Little progress in stemming STDs

Jacqueline Stenson MSNBC contributor

Despite all the safe sex messages, there has been little progress in stemming the spread of sexually transmitted diseases in the United States.

STDs like chlamydia and herpes are more common than ever, and doctors are now starting to see a couple of new or previously unrecognized infections.

"The overwhelming concern is that STDs continue to be epidemic and that some of the infections are increasing," says Julius Schachter, editor of the journal Sexually Transmitted Diseases and a professor of laboratory medicine at the University of California, San Francisco.

There are an estimated 19 million new cases of STDs each year in the United States, up from 15 million nearly a decade ago. Experts don't have exact numbers because not all diseases are reported to the Centers for Disease Control and Prevention in Atlanta and many people don't know they're infected.

Among the most shocking estimates are that one in five Americans has genital herpes and more than half of women will contract HPV, or human papillomavirus, which causes genital warts and can lead to cervical cancer. At least a million Americans are living with the deadly AIDS virus.

STDs can cause lesions, discharge and other symptoms, but oftentimes they are "silent" and show no outward signs.

That's frequently the case with chlamydia. Just over 877,000 cases were reported in 2003, yet it's estimated there are 2.8 million new cases annually.

There are some signs of progress. While chlamydia and HPV cases are rising, some of the increase is due to better testing and detection, experts say. Gonorrhea cases are at an all-time low, though they are increasing among gay men.

In addition, scientists are working to create vaccines that would prevent HIV and HPV. Researchers are reporting tremendous success with the HPV vaccine, which could become available within a few years. Work also is under way on microbicides, which are creams or gels that a woman would apply to her vagina to protect against STDs, but progress has been slow on this front.

In the dark about STDs
Think you're not at risk for a sexually transmitted disease? So do many people, which is precisely the problem. In fact, most people who transmit STDs aren't aware of it, experts say.

"One of the great misconceptions is that people who have STDs know they have them," says Dr. Edward Hook, a spokesperson for the American Social Health Association and a professor of medicine at the University of Alabama at Birmingham. "That is absolutely incorrect."

The solution: get tested — regularly if you have multiple sex partners. But discussions about STDs are too often missing during routine check-ups.

"Both doctors and patients are waiting for the other person to raise the subject and as a result nobody talks about it," says Hook.

If you don't know you're infected, you can't have an informed discussion with a potential partner. But frank talk about STDs among sexual partners also is much too infrequent.

Results of the Zogby/MSNBC.com online survey on sexuality found that just 39 percent of respondents always asked whether a prospective partner was infected with HIV or other STDs.

Hook isn't surprised. "People don't want to conceptualize themselves as being at risk," he says. People tend to think, "I'm not that kind of person and since I'm not, I wouldn't hang out with that kind of person," he says.

"There's just a disconnect," says Dr. Richard Sweet, director of the Women's Center for Health at the University of California at Davis and a spokesperson for the American College of Obstetricians and Gynecologists.

And many of those most at risk — teens and young adults — think they are invincible, according to Sweet. "A 16-year-old guy — he's a superhero," he says.

But the failure to come to grips with the threat of STDs is a major problem in the United States. "We have the highest rates of STDs in the industrialized world," Sweet adds.

The health consequences can be significant.

"STDs are taking a tremendous toll on American health," says Jessica Frickey, an HIV and STD specialist at the CDC.

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