Take 5: New Developments in the Realm of STIs and STDs

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1. Gardasil for Men and Boys.
The Gardasil vaccine (Merck)—initially approved for use in women and girls to prevent four types of HPV, including two strains responsible for 75 percent of all cervical cancers—has been the domain of Ob/Gyns and GPs. But its approval last year for prevention of HPV in men and boys, means male patients may be asking dermatologists about the preventive therapy. According to the PI, Gardisil was 89 percent effective against HPV-6 and HPV-11 related genital warts in trials in men.

2. STIs Rising in Teenage Girls.
A recent study shows the risk for sexually transmitted infections (STIs), including HPV, is high among sexually active young women (Pediatrics 124; 6: 1505-1512). Investigators examined prevalence of the most common STIs among a representative sample of female adolescents in the US. Results showed that the prevalence of any of five STIs was 24.1 percent among all and 37.7 percent among sexually experienced female adolescents. HPV was the most common STI among all female adolescents (18.3 percent), followed by C trachomatis infection (3.9 percent). Prevalence of any of the STIs was 25.6 percent among those whose age was the same or one year greater than their age at sexual initiation and 19.7 percent among those who reported only one lifetime sex partner.

3. New Data on Age and STDs.
STIs and STDs are not just a problem of youth. Another study has found that knowledge of an HIV-infected individual's sexual behaviors and routine STDs testing greatly facilitates HIV prevention efforts (AIDS Care 13: 1-7). Researchers compared sexual behaviors and STD prevalence between older HIV-infected individuals and their younger counterparts. Prevalence for diseases such as gonorrhea, chlamydia, and syphilis was highest among younger individuals. The results also showed that although sexual activity declines in old age, inconsistent condom use remains commonly reported and thus the risk of STI and STDs remains high in this group.

4. Overall STD Trends.
According to the CDC's most current reported estimates, there are approximately 19 million new STD infections each year, nearly half of which are among young people 15 to 24 years of age. They estimate the cost of STDs to the US health care system as high as $15.9 billion annually. While rates of gonorrhea and syphilis have been relatively flat over the past several years, rates of chlamydia continue to rise.

5. Healthcare Reform Initiatives.
One of the many measures in the recently passed healthcare reform law is an initiative aimed to educate young people and prevent early pregnancy and sexually transmitted diseases. Lessons on healthy relationships, financial literacy, and other life skills are also woven into the program, called PREP for Personal Responsibility Education Program, the New York Times reports. The programs are financed by $375 million in grants and will be distributed to the states over five years.

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