Increase in STDs noted in youth

The issue of STDs in adolescent populations cannot be understated, according to a speaker at the 68th Annual Meeting of the American Academy of Dermatology in Miami Beach, Fla.

“The number of STD cases continues to grows exponentially,” said Whitney A. High, MD, who is associate professor of dermatology and pathology at the University of Colorado Health Sciences Center, Denver.

A June 2007 report from the U.K. National Health Service, titled “Sex, Drugs, Alcohol and Young People,” showed a 12-year increase of 200- to 2,000-fold for various STDs; an increase mirrored by a rise in underage drinking.

High said this same report found that 40% of 13- to 14-year-olds who were sexually active reported being drunk or high at the time of their first sexual intercourse, suggesting that adverse social behaviors diminish judgment, leading to increased participation in risky behavior.

Other data from the 2003-2004 National Health and Nutrition Examination Survey recently indicated that about 3 million U.S. girls aged 14 to 19 years are estimated to have at least one of the five most common STDs.

“Recent reports show about a 5.5% increase in chlamydia, coupled with a 5.6% increase in the rate of gonorrhea and a 13.8% increase in the number of patients presenting with syphilis,” High said during an American Academy of Dermatology session on sexually transmitted infections. “Of those patients presenting with STDs, 50% are between the ages of 15 and 24 years.”

High said there are record numbers of patients presenting with chlamydia this year, more than 1.2 million cases. Although a vaccine against chlamydia may be near development, currently, the best treatment option is a single 1-g dose of azithromycin that is taken in the physician’s office under supervision, which improves compliance with treatment.

High said there are other STD vaccines, such as the human papillomavirus quadrivalent (Gardasil, Merck) and bivalent (Cervarix, GlaxoSmithKline).

“Gardasil is quadrivalent and covers HPV subtypes 6, 11, 16 and 18 and is seeking to prevent both genital warts and cervical cancer,” he said. “Ceravix, which was just recently approved, is bivalent, covering HPV subtypes 16 and 18, and is designed to prevent cervical cancer but does nothing for condyloma caused by HPV 6 and 11.”

High said a high rate of resistance in certain areas and populations has changed gonorrhea treatment recommendations. Resistance in recent years has prompted the CDC and the AAP to change their recommendations, specifically recommending that fluoroquinolones not be used as primary treatment for this infection. Ceftriaxone and cefixime (Suprax, Lupin Pharmaceuticals) remain effective in most cases.

High told physicians to remain aware of risk factors that may put patients at risk for STDs and encourage dialogue on these behaviors when possible.

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