STD Superspreaders

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    B_Italian1 New Member

    Jul 24, 2007
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    STD Superspreaders - Page 1 - Men's Health - MSN Health & Fitness

    STD Superspreaders

    Who’s most likely to acquire and spread STDs—and why you’re not immune.
    By Rich Maloof for MSN Health & Fitness

    By fact or fiction, by stats or by stigma, a handful of groups within our population have been linked to elevated STD risk. Some assumptions feed the fallacy that only certain “types” of people acquire sexually transmitted diseases, when the plain fact is that nearly everyone who has sexual relations is vulnerable.

    However, official statistics and figures culled by researchers do reveal groups that are disproportionately affected. Who are they? Are the high rates explained by factors beyond their control, and is the health care system somehow failing these people? Moreover, are the high STD rates among specific groups having an impact on the rest of the population? Let’s take a look.

    The Military

    As if our men and women in uniform didn’t face enough threat to their well-being, the U.S. Army, Navy, Air Force and Marines have historically had higher STD rates than the civilian population. The running theory has always been that personnel of a sexually active age with long tours away from home—especially those deployed to countries with limited health care—simply find or put themselves at higher risk.

    In October 2006, a study of 1,700 women on active duty in support of the war in Iraq found that 2.5 percent were infected, most with genital herpes, chlamydia, or genital HPV. Though 95 percent of the female soldiers with STDs were redeployed without any health complications, the study was evidence of our need for more extensive STD screening in the military.

    A sweeping report, this one covering sexually transmitted infections of both men and women in the military from 2000 through 2005, found elevated reports of chlamydia, gonorrhea, nongonococcal urethritis, and syphilis in all branches of the military. The Army steadily led the other three branches. However, the numbers peaked in 2002, and in 2005 the rates for gonorrhea were actually lower than among civilians.

    Still, STDs remain a big problem in the military. Unfortunately, viral infections—which can be treated but not cured—seem to be more commonly reported among the military than bacterial infections.

    Statistics are currently lacking but the subsequent impact on hometown communities is assumed to be significant.

    Internet Hook-Ups

    Meeting someone on the Internet doesn’t have to carry more risk than any other means of hooking up. But as always, the chance of finding a safe partner dwindles when we seek an anonymous companion. Worsening the problem is that some sites allow people to connect based unapologetically on high-risk activities. The July 2007 edition of the journal Sexually Transmitted Diseases cites two studies providing evidence that “Internet-based sex partner recruitment for unprotected sex has emerged as an important risk factor for increases in syphilis among [men who have sex with men].”

    One of those studies also contained a positive element. Researchers from Denver concluded that many male and female subjects had used the Internet to seek information about STDs.

    Cons and Ex-Cons

    The relationship between STDs and prison inmates is a revolving-door problem: There are high rates of infected people entering jail, high infection rates inside of jails, and high potential for impact on the communities where ex-cons are released.

    As STI notes, many studies have shown a high prevalence of STDs among people entering jail and juvenile facilities. The authors write, “In some locations, a substantial proportion of all early syphilis cases are reported from correction facilities.” The bad news extends to men and women alike; among adolescent women entering 57 juvie halls in 2005, a 14.2 percent median (more than 50 percent higher than the national percentage) tested positive for chlamydia.

    The organization Human Rights Watch has come down hard on prison officials in the United States, saying that opportunities to protect prisoners against HIV and STDs have been squandered. “Despite overwhelming evidence that condom use prevents the transmission of HIV,” the organization noted, “U.S. prison officials continue to limit the availability of condoms to incarcerated persons. Less than 1 percent of U.S. correctional facilities provide condoms to inmates.”

    Correctional health and public health advocates are concerned for people on both sides of the prison wall. A recent study spanning 1997–2004 and involving 43,000 people found that screening in county jails was associated with decreased prevalence of gonorrhea and chlamydia in surrounding communities with high incarceration rates. In other words, preventing and treating STDs within prisons helped keep diseases from reaching the public.

    Intravenous Drug Users

    It’s an established fact that any number of diseases, including those we identify as sexually transmitted, can be spread by sharing needles used for intravenous drugs. The capability for HIV and hepatitis, especially, to be spread by sharing sharps is at the heart of controversial needle exchange programs.

    Some of the highest HIV rates on record appear to result from a trifecta of risk. A study published in April 2006 looked at infection rates for intravenous drug-using men who had sex with other men. Of the 227 subjects recruited from the streets of San Francisco, the majority (68 percent) had been paid for sex, and less than half (41 percent) used condoms. The prevalence of HIV among them was 12 percent.

    Migrant Workers

    Uncounted, uninsured, and often unable to access health care, migrant workers in the U.S. represent another challenge in STD prevention and treatment.

    While there are few studies illuminating the health status of immigrant workers countrywide, a handful of snapshots have provided insight. Low socioeconomic status, education, and literacy were cited as barriers to healthcare for Latino day workers in a 2003 study. The researchers, whose work was based on 292 Latino men working in San Francisco, also noted that low levels of condom use, poor safe-sex knowledge, and high-risk sexual behaviors could contribute to the potential for STD infection.

    A frequently cited study from 1992 found high rates of syphilis, HIV and tuberculosis among migrant farm workers in Immokalee, Fla. Though its statistics are long outdated now, the study’s closing editorial made a point that remains central. The survey “identified a substantial number of migrant farm workers with unrecognized and untreated preventable diseases,” it read. “In particular, treatment and counseling of these persons could prevent transmission of STDs to their sex partners and, for TB, to those with whom they live and travel.”

    The sad truth highlighted by these studies is that people are spreading and suffering from diseases that are preventable. Immigrant health is often politicized, but there’s little arguing with the benefits of STD awareness and preventive services that break through language and cultural barriers. Such programs not only help immigrants and their families but maintain a baseline of health in the towns where they live.

    Socioeconomics and Sex

    Though we’re describing STD prevalence among a few isolated groups, high rates can be influenced by a number of social, cultural, and economic factors—which not only make the numbers more daunting but the problem more difficult to solve. When the CDC looked at eight southern communities in 1999 to understand why rates of syphilis were high, they made a direct connection between socioeconomics and sexual health. In Lowndes County, Ala., where the median income was $15,584 per year, there was no public library, no YMCA, no swimming pools. “It is reported that the primary source of recreation for teens in the county is sex,” the report said.

    We’re All Connected

    If you’re feeling immune to the risks faced by all the groups described here, consider that STD statistics continue to bring all sorts of surprises. For several conditions, declining trends have been reversed in recent years. Even as we fight back infection rates with education and science, the number of groups not at risk seems to shrink.

    The sexual health of our country ultimately affects everyone who is sexually active. Even when we take precautions, it’s nearly impossible to gauge when we are in range of the risk emanating from other places in the vast sexual network. The special populations spotlighted here are links in the same chain that connect you to risk in your own life. By recognizing the connection we can maintain our health, maintain our humanity, and help break the chain of STD transmission.
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