Trends in the Well-Being of America's Children and Youth, 1997. SD 4.10 Sexually transmitted diseases among adolescents

04/01/1997

Sexually transmitted diseases (STDs) have potentially severe consequences. Women can develop pelvic inflammatory disease which in turn may lead to adverse reproductive consequences such as infertility, ectopic pregnancy, or the birth of children with physical and mental developmental disabilities. The increase in sexual activity among teenagers described in Section SD 4.1 has exposed a growing number of young people to the risk of sexually transmitted diseases. Despite this increased risk, the reported rate of incidence has declined among adolescents for both gonorrhea and syphilis.66

Decline in Gonorrhea Rates. Since 1975, the reported gonorrhea rate for all youth has declined (see Table SD 4.10.A). Among youth ages 15-19, rates decreased by almost half, from 1275.1 cases of gonorrhea per 100,000 youth in 1975, to 664.6 cases per 100,000 youth in 1995. Gonorrhea rates also decreased among youth ages 10-14, but the decline started later and has not been as dramatic as among older youth. The rate for this age group peaked at 68.9 cases per 100,000 youth in 1990; by 1995, the reported rate had declined to 42 cases per 100,000 youth age 10-14.

Differences in Gonorrhea Rates by Gender. For youth ages 15-19 and ages 10-14, females have had consistently higher reported rates of gonorrhea than males (see Figure SD 4.10.A). In 1994 rates for females ages 15-19 were 839.7 per 100,000, versus 498.4 per 100,000 males of the same age.

Differences in Gonorrhea Rates by Race and Ethnicity. Blacks have consistently had the highest reported rates of gonorrhea, more than 10 times the rate of any other race or ethnic group. However, rates for blacks are falling, in contrast to gonorrhea rates among Hispanics, which have risen since 1990, the first year for which data by race and ethnicity are available (see Table S.D. 4.10.A).

Decline in Syphilis Rates. Table SD 4.10.B shows that reported rates for primary and secondary syphilis have decreased for youth, ages 10-14 and 15-19, since their peak in 1990. While the rate for both groups has decreased, the rate for teens ages 15-19 is substantially higher than the rate for youth ages 10-14. For example, the reported rate for syphilis in 1995 for teens ages 15-19 was 10.0 cases per 100,000 youth compared to 0.6 cases per 100,000 for youth 10-14.

Higher Syphilis Rates Among Females. Females from both age groups have reported more cases of syphilis than their male counterparts (see Figure 4.10.B). For example, teenage females ages 15-19 had a rate of 13.6 cases per 100,000, about double the male rate of 6.6 cases per 100,000.

Differences in Syphilis Rates by Race and Ethnicity. Blacks ages 15-19 had rates of syphilis more than 10 times higher than all other racial and ethnic groups throughout the period 1990-1995. Rates have been falling for all groups except Native Americans, whose reported syphilis rates have fluctuated between 1990 and 1995 (see Table SD 4.10.B).
 

Figure SD 4.10.A  
Reported Gonorrhea Rates (per 100,000 Population), by Gender, Ages 15-19: Selected Years, 1975-1995 

SD4_10A.GIF

Note: aAlthough most areas generally adhere to the case definitions for STD found in Case Definitions for Public Health Surveillance (MMWR 1990; 39: 1-43) there are significant differences between individual areas in case definitions as well as in the policies and systems for collecting surveillance data. In many areas reporting from publicly supported institutions (e.g., STD clinics) was more complete than from other sources (e.g., private practitioners).
bFor 1994 Georgia only reported gonorrhea cases to CDC for part of the year. Therefore, Georgia cases and population were excluded from gonorrhea figures and tables. In past years, Georgia has been among the states reporting the highest gonorrhea rates.

Source: Division of STD Prevention. Sexually Transmitted Disease Surveillance, 1980. U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for Disease Control and Prevention. Plus additional yearly updates of this report.
 
 

Figure SD 4.10.B  
Reported Syphilis Rates (per 100,000 Population), by Gender, Ages 15-19: Selected Years, 1975-1995 

SD4_10B.GIF

Note: a Although most areas generally adhere to the case definitions for STD found in Case Definitions for Public Health Surveillance (MMWR 1990; 39: 1-43) there are significant differences between individual areas in case definitions as well as in the policies and systems for collecting surveillance data. In many areas reporting from publicly supported institutions (e.g., STD clinics) was more complete than from other sources (e.g., private practitioners).
b Cases and population denominators for Baltimore, MD have been excluded for 1993 because age was not reported for most cases.

Source. Division of STD Prevention. Sexually Transmitted Disease Surveillance, 1980. U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for Disease Control and Prevention. And yearly updates of this report.
 
