People Between Ages 15 and 24 Account for 50% of All STD Cases, Including HIV, in U.S., Reports Say

Sexually active people between the ages of 15 and 24 accounted for 50% of all new cases of sexually transmitted diseases in 2000 in the United States, according to two studies published in the January/February issue of the Allan Guttmacher Institute's journal Perspectives on Sexual and Reproductive Health, the Raleigh News & Observer reports (Avery, Raleigh News & Observer, 2/25). The reports provide the first national estimates for the prevalence and cost of STDs among young people (Sternberg, USA Today, 2/25). For the first study, researchers from Family Health International and CDC's Division of STD Prevention examined data from national STD case reports, national surveys, literature reviews and the World Health Organization in order to estimate STD incidence and prevalence for 2000 among people between the ages of 15 and 24. Researchers found about 18.9 million new STD cases occurred in 2000, and 9.1 million of the cases, or roughly 50%, occurred among people between the ages of 15 and 24. Researchers also found that human papillomavirus, trichomoniasis and chlamydia accounted for 88% of all new STD cases in that age group (Weinstock et al., Perspectives on Sexual and Reproductive Health, January/February 2004).

At What Cost?
According to the second study, the direct cost associated with the 9.1 million STD cases among the 15- to 24-year-old age group was $6.5 billion in year 2000 dollars (Wetzstein, Washington Times, 2/25). CDC researchers and economists tracked the lifetime medical cost per case of eight STDs within the age group: HIV, HPV, genital herpes simplex type 2, hepatitis B, chlamydia, gonorrhea, trichomoniasis and syphilis. Researchers next estimated the "total burden" in financial cost of the diseases by multiplying the cost per case estimates by the approximate number of new cases for each STD among people ages 15 to 24. Researchers found that HIV and HPV had the highest estimated direct medical costs at $5.9 billion, accounting for 90% of the total cost (Chesson et al., Perspectives on Sexual and Reproductive Health, January/February 2004). Researchers also found that incurable viral STDs -- including genital herpes, HIV, hepatitis B and HPV -- accounted for 94% of the total costs, while non-viral curable infections, including chlamydia, gonorrhea, syphilis and trichomoniasis, accounted for 6% of the total costs (Washington Times, 2/25). Both studies said that a lack of symptoms for some STDs is a "major obstacle" to diagnosis and treatment, according to the AP/Atlanta Journal-Constitution. Both studies also called for expanded STD testing and other preventive measures, including partner notification, the AP/Journal-Constitution reports (Sherman, AP/Atlanta Journal-Constitution, 2/25).

Analysis
In a separate analysis, titled "Our Voices, Our Lives, Our Futures: Youth and STDs," University of North Carolina-Chapel Hill School of Journalism and Mass Communication researchers examined the CDC data to determine the potential implications of the prevalence estimates and suggested solutions (UNC-CH JOMC release, 2/24). Lead researcher Joan Cates assembled a 13-member panel of national sexual health experts to assess the STD prevalence and cost reports and to "defin[e] the economic and emotional impact" of STDs, according to the study. The project also convened a nine-member youth panel, comprised of people between the ages of 17 and 24 from around the country who offered their perspectives and suggested possible solutions ("Our Voices, Our Lives, Our Futures: Youth and STDs," February 2004). Cates said that the panel identified a "pass-the-buck mentality that helped foster a silent epidemic" of STDs among young people, according to the News & Observer. She said, "The evidence is that frank conversations can be effective. It's really amazing that we often ask for more money for programs, but the bottom line in this area is that if we just started talking -- parents to children, partner to partner, health care provider to patient -- we would get so much further" (Raleigh News & Observer, 2/25).

Reaction
James Wagoner, president of Advocates for Youth, said, "Over 27 million people between the ages of 15 and 24 have had sex, and they need all the facts -- including medically accurate information on condoms -- to protect their health," adding, "With STDs, the stakes are just too high to talk only about abstinence" (Advocates for Youth release, 2/24). AGI President and CEO Sharon Camp said that it is "not surprising" that young people account for a disproportionate share of STD cases. "Most young people are sexually active, and many are ill equipped to prevent STDs or seek testing and treatment," she said, adding, "Although abstaining from sexual activity is guaranteed to prevent STDs, some adolescents and virtually all young adults will eventually choose to have sex. Before they do, they need realistic sex education that teaches them how to prevent STDs and unwanted pregnancies." Camp added that it is "essential to have medically accurate information about condoms and other contraceptive methods and guidance on how to access appropriate prevention, testing and treatment services" available to teens and young adults (Fox, Reuters, 2/25). AIDS Project Los Angeles Executive Director Craig Thompson said that the reports' findings are "disheartening and preventable," adding, "These data represent the social dividends of our current investment in condom disinformation and rigid abstinence-only sexual education programming. The time has come to reassess this portfolio and to reinvent our approaches to STD prevention and control" (APLA release, 2/24).

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