Trends in Sexually Transmitted Diseases in the United States: 2009 National Data for Gonorrhea, Chlamydia and Syphilis

This fact sheet summarizes 2009 national data on gonorrhea, chlamydia and syphilis that are published in CDC’s report, Sexually Transmitted Disease Surveillance, 2009 (available at www.cdc.gov/std/stats). The data are based on state and local STD case reports from a variety of private and public sources, the majority of which come from non-STD clinic settings, such as private physicians and health maintenance organizations.

Sexually transmitted diseases (STDs) remain a major public health challenge in the U.S. CDC’s surveillance report includes data on the three STDs that physicians are required to report to the agency – chlamydia, gonorrhea and syphilis – which represent only a fraction of the true burden of STDs. Some common STDs, such as human papillomavirus (HPV) and genital herpes, are not reported to CDC. In total, CDC estimates that there are approximately 19 million new STD infections each year, which cost the U.S. healthcare system $16.4 billion annually and cost individuals even more in terms of acute and long-term health consequences.

Despite the continued high burden of STDs, the latest CDC data show some signs of progress:

• Gonorrhea: The national gonorrhea rate is at the lowest level ever recorded.
• Chlamydia: Continuing increases in chlamydia diagnoses likely reflect expanded screening efforts, and not necessarily a true increase in disease burden; this means that more people are protecting their health by getting tested and being linked to treatment. This is critical, since chlamydia is one of the most widespread STDs in the United States.
• Syphilis: For the first time in five years, reported syphilis cases did not increase among women overall. Likewise, cases of
  congenital syphilis (transmitted from mother to infant) did not increase for the first time in four years.

Yet, there are large disparities by race and age. CDC surveillance data show much higher rates of reported STDs among some racial or ethnic minority groups than among whites. This is consistent with other data sources showing marked STD disparities in some minority populations. A range of factors contributes to these disparities, including poverty, lack of access to health care and an already high prevalence of STDs in communities of color that increases a person’s risk of infection with each sexual encounter. And regardless of race or gender, data show that sexually active adolescents and young adults are at increased risk for STDs when compared to older adults. Acknowledging disparities in STD rates is one of the first steps in empowering affected communities to focus on the problem and helping the public health community direct prevention and treatment resources appropriately.

Less than half of people who should be screened receive recommended STD screening services. Undetected and untreated STDs can increase a person’s risk for HIV and cause other serious health consequences, such as infertility. STD screening can help detect disease early and, when combined with treatment, is one of the most effective tools available to protect one’s health and prevent the spread of STDs to others.

Health Consequences of Untreated STDs

Untreated gonorrhea and chlamydia can result in pelvic inflammatory disease in women, a condition that can cause infertility. Each year, STDs cause at least 24,000 women in the U.S. to become infertile. Untreated syphilis can lead to serious long-term complications, including brain, cardiovascular and organ damage. Syphilis in pregnant women can also result in congenital syphilis (syphilis among infants), which can cause stillbirth, death soon after birth, and physical deformity and neurological complications in children who survive. Untreated syphilis in pregnant women results in infant death in up to 40 percent of cases. Studies suggest that people with gonorrhea, chlamydia or syphilis are at increased risk for HIV. This is especially concerning for young black men, among whom the rate of syphilis is increasing.

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