Hello. I am Dr. Catherine Satterwhite,
Epidemiologist in the Division of STD Prevention
at the Centers for Disease Control and Prevention.
I am also the lead author of the new paper released
in February of 2013 estimating the
number of prevalent and incident
sexually transmitted infections in the United States.
Every year in the United States there
are nearly 20 million new sexually
transmitted infections, or S-T-Is.
Nearly half of these new infections
occur in young people, aged 15 to 24 years.
The high number of incident STIs in the U.S. underscores
the ongoing need for increased prevention efforts.
Most of these STIs will not cause harm,
however, if left untreated, some of them
can lead to serious health issues.
Undiagnosed and untreated chlamydia or
gonorrhea, for example, can increase a
woman’s chances of infertility. Increasing
strains of drug-resistant gonorrhea have
made successful treatment of the infection
more difficult, and have prompted CDC to
update recommendations for its treatment regimen.
In addition, some types of human
papillomavirus infections, or HPV, can
lead to genital warts and cervical cancer.
For these reasons, it is important for clinicians
to talk to their young patients about
STI prevention and appropriate testing.
Young people often face unique prevention
challenges, including embarrassment and
confidentiality concerns.
Research shows that young patients may be
afraid to initiate a conversation about STIs
and will be looking to you,
their health care provider,
to begin the discussion.
During these conversations,
it is important for you to create an environment
that feels safe for your young patients
to talk openly without judgment.
It is also important that you make it clear that you
understand their health needs are different
from the health needs of adults.
Discussing your young patient’s sexual history is a
good starting point for these discussions and will
help you determine what tests and prevention
counseling messages are necessary for your patient.
For more information on how to take a sexual history,
please visit www.cdc.gov/std.
The new CDC analysis also estimated
about 110 million prevalent, or existing, STIs.
As with incident infections, HPV accounts for the
majority of prevalent infections.
Although the body’s immune system clears most
HPV on its own within two years, some infections
persist and can cause genital warts, cervical cancers,
and other cancers. While there is no treatment for the
virus itself, vaccines are available to prevent some of
the most important types of HPV infection, including
two of the most common types of HPV that can lead to
cervical cancer. And given that most sexually active
men and women will get HPV at some point in
their lives, many can benefit from the protection
that the HPV vaccine provides.
Currently, HPV vaccine is routinely recommended
for 11 or 12 year old boys and girls, as part of the
adolescent vaccine schedule that also includes Tdap
and the meningococcal vaccine. HPV vaccine is most
effective when given before sexual debut.
CDC also recommends HPV vaccination for
teen girls and women through age 26 and
teen boys and men through age 21
who have not been previously vaccinated.
CDC recommends HPV vaccination for gay,
bisexual, and other men who have sex with men
through age 26, who have not been
previously vaccinated.
CDC also recommends screening
for the following STIs:
All adults and adolescents between the ages of
13 and 64 years should be tested at least once for HIV,
regardless of recognized risk factors.
Adolescents and adults at increased risk
for HIV infection, such as those who have
unprotected sex with multiple partners or
exchange sex for money or drugs,
should be tested annually.
Clinicians should also screen all pregnant women for HIV.
All sexually active women aged 25 and younger
should be tested for chlamydia every year.
At-risk sexually active women should be tested for
gonorrhea each year. This includes women with new
or multiple sex partners or women who live in
communities with high burden of disease.
In addition, all sexually active gay, bisexual, and other
men who have sex with men should be tested at least
once a year for syphilis, chlamydia, gonorrhea,
and HIV. Those who have multiple or
anonymous partners should be screened more frequently.
For more detailed information about how to
talk to your patients about sexually transmitted
diseases or printable fact sheets to pass along
to them, please visit CDC’s STD homepage at
www.cdc.gov/std.