Time to Get Tough on STDs

WASHINGTON, D.C.--Prompted by alarming statistics on the incidence and costs of sexually transmitted diseases (STDs) in the United States, a blue-ribbon medical panel today called for a national campaign against this underreported epidemic.

Each year, more than 12 million people in the United States, a quarter of them teenagers, are infected with STDs or suffer long-term sequelae such as pelvic inflammatory disease--a far higher infection rate than in other developed countries, says the panel, which was appointed by the Institute of Medicine. Several of these diseases--including herpes and "modern" STDs such as hepatitis B and AIDS--are caused by viruses and therefore are difficult or impossible to cure. The overall picture, says David Celentano of the Johns Hopkins University School of Hygiene and Public Health, is "a national embarrassment."

In a report called "The Hidden Epidemic," the panel, headed by internist William T. Butler of the Baylor College of Medicine in Houston pieced together a disturbing picture that is emerging in the scientific literature and in government data. Here are some of the highlights:

  • *Adolescents are the group most at risk of contracting STDs, but only 11% of adolescents reported having gotten the facts of life--basic information about sex, that is--from their parents.

    *By the 12th grade, 70% of adolescents have had sexual intercourse, and close to 40% of these have had four or more partners.

    *In 1994, pelvic inflammatory disease racked up the highest medical bills--$4.15 billion--of any STD other than AIDS.

    *U.S. gonorrhea rates are 50 times as high as they are in Sweden.

Exposure to STDs is commonplace and "hidden" for a number of reasons, says the report. It says parents and teachers don't like to talk about the adverse consequences of sex, some doctors are ignorant of the insidious nature of STDs, and many disorders show no symptoms in the early stages, especially in women. Heightened awareness of AIDS and the way it's spread is forcing STDs out of the closet, says Celentano, a panel member. "Probably the number one risk [factor] for HIV is an STD," he says.

The report calls for a national campaign to educate the public and physicians about STDs, and says health care providers need to make a special effort to track and treat partners of patients with STDs. This recommendation, Butler says, is aimed in particular at easily curable bacterial infections such as gonorrhea, syphilis, and chlamydia.