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US
Leads In Sexually Transmitted Disease Rate
RedNova.com 2-1-5 HealthDay News
Rates of early death and disability that can be
attributed to sexual behavior are three times higher
in the United States than other so-called developed
nations, a new study finds. This finding precludes
the AIDS epidemic in many African countries. American
men still die more often as a result of having a
sexually transmitted disease, researchers from the
U.S. Centers for Disease Control and Prevention
said, but more cases are reported in American women.
The findings were published in the Jan. 27 issue
of the British journal Sexually Transmitted Infections.
"It certainly is disturbing," said Dr. Cynthia Krause,
assistant clinical professor of obstetrics/gynecology
at Mount Sinai School of Medicine in New York City.
"The challenge is how to represent this in a way
that's not alarmist, to make women aware of the
real risks." An earlier survey had found that half
of all deaths in the United States in 1990 were
attributable to nine risk factors that included
sexual behavior. That category alone accounted for
30,000 deaths.
The researchers behind the new study didn't think
this provided a complete picture of the health toll,
given that sexually transmitted diseases are associated
with other problems such as infertility, psychological
trauma and stigma. They set out to quantify the
public health burden of sexually transmitted diseases
in 1998 by looking at national data on sexual health
and reproduction, surveillance systems for infectious
diseases, hospital and outpatient statistics, birth
and death records as well as published research.
They then calculated "adverse health consequences,"
such as infertility, cervical cancer, and HIV infections.
They also factored in premature deaths and "disability
adjusted life years" (DALYs), a figure indicating
years of life cut short by premature death and loss
of healthy living years as a result of disability.
In 1998, sexual behavior accounted for about 20
million "adverse health consequences"
(equivalent to more than 7,500 per 100,000 people)
and 29,782 deaths (or 1.3 percent of all deaths
in the United States),
the study found. Sixty-two percent of the "adverse
health consequences" and 57 percent of "disability
adjusted life years" were among women. Curable infections
and their consequences accounted for more than half
of these health problems. Viral infections -- mostly
HIV/AIDS -- and their consequences accounted for
almost all deaths among men and women. In terms
of percentages, more men (66 percent) than women
died due to sexually transmitted diseases. But if
HIV/AIDS were not considered, then 89 percent of
deaths attributed to sexual behavior would have
been among women. HIV/AIDS was the leading cause
of death among men, while cervical cancer and HIV/AIDS
were the leading causes of death among women. These
estimates are probably conservative, the authors
stated.
The study did not address why the United States
was hit so hard by sexually transmitted diseases,
although the study's lead author, Dr. Shahul Ebrahim,
said that behavior was only part of the equation.
"Everybody is having sex in the world, but some
places have a low HIV prevalence," said Ebrahim,
who is a medical epidemiologist with the CDC's National
Center for Birth Defects. "Behavior is just one
indicator. Another issue is transmission risk factors."
Researchers are planning to use the data to increase
the public's awareness of the problem.
"The two most important issues are HIV and cervical
cancer [which can occur from having numerous sexual
partners]," Ebrahim said. "For cervical cancer,
we have a national program to screen all women of
a certain age group and risk, but not everybody
is accessing that. We've reached the 80 percent
mark but we still have 20 percent remaining." A
similar problem exists for HIV. "Not everybody is
getting tested for HIV. Once you get tested, you
can access treatment and probably prolong life,"
Ebrahim said.
None of this is going to happen overnight, he added.
The consequences of "sexual behavior are totally
preventable," he said. "If you have protected or
safe sex, you are not going to have these."
SOURCES: Shahul Ebrahim, M.D., medical epidemiologist,
National Center for Birth Defects, U.S. Centers
for Disease Control and Prevention, Atlanta; Cynthia
Krause, M.D., assistant clinical professor of obstetrics/gynecology,
Mount Sinai School of Medicine, New York City; Jan.
27, 2005, Sexually Transmitted Infections~INFC~~AIDS~~STD-~~DEAD~
Source: HealthSCOUT
© 2002-2004 RedNova.com. All rights reserved.
http://www.rednova.com/news/display/?id=122395
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