U.S. Leads in Sexually Transmitted Disease Rate
Deaths, disabilities three times higher than other
developed nations, study finds
By Amanda Gardner, HealthDay Reporter
More on this in Health & Fitness
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WEDNESDAY, Jan. 26 (HealthDay News) -- Rates of early
death and disability that can be attributed to sexual
behavior are three times higher in the United States
than other so-called developed nations, a new study
finds.
This finding precludes the AIDS epidemic in many
African countries.
American men still die more often as a result of
having a sexually transmitted disease, researchers
from the U.S. Centers for Disease Control and
Prevention said, but more cases are reported in
American women. The findings were published in the
Jan. 27 issue of the British journal Sexually
Transmitted Infections.
"It certainly is disturbing," said Dr. Cynthia Krause,
assistant clinical professor of obstetrics/gynecology
at Mount Sinai School of Medicine in New York City.
"The challenge is how to represent this in a way
that's not alarmist, to make women aware of the real
risks."
An earlier survey had found that half of all deaths in
the United States in 1990 were attributable to nine
risk factors that included sexual behavior. That
category alone accounted for 30,000 deaths. The
researchers behind the new study didn't think this
provided a complete picture of the health toll, given
that sexually transmitted diseases are associated with
other problems such as infertility, psychological
trauma and stigma.
They set out to quantify the public health burden of
sexually transmitted diseases in 1998 by looking at
national data on sexual health and reproduction,
surveillance systems for infectious diseases, hospital
and outpatient statistics, birth and death records as
well as published research.
They then calculated "adverse health consequences,"
such as infertility, cervical cancer, and HIV
infections. They also factored in premature deaths and
"disability adjusted life years" (DALYs), a figure
indicating years of life cut short by premature death
and loss of healthy living years as a result of
disability.
In 1998, sexual behavior accounted for about 20
million "adverse health consequences" (equivalent to
more than 7,500 per 100,000 people) and 29,782 deaths
(or 1.3 percent of all deaths in the United States),
the study found.
Sixty-two percent of the "adverse health consequences"
and 57 percent of "disability adjusted life years"
were among women. Curable infections and their
consequences accounted for more than half of these
health problems. Viral infections -- mostly HIV/AIDS
-- and their consequences accounted for almost all
deaths among men and women.
In terms of percentages, more men (66 percent) than
women died due to sexually transmitted diseases. But
if HIV/AIDS were not considered, then 89 percent of
deaths attributed to sexual behavior would have been
among women.
HIV/AIDS was the leading cause of death among men,
while cervical cancer and HIV/AIDS were the leading
causes of death among women.
These estimates are probably conservative, the authors
stated.
The study did not address why the United States was
hit so hard by sexually transmitted diseases, although
the study's lead author, Dr. Shahul Ebrahim, said that
behavior was only part of the equation.
"Everybody is having sex in the world, but some places
have a low HIV prevalence," said Ebrahim, who is a
medical epidemiologist with the CDC's National Center
for Birth Defects. "Behavior is just one indicator.
Another issue is transmission risk factors."
Researchers are planning to use the data to increase
the public's awareness of the problem.
"The two most important issues are HIV and cervical
cancer [which can occur from having numerous sexual
partners]," Ebrahim said. "For cervical cancer, we
have a national program to screen all women of a
certain age group and risk, but not everybody is
accessing that. We've reached the 80 percent mark but
we still have 20 percent remaining."
A similar problem exists for HIV. "Not everybody is
getting tested for HIV. Once you get tested, you can
access treatment and probably prolong life," Ebrahim
said.
None of this is going to happen overnight, he added.
The consequences of "sexual behavior are totally
preventable," he said. "If you have protected or safe
sex, you are not going to have these."
More information
The CDC has more on sexually transmitted diseases.
=====
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