"Modest" Increase in Sexually Transmitted Diseases

After a decline in STD's in the late '80's and '90's that is believed to have been driven by "safer sex" strategies brought on by the spread of HIV, numbers of infections have increased for the second year in a row.

The increase may actually be the result of increased efforts at screening and more sensitive tests, according to the CDC.

The report notes that the greatest risk is found in men having sex with men and girls 15-19. These numbers may simply reflect the fact that these populations are more likely to be screened for diseases and that there's been a push to increase screening, particularly in the former demographic.

There's a physiological explanation about why younger girls are more likely to catch diseases like chlamydia and HPV, the virus that causes abnormal pap smears and can lead to cervical cancer. There's also a behavioral explanation: younger girls are more likely to engage in riskier behavior, have higher-risk partners and have more partners.

The cells of the cervix of the young girl are more susceptible to injury and to invection. As the girl matures, the columnar epithelium is replaced by squamous cell epithelium. (At the risk of grossing people out being indelicate - think of it as the difference between the tissues of the inside of your cheeks and the tissue on the outside of the lips.)

(Similar risk factors probably apply to the men having sex with men category, too, although I didn't see any specific discussion about these risks for girls or men in the mainstream press articles here, here, and here. This this article in a gay publication does review the girl's tissue changes and the difficulty of notifying the partner of an infected patient who is more likely to have anonymous sex partners. )


It is alarming, however, that the two vulnerable groups are also the people who are most likely to have life-long consequences of STD's. The girls risk early pregnancy and infertility and the men having sex with men risk truly deadly diseases like drug resistant strains of HIV/AIDS, syphilis, and gonorrhea.

I'm afraid that this report will fuel criticism of abstinence education. But let's face it, teaching condom use and oral contraceptives are not the answer for either of these populations.

We know a little about what works and a lot about what doesn't.

Edit, 11/27/07, grammar typos.