.21-4.0 (n=421) (n=174) (n=2544) >4.0 Note: Data are for primary and secondary syphilis. Source: STD Surveillance System, NCHSTP,CDC.

17. Congenital Syphilis: Infections by Race and Ethnicity Total Black American Indian Hispanic White 2002 Reported incidence per 100,000 live births Asian/ Pacific Islander Note: Data represent the mother’s race and ethnicity. American Indian includes Alaska Native. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Persons were asked to select only one race category; selection of more than one race was not an option. Source: STD Surveillance System, NCHSTP,CDC. Obj. 25-9 1997 2010 Target

18. Obj. 25-4 Percent Genital Herpes: Infections by Gender and Age Group, 1999-2002 Note: I = 95% confidence interval. Source: National Health and Nutrition Examination Survey, NCHS, CDC. Total 20 - 29 30 - 39 40 - 49 Female Male 2010 Target 14 - 19

19. Total 1999-02 Percent Obj. 25-4 1988-94 2010 Target Mexican Black White Genital Herpes Infection among Adults 20 to 29 Years by Race/Ethnicity Note: Black and white exclude persons of Hispanic origin. Persons of Mexican- American origin may be any race. I = 95% confidence interval. Source: National Health and Nutrition Examination Survey, NCHS, CDC.

20. Need for Treatment of PID by Race/Ethnicity and Education Level, 1995 Percent of women requiring treatment Total White Hispanic High School Black Less than HS At some least college Obj. 25-6 Note: PID refers to pelvic inflammatory disease. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Data are for females aged 15 to 44 years. I = 95% confidence interval. Source: National Survey for Family Growth, NCHS, CDC. 2010 Target

21. Pelvic Inflammatory Diseases Initial Visits to Physicians’ Offices PID Hospitalizations – Acute PID Hospitalizations - Chronic Note: Data are for women ages 15 to 44 years. Source: National Disease and Therapeutic Index,IMS America, Ltd.; National Hospital Discharge Survey, NCHS, CDC. Number (in thousands)

22. Fertility Problems among Childless Females with an STD or PID, 1995 Black 15-24 years 25-34 years White Less than high school Hispanic Total High school 35-44 years At least college Note: Data are for females ages 15 to 44 years. Fertility problems refer to the standard medical definition of infertility or impaired fecundity. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. I = 95% confidence interval. Source: National Survey for Family Growth, NCHS, CDC. Obj. 25-7 2010 Target Percent

23. Obj. 25-11 Responsible Adolescent Sexual Behavior Note: Data are for students grades 9 through 12. Black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Source: Youth Risk Behavior Surveillance System, NCHSTP, CDC. Never had sex Had sex, but not in the past 3 months Had sex in the past 3 months, used a condom Total Female Male WhiteBlackHispanic 1999 2003 2010 Target

24. Progress review data and slides can be found on the web at: http://www.cdc.gov/nchs/hphome.htm