Old enemies: combating syphilis and gonorrhea in the 1990s

Article Abstract:

Recent findings by the United States Centers for Disease Control (CDC) regarding sexually transmitted diseases are discussed in two articles in the September 19, 1990 issue of the Journal of the American Medical Association (JAMA). These articles reveal an increase in the number of reports of both syphilis and gonorrhea, the most common of the sexually transmitted diseases. One of the articles shows that some strains of the organism that causes gonorrhea, Neisseria gonorrhoea, have become resistant to antibiotic treatment. Consequently, it is now recommended that all cases of gonorrhea be treated as if they were resistant. Because the follow-up rate of treatment of gonorrhea is never 100 percent, a treatment approach that comes as close as possible to a 100 percent obliteration of the disease is important. Health departments are encouraged to monitor the antibiotic resistance of strains of bacteria seen in their localities, in order to be able to alert physicians to adjust their dispensing practices. The other article documents the recent explosive development of the syphilis epidemic within the United States. This has become particularly disturbing in the nearly doubling of the incidence of primary and secondary syphilis among blacks between 1985 and 1990. The rate of infection in whites, Asian or individuals of Pacific Islanders has remained low or even declined during this period. The reasons for the higher incidence in some groups are complex and uncertain, but it is possible that the rise in syphilis is accompanying an increased use of substance abuse, and high-risk sexual behavior (e.g. ''sex for crack'') has been suggested as a cause. Individuals diagnosed with Chlamydia infection, genital herpes, or genital warts should be tested for syphilis. The occurrence of any sexual transmitted disease should provoke screening for other diseases, counseling and testing for human immunodeficiency virus, inquiries into sexual and drug use habits, and an examination of the patient's lifestyle and environment. Treatment is best performed according to the guidelines of CDC. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Demographic aspects, Syphilis, United States. Centers for Disease Control and Prevention, editorial

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Progress toward achieving the 1990 objectives for the nation for sexually transmitted diseases

Article Abstract:

The 1990 health promotion objectives for the nation, published in 1980, included goals for the reduction of sexually transmitted diseases (STDs). The five top priority goals for STD control are listed and the nation's progress towards meeting them is evaluated. The first goal, to reduce the rate of syphilis, will probably not be met because while syphilis declined from 1982 to 1986, it increased to the highest rate in 40 years by 1988. Two other objectives, for reducing gonorrhea and gonococcal pelvic inflammatory disease (PID), will most likely be met. A goal was set that 95 percent of the health professionals seeing patients with suspected cases of STD should be able to diagnose and treat all known STDs. The nation is not likely to come close to meeting this objective since half of the medical schools presented no course work on STDs and only 10 percent of primary-care providers asked patients about their sexual behaviors. Another educational objective, that all junior and senior high school students receive accurate, timely information on STDs, will probably not be met. After the objectives were written in 1980, a new STD, AIDS (acquired immunodeficiency syndrome), caused a major impact on the nation's health. The variety of STDs has also grown; genital chlamydia, now the most common bacterial STD, has been recognized as difficult to treat and likely to cause infertility in women. Homosexual men have shown increasing efforts to prevent STD transmission, but teenagers appear to be less cautious than in previous years because they are having sexual intercourse at a younger age. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, Prevention, Health promotion, Sexually transmitted disease prevention

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Trends in gonorrhea in homosexually active men - King County, Washington, 1989

Article Abstract:

Gonorrhea is a sexually transmitted disease. The rate of anal gonorrhea in sexually active homosexual men in King County, WA has increased rapidly during 1989. Despite the fact that the rate of infection by gonorrhea in the general King County population has continued its decade-long decline, the rate in homosexual males is projected to triple in 1989 from its 1988 rate. It is believed that this increase is not an artifact in reporting infection or screening examinations, but is a true expression of a rise in gonorrhea in this group. The reasons for this rise are unknown, but several possibilities are considered. Some homosexual men may not have fully adopted safe-sex practices, or the causative bacteria may have been introduced or reintroduced into a group of individuals with high-risk practices. Another possibility is that there has been an increase in high-risk sexual practices within the homosexual population. Strategies are now being developed to evaluate the increased risk of anal gonorrhea in sexually active homosexual men.

Health aspects, Analysis, Risk factors, Diseases, Gay men, Colorectal diseases, Intestinal diseases, Safe sex, King County, Washington, Washington (State)

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