Sexually Transmitted Disease Surveillance 1995

Division of STD Prevention

September 1996

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,
1995. U.S. Department of Health and Human Services, Public Health Service.
Atlanta: Centers for Disease Control and Prevention, September 1996.

Copies can be obtained from Information Technology and Services Office,
National Center for HIV, STD, and TB Prevention, Centers for Disease
Control and Prevention, 1600 Clifton Road, Mailstop E-06, Atlanta, Georgia
30333 or by telephone at (404) 639-1819.

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                           STDs in Minorities

Public Health Impact

Surveillance data show high rates of STDs for some minority racial/ethnic
groups when compared with rates for whites. There are no known biologic
reasons to explain why racial or ethnic factors alone should alter risk for
STDs. Rather, 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/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 federal Region
    X (Alaska, Idaho, Oregon, and Washington) show consistently higher
    rates among minorities (Figure_J).

--  In 1995, African-Americans accounted for about 79% of total reported
    cases of gonorrhea (Table_9A). The overall gonorrhea rates in 1995
    were 1,086.9 cases per 100,000 for African-Americans and 90.6 for
    Hispanics compared with 29.1 for non-Hispanic whites (Figure_11,
    Table_9B). Compared with 1994, 1995 rates decreased for all
    race/ethnic groups except Hispanics.

--  Gonorrhea rates are very high for African-American adolescents and
    young adults. In 1995, black 15- to 19-year-old women had a gonorrhea
    rate of 4,432.6 cases per 100,000 population. Black men in this age
    group had a gonorrhea rate of 3,267.3. These rates were on average more
    than 27 times higher than those of white adolescents 15- to
    19-years-old (Table_9B). Among 20- to 24-year-olds in 1995, the
    gonorrhea rate among blacks was 35 times greater than that of whites
    (4,238.9 vs. 121.1, respectively) (Table_9B).

--  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
    1994 and 1995 gonorrhea rates for black 15- to 19-year-old women
    declined by 7.1%, and for black men in this age group, by 16.1%
    (Table_9B and Figure_K and Figure_L). 

--  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 among
    African-Americans and Hispanics continued to be higher than for
    non-Hispanic whites. In 1995, African-Americans accounted for about 86%
    of all reported cases of P&S syphilis (Table_21A). Although the
    rate among African-Americans declined from 58.6 cases per 100,000
    population in 1994 to 46.2 in 1995, the latter rate was nearly 60-fold
    greater than the non-Hispanic white rate of 0.8 per 100,000. The 1995
    rate of P&S syphilis in Hispanics was 3.0 (Figure_24 and
    Table_21B).

--  In 1995, the rate of congenital syphilis in African-Americans was 162.2
    per 100,000 live births and 49.7 in Hispanics compared with 3.9 in
    whites (Figure_M). Compared with 1994, this represented a 30%
    decrease among blacks and a 35% decrease among Hispanics.

Figure_J.  Chlamydia -- Percent positivity among women tested in family
               planning clinics by race and ethnicity: Region X, 1988-1995
Figure_K.  Gonorrhea -- Reported rates for 15- to 19-year-old females by
               race and ethnicity: United States, 1981-1995
Figure_L.  Gonorrhea -- Reported rates for 15- to 19-year-old males by
               race and ethnicity: United States, 1981-1995
Figure_M.  Congenital syphilis -- Rates for infants <1 year of age by
               race and ethnicity: United States, 1991-1995 and the Healthy
               People year 2000 objective

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(1) Rolfs RT, Nakashima AK. Epidemiology of primary and secondary syphilis
    in the United States, 1981 through 1989. JAMA 1990;264:1432-7.

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