New York Times (11.09.05) - Wednesday, November 09, 2005
Lawrence K. Altman

In 2004, the national gonorrhea rate fell to 113.5 cases per 100,000 people. This was the STD's lowest rate since 1941, when the government began tracking cases, said Dr. Ronald O. Valdiserri, acting director of the HIV, STD and TB prevention unit at CDC. According to Valdiserri and Dr. John M. Douglas, CDC's STD prevention director, gonorrhea rates soared in the late 1960s and peaked in the 1970s due to changes in sexual behavior, increased use of oral contraceptives and decreased use of condoms. Rates fell in the 1980s in response to increased control measures. However, Douglas noted that the 330,132 cases reported in 2004 were likely less than half the number estimated to have actually occurred.

After hitting an all-time low in 2000, rates of early-stage syphilis rose for four consecutive years to reach 2.7 cases per 100,000 in 2004. CDC said this increase is largely due to more infections among men who have sex with men. Many MSM, Valdiserri said, may not realize that oral sex can transmit syphilis. The early-stage syphilis rate for men climbed from 2.6 cases per 100,000 in 2000 to 4.7 cases in 2004.

CDC documented 929,462 cases of chlamydia in 2004, but it estimated that 2.8 million new infections probably took place that year. The chlamydia rate hit 319.6 cases per 100,000, up 5.9 percent from 2003. Valdiserri said improved and increased screening, not an actual increase in new infections, was likely behind the higher figure for this STD.

Valdiserri acknowledged "a resource challenge" in the fight against STDs. "We certainly hear from state and local health departments that they do not always have the resources they require to address all the STD issues that they need to address," he said.

And while the Internet appears to have fueled the increase of some high-risk behavior, CDC said public-health workers are also using it as a means to educate gay men and others about the dangers of unprotected sex.

The estimated 19 million new STD infections that occurred in 2004 resulted in health care costs of about $19 billion, CDC said.
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