Sexually Transmitted Diseases Peter R. Kerndt, MD, MPH Los Angeles County Department of Public Health Sexually Transmitted Disease Program
2 Herpes (~50 million) Chlamydia (2 million) Hepatitis B (417 000) HIV (1 million) Genital HPV (20 million) Estimated Prevalence of Leading STIs Herpes: the Most Prevalent STI in the USA
3 Overview Background Epidemiology CT, GC, Syphilis, HPV, HSV HIV Incidence STD Control Programs –Partner Notification Social Marketing Campaigns –
Reportable STDs in California Chlamydia Gonorrhea Syphilis HIV/AIDS Hepatitis B Chancroid Pelvic Inflammatory Disease (PID)
7 Non-reportable STDs –Viral/Parasitic Herpes simplex virus (HSV) Human papillomavirus (HPV) Trichomonas vaginalis
8 STDs in California: The Economic Burden 2007 study by Public Health Institute Est. number and cost to treat 8 most common STDs by California county. –Chlamydia, Gonorrhea, Syphilis, Genital Herpes, HPV, Hepatitis B, Trichomoniasis, HIV –Estimated 1.1 million new cases of STDs in 2005 among 15-24 year-olds –Direct medical costs estimated at $1.1 billion
11 The Cost Estimate of STD to the Healthcare System U.S $16.4 Billion* California Los Angeles County @$820 Million In 2010: •23,679 Living AIDS Cases(36% CA; 5% US) •45,486 Chlamydia (31% CA; 4% US) •10,369 Gonorrhea (34% CA; 2% US) •651 P&S Syphilis (33% CA; 6% US) •Centers for Disease Control and Prevention (CDC). Sexually Transmitted Diseases Surveillance 2009. Division of STD Prevention. November 2010.
Reported STDs and HIV/AIDS Cases Los Angeles County, 2010* •*Data preliminary •Source: STD Program/HIV Epidemiology Program Los Angeles County Department of Public HeOver 58,000 STD /HIV were reported in 2010 73% Chlamydia 16% gonorrhea 5% Syphilis 6% HIV/AIDS
Chlamydia trachomatisMost common bacterial STD in US Chlamydial infections can cause PID, ectopic pregnancy, infertility and pregnancy complications Up to 70% of sexually active women have asymptomatic chlamydial infections ~15-30% women re-infected by 6 -12 months Asymptomatic oral and rectal infections in MSM
Reported Chlamydia Rates per 100,000 Population Among Females by Age Group and Race/Ethnicity, LAC, 2009 Note: Exclude cases in Long Beach and Pasadena 15
Reported Chlamydia Rates per 100,000 Population Among Males by Age Group and Race/Ethnicity, LAC, 2009 Note: Exclude cases in Long Beach and Pasadena 16
18 Chlamydia —Rates by sex: United States, 1984–2004 Rate (per 100,000 population)MenWomen010020030040050019848688909294969820000204
Chlamydia - summary points Epidemic particularly among young women in Los Angeles County Often asymptomatic Serious sequelae, particularly with repeat infections Need novel strategies for control –Expanded screening –Patient Delivered Partner Therapy –Field Delivered Partner Therapy
Gonorrhea •Second most common bacterial STD in US •Usually symptomatic in males, often asymptomatic in women •Can cause PID, infertility, ectopic pregnancy, and complications in pregnancy in women •
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- Fall '13
- Human papillomavirus, Herpes simplex, Sexually transmitted diseases and infections