Sexually Transmitted Disease Surveillance 1996

Division of STD Prevention September 1997

U.S. Department of Health and Human Services 
Public Health Service 
Centers for Disease Control and Prevention  
National Center for HIV, STD, and TB Prevention 
Division of STD Prevention 
Atlanta, Georgia 30333

Copyright Information 

All material contained in this report is in the public domain and may be
used and reprinted without special permission; citation to source, however,
is appreciated.

Suggested Citation

Division of STD Prevention. Sexually Transmitted Disease Surveillance,
1996. U.S. Department of Health and Human Services, Public Health Service.
Atlanta: Centers for Disease Control and Prevention, September 1997.

Copies can be obtained from the Office of Communications, National Center
for HIV, STD, and TB Prevention, Centers for Disease Control and
Prevention, 1600 Clifton Road, Mailstop E-06, Atlanta, Georgia 30333.

The reports for 1993 through 1996 are available electronically on CDC
WONDER. For information about registering for CDC WONDER, please contact
CDC's Epidemiology Program Office at (888) 496-8347. These reports are also
available from the Internet via the CDC home page address
http://wonder.cdc.gov/wonder/data/Reports.html. 


STDs in Minorities

Public Health Impact

Surveillance data show high rates of STDs for some minority racial or
ethnic groups when compared with rates for whites. Race and ethnicity in
the United States are risk markers that correlate with other more
fundamental determinants of health status such as poverty, access to
quality health care, health care seeking behavior, illicit drug use, and
living in communities with high prevalence of STDs. Acknowledging the
disparity in STD rates by race or ethnicity is one of the first steps in
empowering affected communities to organize and focus on this problem.

Surveillance data are based on cases of STDs reported to state and local
health departments (see Appendix). In many areas, reporting from public
sources (e.g., STD clinics) is more complete than reporting from private
sources. Since minority populations may utilize public clinics more than
whites, differences in rates between minorities and whites may be increased
by this reporting bias.

Observations

--  Although chlamydia is a widely distributed STD among all racial and
    ethnic groups, trends in positivity in women screened in Health and
    Human Services Region X (Alaska, Idaho, Oregon, and Washington) show
    consistently higher rates among minorities (Figure_N).

--  In 1996, African-Americans accounted for about 78% of total reported
    cases of gonorrhea (Table_12A). The overall gonorrhea rates in 1996
    were 825.5 cases per 100,000 for African-Americans and 69.0 for
    Hispanics compared with 25.9 for non-Hispanic whites (Figure_16,
    Table_12B). Compared with 1995, 1996 rates decreased for all
    race/ethnic groups except American Indian/Alaska Native.

--  Gonorrhea rates are very high for African-American adolescents and
    young adults. In 1996, black females aged 15 to 19 years had a
    gonorrhea rate of 3,790.9 cases per 100,000 population. Black men in
    this age group had a gonorrhea rate of 2,357.2. These rates were on
    average about 24 times higher than those of 15- to 19-year-old white
    adolescents (Table_12B). Among 20- to 24-year-olds in 1996, the
    gonorrhea rate among blacks was almost 30 times greater than that of
    whites (3,015.5 vs. 103.9, respectively) (Table_12B).

--  Despite declines in gonorrhea rates for most age and race/ethnic groups
    during the 1980's, African-American adolescents did not show declining
    trends in rates until 1991 (black women) and 1992 (black men). Between
    1995 and 1996 gonorrhea rates for black females aged 15 to 19 years
    declined by 14.1%, and for black males in this age group, by 27.1%
    (Table_12B, Figure_O and Figure_P). 

--  The most recent epidemic of syphilis was largely an epidemic in
    heterosexual, minority populations (1). Since 1990, rates of primary
    and secondary (P&S) syphilis have declined among all racial and ethnic
    groups except American Indian/Alaska Native. However, rates for
    African-Americans and Hispanics continue to be higher than for
    non-Hispanic whites. In 1996, African-Americans accounted for about 84%
    of all reported cases of P&S syphilis (Table_24A). Although the
    rate for African-Americans declined from 44.9 cases per 100,000
    population in 1995 to 30.2 in 1996, the latter rate was nearly 50-fold
    greater than the non-Hispanic white rate of 0.6 per 100,000. Between
    1995 and 1996, primary and secondary syphilis rates for black females
    aged 15 to 19 years declined by 39.8%, and for black males in this age
    group, by 38.7% (Figure_Q and Figure_R, Table_24B). The
    1996 rate of P&S syphilis in Hispanics was 1.9 (Figure_30,
    Table_24B).

--  In 1996, the rate of congenital syphilis in African-Americans was 127.8
    per 100,000 live births and 36.4 in Hispanics compared with 3.2 in
    whites (Figure_S). Compared with 1995, this represented a 37%
    decrease for blacks and a 42% decrease for Hispanics. 

Figure_N.   Chlamydia -- Percent positivity among women tested in 
                family planning clinics by race and ethnicity: Region X,
                1988-1996
Figure_O.   Gonorrhea -- Reported rates for 15-19 year old females by 
                race and ethnicity: United States, 1981-1996
Figure_P.   Gonorrhea -- Reported rates for 15-19 year old males by 
                race and ethnicity: United States, 1981-1996
Figure_Q.   Primary and secondary syphilis -- Reported rates for 15-19 
                year old females by race and ethnicity: United States,
                1981-1996
Figure_R.   Primary and secondary syphilis -- Reported rates for 15-19 
                year old males by race and ethnicity: United States,
                1981-1996
Figure_S.   Congenital syphilis -- Rates for infants <1 year of age by 
                race and ethnicity: United States, 1991-1996


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(1) Nakashima AK, Rolfs RT, Flock ML, Kilmarx P, Greenspan JR. Epidemiology
    of syphilis in the United States, 1941 through 1993, Sexually
    Transmitted Diseases 196;23(1):16-23.

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