Sexually transmitted diseases: United States, 1995.

Over the past two decades, the United States has experienced some dramatic changes in the rates of three "classic" sexually transmitted diseases (STDs) as well as the introduction of a variety of newer and more complex STD organisms. Rates of primary and secondary syphilis increased through the mid-1980s to a record high of 20.3 cases per 100,000 population in 1990. Since then, rates have dropped 69 percent to 6.3, the lowest rate in 35 years. Gonorrhea rates increased steadily between 1950 and 1975, plateaued between 1975 and 1978, before beginning a gradual but quite steady decline. In 1995 the rate of gonorrhea reached a 30-year low of 149.5 per 100,000. Rates of chlamydial infections, however, have increased more than 55 since 1984 as screening programs proliferated and reporting improved. These infections are commonly found in sexually active adolescents and young adults, and for every case detected in men, there are approximately six detected in women. Rates of syphilis (primary and secondary) and gonorrhea are concentrated primarily in southern states, while chlamydial infections appear to be more widespread geographically. Despite the availability of diagnostic tests and effective treatment regimens for many infectious diseases, STDs continue to target certain populations. They disproportionately affect the poor, inner-city residents and minority groups. The consequences of the diseases are many and varied, and risk of sterility, ectopic pregnancy, fetal death and/or blindness are markedly increased among women with STDs. In addition, risk of HIV infection appears to be increased among persons with a history of having an STD.