MADELEINE BRAND, host:
From NPR News, this is Day to Day. Sexually transmitted diseases appear to be on the rise in the United States. That's according to the latest report from the Centers for Disease Control. A quick glance at the data tells you that infections are up. But Day to Day's medical adviser, Dr. Sydney Spiesel, says the facts may not be so simple. Syd is a Yale Medical School professor and a pediatrician, and welcome back to Day to Day.
Dr. SYDNEY SPIESEL: Always glad to be here.
BRAND: All right, this study focuses on three big diseases: chlamydia, gonorrhea and syphilis. And what does it say?
Dr. SPIESEL: Well, it says that of all of them, there's been a tremendously striking rise in chlamydia, in particular. And in fact, the numbers are so huge - there - in 2007, there were more than a million cases reported to CDC for the year, and that represents the largest number of cases ever reported to CDC for any condition. So, that's really pretty huge. And between 2006 and 2007, it went up 7.5 percent, for example.
BRAND: And also with syphilis and gonorrhea?
Dr. SPIESEL: Gonorrhea is really pretty much stable. Syphilis, the total amount has not really increased, but the distribution has changed. It formerly was equally distributed between men and women. And now the number of cases reported - men has gone up a lot, and the number of cases reported in women has gone down a lot. And that may be because of - there's increased frequency of syphilis in men having sex with men.
BRAND: So, what does this tell you, Syd, about the data? I mean, it seems pretty straightforward that there's an increase in all three of these.
Dr. SPIESEL: Well, the data are really open to multiple interpretations. For instance, there's been a tremendous change just in the last few years in many parts of the country in the way testing is done. So, in the old days, testing, especially for men, especially for chlamydia and for gonorrhea were - how to put it delicately - very uncomfortable. And so, men shied away from getting tested. Men wouldn't get tested. Now, it's a urine test. It's not invasive at all, not annoying at all. And so, many more men are being tested than used to be the case. And maybe that's reflected in the fact that between 2006 and 2007 there were, like, a 43 percent increase in the number of positive cases in men. So, does that simply reflect more testing?
BRAND: Still, with chlamydia, it looks like a massive increase in the number of cases. Could it all come down to that, that there's just more testing?
Dr. SPIESEL: I think the actual rate of chlamydia has gone up. It's particularly an issue for young, African-American women. And that may have to do with all kinds of things. They may have less access to good-quality health care, which would provide both counseling and treatment early on. There's a lower rate of circumcision in African-American men, and that may lead to - there's no question that circumcision decreases the rate of transmission. So, there are all these things that we just don't know, and I think we just need more research.
BRAND: Now, the thing about chlamydia is it's not a serious disease. It's not like HIV. You can cure it with antibiotics, right?
Dr. SPIESEL: I really don't want people to become casual. These diseases are still serious and with very significant consequences, especially for women and children. Syphilis, we'd almost eliminated, but now it's rising, and not exactly sure why, although there are some ideas about that. We shouldn't forget that having an STD promotes the transmission of HIV. So, we do have - listen, these diseases are serious and dangerous, and should be taken seriously.
COHEN: Syd, thank you.
Dr. SPIESEL: My pleasure.
BRAND: That's opinion from Dr. Sydney Spiesel. And you can read his column at Slate.com.
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