Sexually Transmitted Infections (STIs)
What age group is most at risk for acquiring a STIs?
- Compared to older adults, sexually active adolescents 15-19 years of age and young adults 20-24 years of age are at higher risk for acquiring STIs for a combination of behavioral, biological, and cultural reasons.
- The higher prevalence of STIs among adolescents reflects multiple barriers to accessing quality STI prevention services, including lack of insurance or other inability to pay, lack of transportation, discomfort with facilities and services designed for adults, and concerns about confidentiality.
- Recent estimates suggest that while representing 25% of the ever sexually active population, 15 to 24 year-olds acquire nearly half of all new STDs. 12
What are the rates of chlamydia and gonorrhea for adolescents and young adults?
- Rates of gonorrhea and chlamydia are heavily concentrated among young people. 15-19 year old females have the highest age-specific rates of gonorrhea and chlamydia. 13
- Young women aged 15–24 are hit hardest by chlamydia, with rates more than five times as high as women overall. 13
What are the trends in chlamydia and gonorrhea rates for adolescents and young adults?
- Chlamydia and gonorrhea rates for 15-24 year-olds continued to increase as they have for all age groups. Between 2006 and 2007, the increase for those 15-19 years of age was 7.7%, and 6.6% for those 20-24 years of age. 13
- For the third consecutive year, gonorrhea rates for 15-24 year-olds increased. Between 2006 and 2007, the increase for 15-19 year-olds was 2.1%, and 0.7% for 20-24 year-olds. 13
- In 2007, as in previous years, 20-24 year-old females had the second highest rate of gonorrhea (614.5 per 100,000 population). Gonorrhea rates in this group have also increased for the past three years. 13
- As in previous years, in 2007 15-19 year-old females had the highest rate of gonorrhea (647.9 per 100,000 population) compared to any other age/sex group. Gonorrhea rates for this group have increased for the past three years. 13
- In 2007, as in previous years, 20-24 year-old females had the second highest rate of chlamydia (2,948.8 per 100,000 population). Chlamydia rates for this group increased 5.6% from 2006 to 2007. 13
- In 2007, 15-19 year-old females had the highest rate of chlamydia (3,004.7 per 100,000 population) compared to any other age/sex group. Chlamydia rates for this group increased 6.4% from 2006 to 2007. 13
- As in previous years, in 2007, 20-24 year-old males had the highest rate of chlamydia among men (932.9 per 100,000 population). Chlamydia rates in men of this age group increased 9.4% from 2006 to 2007. 13
- Chlamydia rates for 15-19 year-old males increased 14.3% from 537.9 per 100,000 population in 2006, to 615.0 per 100,000 population in 2007. 13
- As in previous years, in 2007, 20-24 year-old males had the highest rate of gonorrhea among men (450.1 per 100,000 population). Gonorrhea rates in men of this age group declined 0.4% from 2006 to 2007. 13
- Gonorrhea rates for 15-19 year-old males increased 3.8% from 275.4 per 100,000 population in 2006 to 286.0 per 100,000 population in 2007. Gonorrhea rates in men of this age group have increased for the past three years. 13
What are the rates of other STIs for adolescents and young adults?
- The prevalence of HIV is low among young adults in general, but the number of HIV/AIDS cases among teens and young adults rose between 2001 and 2006.
- Five percent (5%) of the people living with HIV in 2006 were between the ages of 13-24 (56,500 persons). It is important to note that because this is the population living with, not newly infected with, HIV, this is not an indication of the likely age of infection. 14
- Syphilis rates among 15-19 year-old females have increased annually since 2004 from 1.5 cases per 100,000 population to 2.4 per 100,000 population in 2007. Rates in females have been the highest each year in the 20-24 year age group. 13
- In contrast, in males, rates among 15-19-years-olds are much lower than those in males in older age groups. However, these rates have increased since 2002 from 1.3 cases per 100,000 population to 3.8 in 2007. 13
- The CDC estimates that one out of five adolescents has had a genital herpes infection. 15
- The human papillomavirus (HPV) is so common in the United States it has been described as a virtual “marker” for having had sex. The CDC estimates that 20 million people are currently infected with HPV; 6.2 million Americans become infected each year, and at least 50% of sexually active individuals will acquire an HPV infection at some point in their lives. 16
What vaccines exist for viral STIs?
- To date, there are vaccines for only two viral STIs: hepatitis B and human papillomavirus (HPV). The hepatitis B vaccine was introduced in 1982, and today an estimated 70 million adolescents and adults have received at least one dose of the vaccine. 17
- In 2006, the U.S. Food and Drug Administration approved an HPV vaccine that protects against the four high-risk strains of HPV that account for 70% of cervical cancers and 90% of genital warts. 18
- The three-dose HPV vaccine can be given to girls as young as age nine, but is recommended for girls aged 11–12, with catch-up vaccinations recommended for those aged 13–26. 18
- As of December 31, 2008, 23 million doses of the vaccine had been distributed in the United States. 19
What are the most effective ways of reducing the risk of contracting an STI?
- The three most effective ways to avoid sexual transmission of STIs are to abstain from all sexual activity; to be in a long-term, mutually monogamous relationship with a partner who does not have an STI; and to use condoms consistently and correctly.
- All three of the most effective STI prevention strategies rely on the knowledge, behavior and interpersonal skills of the individuals. Comprehensive sex education helps young people who are not ready for sex to withstand pressure to become sexually active and equips them with the information and skills they need to have healthy, responsible and mutually protective relationships when they do begin having sex.
- Consistent and correct use of male latex condoms can greatly reduce, though not eliminate, the risk of STI transmission. Condoms, when used consistently and correctly, are very highly effective in preventing the sexual transmission of HIV. Similarly, latex condoms reduce the risk of many other STIs that are transmitted by genital secretions such as semen or vaginal fluids, and to a lesser degree, genital ulcer diseases. Condom use also reduces the risk of HPV infection and HPV-associated diseases, such as genital warts and cervical cancer. 20
15 CDC, Genital herpes, CDC Fact Sheet, December 2007, www.cdc.gov/std/Herpes/STDFact-Herpes.htm accessed Aug. 7, 2008.
16 CDC, Genital HPV infection, CDC Fact Sheet, May 2004, www.cdc.gov/std/HPV/STDFact-HPV.htm accessed June 26, 2006.
17 Immunization Action Coalition, Hepatitis B: questions and answers, information about the disease and vaccines, 2008, www.immunize.org/catg.d/p4205.pdf accessed June 2, 2009.
19 CDC, Reports of health concerns following HPV vaccination: HPV vaccine safety, 2009, www.cdc.gov/vaccinesafety/vaers/gardasil.htm, accessed June 2, 2009.
20 CDC, Condoms and STDs, Fact Sheet for Public Health Personnel, 2009, www.cdc.gov/condomeffectiveness/brief.html accessed June 3, 2009.