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The Hidden Epidemic: Confronting Sexually Transmitted Diseases (1997)
Institute of Medicine (IOM)

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. "APPENDIX B." The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: The National Academies Press, 1997.

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STD (etiologic agent)

Estimated Annual Incidence, 1994a

Estimated Prevalence, 1994b

Estimated Annual Total Costs (millions of 1994$)c

Routes of Transmissiond

Frequency of Asymptomatic Infectionse

Major Long-Term Health Consequences.f

Increases Risk for Acquisition or Transmission of HIV Infection?g

Effective Curative Treatment Available/Vaccine Available?h

 

 

 

 

 

 

Adults

Pregnant Women and Infants

 

 

Hepatitis B virus infection (hepatitis B virus)

53,000 (sexually transmitted cases)

NA

156 (sexually transmitted cases)

Vaginal, anal, and oral sex. Parenterally, through exposure to infectious blood, especially intravenous drug use. Mother-to-infant transmission. Close direct contact with infectious body fluids, especially in health care settings, including blood, saliva, semen, and vaginal fluids.

Women and men common.

Women and men: chronic liver disease, cirrhosis, liver cancer, death.

Infants: same as adults, chronic infection more likely.

No evidence

No/Yes

Chancroid (Haemophilus ducreyi)

3,500

NA

1

Vaginal and anal sex.

Women: common. Men: uncommon.

Long-term consequences uncommon.

Unknown.

Yes

Yes/No

Trichomoniasis (Trichomonas vaginalis)

3,000,000

NA

NA

Vaginal sex.

Women: common. Men: very common.

Women: chronic vaginal discharge.

Infants: possible low birth weight. Pregnant women: possible preterm delivery.

Possible

Yes/No

HIV-1 infection (human immunodeficiency virus)

NA

630,000-897,000 (estimate for January 1993)

6,683 (sexually transmitted cases)

Vaginal, anal, and oral sex. Parenterally, through exposure to infectious blood, especially through intravenous drug use. Mother-to-infant transmission.

Women and men: common.

Women and men: AIDS.

Infants: pediatric AIDS.

 

No/No

NOTE: NA = not available.

a CDC, DSTD/HIVP (Division of STD/HIV Prevention). Annual report, 1994. U.S. Department of Health and Human Services, Public Health Service. Atlanta: Centers for Disease Control and Prevention, 1995. CDC, DSTDP (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, 1995.

b CDC, DSTD/HIVP, 1995 (see above). Rosenberg PS. Scope of the AIDS epidemic in the United States. Science 1995;270:1372-5.

c IOM Committee on Prevention and Control of STDs, Chapter 2 of this volume.

d Benenson AS, ed. Control of communicable disease manual. 16th ed. Washington, D.C.: American Public Health Association, 1995. Wasserheit JN, Aral SO, Holmes KK, Hitchcock PJ, eds. Research issues in human behavior and sexually transmitted diseases in the AIDS era. Washington, D.C.: American Society for Microbiology, 1991. Donovan P. Testing positive: sexually transmitted disease and the public health response. New York: Alan Guttmacher Institute, 1993.

e Categories are (a) very common: > 75 percent of infections; (b) common: > 25 to 75 percent of infections; (c) less common: 5 to 25 percent of infections; and (d) uncommon: < 5 percent of infections are asymptomatic. SOURCE: Wasserheit et al., 1991 (see above).

f Wasserheit et al., 1991 (see above). Donovan, 1993 (see above).

g Wasserheit et al., 1991 (see above).

h CDC. 1993 Sexually transmitted diseases treatment guidelines. MMWR 1993;42(No. RR-14).
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