 

Table 4.10.A 
Gonorrhea: Reported Ratesa (per 100,000 Population) by Age, Gender, and Race/Ethnicity: 1975-1995

                   
   
1975
1980
1985
1990
1991
1992
1993
1994b
1995
   
 
 
 
 
 
 
 
 
 
AGES 10-14
Total
46.7
48.7
47.7
68.9
64.6
57.8
48.8
48.6
42
Gender
  Male
20.9
23.6
23.8
32.1
32.4
26.2
20.6
16
12.6
  Female
73.6
74.8
72.9
107.5
98.3
91
78.5
82.8
72.8
Racec
  White
 
 
 
14.3
12.9
12.1
9.3
10.6
9
  Black
 
 
 
386.8
364.7
322.4
282
275.8
238.6
  Hispanic
 
 
 
15.3
16.5
17.7
21.5
20.5
21.3
  Asian
 
 
 
4.5
9.9
6.2
4.5
5.8
5.3
  American Indian
 
 
 
22.7
28.9
19.6
31.8
25.1
16.4
                     
AGES 15-19
Total
1,275.10
1,187.30
1189.9
1,114.40
1,031.40
869.6
733.3
739.2
664.6
Gender
  Male
1,103.90
953.4
930.5
993.7
954.6
771
615.7
589.7
498.4
  Female
1,446.40
1,424.60
1,455.10
1,241.60
1,112.20
973.6
857.4
896.8
839.7
Racec
  White
 
 
 
230.3
196.7
165.9
137.2
151.2
142.7
  Black
 
 
 
6,316.20
5,963.90
4,973.10
4,333.40
4,327.60
3,843.20
  Hispanic
 
 
 
268.7
273.1
279.3
279.5
256.7
286.4
  Asian
 
 
 
70
91.5
77.4
75.8
79.1
72.8
  American Indian
 
 
 
414.6
366
317.5
311.3
305.1
248.7
                     
Note: aAlthough most areas generally adhere to the case definitions for STD found in Case Definitions for Public Health Surveillance (MMWR 1990; 39: 1-43) there are significant differences between individual areas in case definitions as well as in the policies and systems for collecting surveillance data. In many areas reporting from publicly supported institutions (e.g., STD clinics) was more complete than from other sources (e.g., private practitioners).  
bFor 1994 Georgia only reported gonorrhea cases to CDC for part of the year. Therefore, Georgia cases and population were excluded from gonorrhea figures and tables. In past years, Georgia has been among the states reporting the highest gonorrhea rates.  
cFor the following years, the states/areas listed did not report race/ethnicity for most cases: 1992 (New York City and New York State); 1993 (New York City, New York State, and Georgia); 1994 (New York City, New York State, and Georgia); and 1995 (Georgia, New Jersey, New York City and New York State).  

Source: Division of STD Prevention. Sexually Transmitted Disease Surveillance, 1980 et seq. U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for Disease Control and Prevention.

 
 

Table 4.10.B 
Primary and Secondary Syphilis: Reported Ratesa (per 100,000 Population) by Age, Gender, and Race/Ethnicity: 1975-1995

                     
   
1975
1980
1985
1990
1991b
1992
1993c
1994
1995
   
 
 
 
 
 
 
 
 
 
AGES 10-14
Total
1.1
0.9
0.9
1.8
1.4
1.3
1
0.6
0.6
Gender                  
  Male
0.7
0.5
0.5
0.5
0.4
0.3
0.3
0.1
0.1
  Female
1.5
1.3
1.4
3.2
2.5
2.3
1.7
1.2
1
Racec
  White
 
 
 
0.1
0.1
0.1
0.1
0.1
0
  Black
 
 
 
10.6
8.6
8.2
6
3.8
3.5
  Hispanic
 
 
 
1.1
0.4
0.4
0.1
0.1
0.1
  Asian
 
 
 
0.2
0.3
0
0.2
0
0
  American Indian
 
 
 
0.5
0
0
0
0
0
                     
AGES 15-19
Total
17.8
17.2
17
29.8
27.8
22.5
17.2
12.7
10
Gender                  
  Male
18
19.2
16.3
20.9
19.1
15.5
11
8.3
6.6
  Female
17.5
15.1
17.7
39.2
37
29.9
23.9
17.4
13.6
Racec
  White
 
 
 
2.9
2.6
2
1.6
1.4
1.1
  Black
 
 
 
174.6
164.8
136.6
105.7
77.6
60.8
  Hispanic
 
 
 
15.2
12.5
8.5
6.1
3
2.5
  Asian
 
 
 
1.7
1.9
1.4
1
0.8
0.4
  American Indian
 
 
 
2.8
7
2.7
0.5
2.1
3.5
                     
Note: a Although most areas generally adhere to the case definitions for STD found in Case Definitions for Public Health Surveillance (MMWR 1990; 39: 1-43) there are significant differences between individual areas in case definitions as well as in the policies and systems for collecting surveillance data. In many areas reporting from publicly supported institutions (e.g., STD clinics) was more complete than from other sources (e.g., private practitioners).  
b Cases and population denominators for Kentucky have been excluded for 1991 because race/ethnicity was not reported for most cases.  
c Cases and population denominators for Baltimore, Maryland have been excluded for 1993 because age was not reported for most cases.  

Source: Division of STD Prevention. Sexually Transmitted Disease Surveillance, 1980 et seq. U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for Disease Control and Prevention.

 

66 There has been a considerable increase in reported rates of chlamydia but this trend reflects "increased screening, recognition of asymptomatic infection (mainly in women), and improved reporting capacity rather than true trends in disease incidence" (p. 5 in Division of STD Prevention, Sexually Transmitted Disease Surveillance, 1994. U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for Disease Control and Prevention, September 1995).
 
 

View full report

Preview
Download

"97intro.pdf" (pdf, 97.9Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"97-sec1.pdf" (pdf, 163.75Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"97-sec2.pdf" (pdf, 235.24Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"97-sec3.pdf" (pdf, 269.73Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"97-sec4.pdf" (pdf, 331.35Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"97-sec5.pdf" (pdf, 202.8Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®