Introductory Section

Acknowledgments

Publication of this report would not have been possible without the contributions of the State and Territorial Health Departments, the Sexually Transmitted Disease Control Programs, the Regional Infertility Prevention Projects, and Public Health Laboratories. We also acknowledge the contributions of staff within the Division of STD Prevention, the Statistics and Data Management Branch and the Epidemiology and Surveillance Branch.

Copyright Information

All material contained in this report is in the public domain and may be used and reprinted without special permission; citation to source, however, is appreciated.

Suggested Citation

Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2008. Atlanta, GA: U.S. Department of Health and Human Services; November 2009.

Selected STD Surveillance and Prevention References and Websites

STD Surveillance Reports 1993–2008
http://www.cdc.gov/std/stats/

STD Data on Wonder
http://wonder.cdc.gov/std.html

STD Data Management & Information Technology
http://www.cdc.gov/std/Program/data-mgmt.htm

STD Fact Sheets
http://www.cdc.gov/std/healthcomm/fact_sheets.htm

STD Treatment Guidelines
http://www.cdc.gov/STD/treatment/

STD Program Evaluation Guidelines
http://www.cdc.gov/std/program/pupestd.htm

STD Program Operation Guidelines
http://www.cdc.gov/std/program/GL-2001.htm

Recommendations for Public Health Surveillance of Syphilis in the United States
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5233a7.htm

Behavioral Surveillance
Youth Risk Behavior Surveillance System: http://www.cdc.gov/healthyyouth/data/yrbs/index.htm

National Survey of Family Growth: Advance Data 362. Sexual Behavior and Selected Health Measures: Men and Women 15–44 Years of Age, United States, 2002. 56 pp. (PHS) 2003–1250: http://www.cdc.gov/nchs/data/ad/ad362.pdf (1.2 MB)

Foreword

"STDs are hidden epidemics of enormous health and economic consequence in the United States. They are hidden because many Americans are reluctant to address sexual health issues in an open way and because of the biologic and social characteristics of these diseases. All Americans have an interest in STD prevention because all communities are impacted by STDs and all individuals directly or indirectly pay for the costs of these diseases. STDs are public health problems that lack easy solutions because they are rooted in human behavior and fundamental societal problems. Indeed, there are many obstacles to effective prevention efforts. The first hurdle will be to confront the reluctance of American society to openly confront issues surrounding sexuality and STDs. Despite the barriers, there are existing individual- and community-based interventions that are effective and can be implemented immediately. That is why a multifaceted approach is necessary to both the individual and community levels.

To successfully prevent STDs, many stakeholders need to redefine their mission, refocus their efforts, modify how they deliver services, and accept new responsibilities. In this process, strong leadership, innovative thinking, partnerships, and adequate resources will be required. The additional investment required to effectively prevent STDs may be considerable, but it is negligible when compared with the likely return on the investment. The process of preventing STDs must be a collaborative one. No one agency, organization, or sector can effectively do it alone; all members of the community must do their part. A successful national initiative to confront and prevent STDs requires widespread public awareness and participation and bold national leadership from the highest levels."¹

¹Concluding statement from the Institute of Medicine’s Summary Report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases, National Academy Press, Washington, DC, 1997, p.43.

Preface

Sexually Transmitted Disease Surveillance, 2008 presents statistics and trends for sexually transmitted diseases (STDs) in the United States through 2008. This annual publication is intended as a reference document for policy makers, program managers, health planners, researchers, and others who are concerned with the public health implications of these diseases. The figures and tables in this edition supersede those in earlier publications of these data.

The surveillance information in this report is based on the following sources of data: (1) notifiable disease reporting from state and local STD programs; (2) projects that monitor STD prevalence in various settings including; the Regional Infertility Prevention Projects (IPP); the National Job Training Program; the Indian Health Service; the Men Who Have Sex With Men (MSM) Prevalence Monitoring Project; the Gonococcal Isolate Surveillance Project (GISP); and (3) national surveys implemented by federal and private organizations.

The STD surveillance systems operated by state and local STD control programs, which provide the case report data for chlamydia, gonorrhea, syphilis, and chancroid are the data sources of many of the figures and most of the statistical tables in this publication. These systems are an integral part of program management at all levels of STD prevention and control in the United States. Because of incomplete diagnosis and reporting, the number of STD cases reported to the Centers for Disease Control and Prevention (CDC) is less than the actual number of cases occurring in the United States population. National summary data of case reports for other STDs are not available because they are not nationally notifiable diseases.

Sexually Transmitted Disease Surveillance, 2008 consists of four parts: (1) The National Profile contains figures that provide an overview of STD morbidity in the United States. The accompanying text identifies major findings and trends for selected STDs. (2) The Special Focus Profiles contain figures and text describing STDs in selected subgroups and populations that are a focus of national and state prevention efforts. (3) The Detailed Tables provide statistical information about STDs at the county, metropolitan statistical area (MSA), regional, state, and national levels. (4) The Appendix (Interpreting STD Surveillance Data) includes information on interpreting the STD surveillance data used to produce this report; Healthy People 2010 (HP2010) STD objectives and progress toward meeting them; Government Performance and Results Act (GPRA) goals and progress toward meeting them; and STD surveillance case definitions.

Any comments and suggestions that would improve the usefulness of future publications are appreciated and should be sent to:

Director, Division of STD Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
1600 Clifton Road, Mailstop E-02
Atlanta, Georgia, 30333

Guide to Acronyms

Add Health	National Longitudinal Study of Adolescent Health
CDC	Centers for Disease Control and Prevention
CSF	Cerebrospinal Fluid
DHHS	Department of Health and Human Services
DSTDP	Division of STD Prevention
GISP	Gonococcal Isolate Surveillance Project
GPRA	Government Performance and Results Act
HEDIS	Healthcare Effectiveness Data and Information Set
HIV	Human Immunodeficiency Virus
HP2010	Healthy People 2010
HPV	Human Papillomavirus
HSV	Herpes Simplex Virus
IPP	Infertility Prevention Project
MICs	Minimum Inhibitory Concentrations
MMWR	Morbidity and Mortality Weekly Report
MPC	Mucopurulent Cervicitis
MSA	Metropolitan Statistical Area
MSM	Men Who Have Sex With Men
NAATs	Nucleic Acid Amplification Tests
NDTI	National Disease and Therapeutic Index
NGU	Nongonococcal Urethritis
NHANES	National Health and Nutrition Examination Survey
NHDS	National Hospital Discharge Survey
OMB	Office of Management and Budget
P&S	Primary and Secondary
PID	Pelvic Inflammatory Disease
QRNG	Quinolone-resistant Neisseria gonorrhoeae
RPR	Rapid Plasma Reagin
STD	Sexually Transmitted Disease
VDRL	Venereal Disease Research Laboratory

Census Regions of the United States

West	Midwest	South	Northeast
Alaska	Illinois	Alabama	Connecticut
Arizona	Indiana	Arkansas	Maine
California	Iowa	Delaware	Massachusetts
Colorado	Kansas	District of Columbia	New Hampshire
Hawaii	Michigan	Florida	New Jersey
Idaho	Minnesota	Georgia	New York
Montana	Missouri	Kentucky	Pennsylvania
Nevada	Nebraska	Louisiana	Rhode Island
New Mexico	North Dakota	Maryland	Vermont
Oregon	Ohio	Mississippi
Utah	South Dakota	North Carolina
Washington	Wisconsin	Oklahoma
Wyoming		South Carolina
		Tennessee
		Texas
		Virginia
		West Virginia