Sexually Transmitted Infections in the United States

Epidemiology

The southeastern United States consistently reports the highest rates of sexually transmitted infections (STIs) and sexually transmitted diseases (STDs) in the country, with a geographic overlap between regions with high STD rates and rapidly expanding heterosexual HIV transmission 1
The southeastern United States shows disproportionately high rates of notifiable STDs, particularly gonorrhea and syphilis 1
This regional concentration reflects a concerning pattern where STD rates and heterosexual HIV transmission overlap geographically 1
Chlamydia remains the most commonly reported infectious disease in the United States 1
African Americans experience approximately fiftyfold higher rates of primary and secondary syphilis compared to whites 1
Sexually active adolescents across the United States have a point prevalence for chlamydial infection of 5-10% 1
In 1996, routine reporting indicated a gonorrhea case rate of 3% for African-American women aged 15-19 years and men aged 20-24 years 1

The southeastern United States is experiencing an increasing proportion of AIDS cases, particularly among young women 1
The shift in the HIV/AIDS epidemic toward African Americans reflects and may be partly attributable to the long-standing disproportionate burden of other STDs in this group 1

Only about half of local public health departments in the United States provide STD preventive services 1
Access to care is often restricted by limited hours of operation and lack of timely services 1
Nearly 40% of local health departments providing STD services cannot see potentially infected patients the same day they seek care 1
In primary care settings, most providers do not routinely obtain sexual histories or screen for STDs 1