Crack, sex and STD

Article Abstract:

In the early 1980s, high rates of sexually transmitted diseases (STDs) existed among homosexual men, but they decreased dramatically when lifestyles changed in response to the risks for acquiring human immunodeficiency virus (HIV), which causes AIDS. During the 1980s, increased rates for many STDs, such as syphilis and gonorrhea, were seen in certain subgroups of the population, namely black and Hispanic heterosexuals. These subgroups had an increased rate of HIV infection (which can also be transmitted heterosexually). During the same period, blacks and Hispanics increased their use of the drug known as crack, a highly addictive form of cocaine. The relations between using the drugs crack and cocaine and acquiring STDs were assessed in this report, which analyzes 16 epidemiologic studies on the subject. Prior to the 1980s, cocaine was available in this country, but its use was distributed among the races in proportion to their numbers in the population. Crack became readily available in the early 1980s, and was in widespread use by the mid 1980s. Its rate of use was much higher among minority populations than among white populations. The trends of STDs and crack usage have followed similar patterns; rates for STDs began to rise in the mid 1980s at about the same time that crack usage was exploding. Simultaneous increases in drug use and high-risk sexual behavior have been reported in the past. Numerous recent studies have demonstrated relations between crack use and STDs, cocaine and STDs, and the exchange of sex for drugs. Although many of these studies were incomplete or limited in scope, the relation between crack use and the risk for STDs seem clear. Programs to treat and prevent drug use are needed to solve the crack/cocaine problem and much of the STD problem. Research needs to focus on defining populations at risk and developing programs that can reach them. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sexual behavior, Research, Usage, Drugs, Crack (Drug), Drugs and sex, editorial

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Control of epidemic early syphilis: the results of an intervention campaign using social networks

Article Abstract:

Increasing the efforts to notify sexual partners and high-risk associates of syphilis patients may help to reduce the spread of this disease. Syphilis is a bacterial disease spread through sexual contact. A high-risk associate is a friend who has syphilis-type symptoms, has had sexual contact with a known syphilis patient, or is an intravenous drug user. Researchers expanded the staff of a county's public health clinics and advertised information about syphilis for a period of 21 weeks. Researchers interviewed 373 syphilis patients. These patients identified 2430 sexual partners and high-risk associates. Researchers located and examined 75% percent of these identified people. Of those identified, 6% had syphilis and received treatment. Researchers identified nearly twice as many syphilis cases compared to routine operations. The cost of this campaign was also nearly double that of normal operations.

Evaluation, Control, Public health administration

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Epidemiology of syphilis in the United States, 1941-1993

Article Abstract:

The pattern of syphilis outbreaks in the U.S. has changed over the past 50 years. The population incidence of syphilis in 1947 in the U.S. was 66.4 per 100,000 persons. Penicillin treatments and acceptance of public health measures may have caused the drop to 3.9 cases per 100,000 persons by 1956. Syphilis in the U.S. was more evenly distributed among the states in the past. Today, the highest rates occur in the south in both rural and urban areas. Minorities, especially blacks, have the highest rates of syphilis, and the south has higher concentrations of blacks. Efforts to control syphilis that focus on social, economic, and cultural issues may be more effective than efforts based on treatment of the disease itself.

Analysis, Epidemics, Prevalence studies (Epidemiology)

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