STDs have become a hidden epidemic

Judith N. Wasserheit, MD, MPH, has a message for health care professionals: "There’s more than one epidemic out there, folks." Wasserheit, director of the Center for Disease Control and Prevention’s Division of STD Prevention, says the rate of sexually transmitted diseases in the U.S. is the highest in the industrialized world.

For about 15 years now, the HIV epidemic has overshadowed other sexually transmitted diseases, including such ancient scourges as gonorrhea and syphilis. And while the overall incidence of those diseases is headed downward, the U.S. Department of Health and Human Services just released a report showing that some areas of the country have astonishingly high rates of non-HIV STDs, most notably the South.

Mississippi ranks first

The statistics suggest that the worst place to engage in sex without a condom is Mississippi. The syphilis rate in Mississippi is almost 12 times higher than the national average, and the state also has the highest gonorrhea rate in the country. In fact, there’s a striking concentration of sexually transmitted diseases in the South, with Alabama, Georgia, and the Carolinas ranking not far behind Mississippi.

The news wasn’t all bad for Mississippi. The state ranked rather low on the chlamydia scale — well behind chlamydia king New Mexico.

The CDC estimates curable STDs such as syphilis cost the health care system $10 billion a year in direct costs, and perhaps up to $30 billion when lost productivity is added in. The entire HIV/STD issue has led some in the scientific community to call for moral policing of sorts, with the establishment of a national campaign to change sexual norms and to "balance" racy messages from the media. The recommendations were recently published as part of a report funded by the CDC, the National Institutes of Health, and Kaiser Permanente.

The report, The Hidden Epidemic, also recommends expanding access to STD clinics. Its statistics show that only half of U.S. health departments provide STD care, and 40% of those can’t see a patient on the same day an exposure occurs. Wasserheit says that fact alone immediately short-circuits care for the most highly motivated individuals in the infected group. Plus, STD clinics tend to keep unfriendly hours. Many are closed when it’s most convenient for patients to come — in the evenings and on weekends.

The report also suggests Americans need a little education when it comes to STDs. One in 10 can’t name a single STD, 17% think all STDs are curable and almost 60% didn’t know that having sex with an HIV-infected individual could dramatically increase the risk of contracting another STD.